Evidence-based Treatments for Military-related Posttraumatic Stress Disorder in a Veterans Affairs Setting

[Latent posttraumatic stress disorder in psychiatry at the Mohammed VI university hospital in Oujda]

INTRODUCTION

Posttraumatic stress disorder (PTSD) is a severe psychiatric disorder following exposure to a traumatic event. It is rarely diagnosed alone. High comorbidity has been observed between PTSD and other psychiatric disorders.

OBJECTIVES

The purpose of this work is to evaluate the prevalence of latent PTSD in a population followed in a service of psychiatry and to describe the associated factors.

MATERIALS AND METHODS

It is a descriptive cross-sectional study of 300 patients treated for psychiatric disorders, using a hetero-questionnaire containing sociodemographic data, personal and family history, clinical and therapeutic data, and characteristics of the traumatic event. The MINI was used to screen for PTSD and assess suicidal risk.

RESULTS

Exposure to a traumatic event is reported by 46.7% of patients, and PTSD by 19.7%. The suicidal risk is 47.7% in the presence of this comorbidity. An ESPT is significantly associated with a schizoaffective disorder and significant suicidal risk. The recentness of the traumatic event, the presence of a state of acute stress and the absence of family psychological support are significantly associated with the occurrence of PTSD.

CONCLUSION

A significant number of patients with a psychiatric disorder have undiagnosed PTSD, thus explaining their clinical deterioration. Screening and treatment of the underlying PTSD would help to improve their management.

The additional burden of PTSD on functioning and depression in veterans with traumatic brain injury

BACKGROUND

Many United States veterans and active military with a history of traumatic brain injury (TBI) also experience challenges from comorbid posttraumatic stress disorder (PTSD), yet the additional burden of PTSD is not clear.

PURPOSE

To address this knowledge gap, this study examined the relationship of PTSD to cognitive, social, and physical functioning and depressive symptoms in veterans recently diagnosed with TBI.

METHODS

Veterans were recruited from a VA rehabilitation clinic. The Patient Competency Rating Scale and Center for Epidemiologic Studies Depression Scale measured functioning and depression, respectively. Chart review captured PTSD diagnosis.

FINDINGS

In the sample of 83 veterans, 65% had a current PTSD diagnosis. After controlling for sociodemographic variables and TBI severity, PTSD was a significant predictor of lower cognitive, social, and physical functioning and higher depressive symptomatology.

DISCUSSION

Clinicians should incorporate PTSD assessment in their work with veterans with TBI. Integrated behavioral health and rehabilitation interventions that provide strategies for veterans to manage TBI symptoms and PTSD are critical.

Exploration of Factors Related to Depressive Symptomatology in Family Members of Military Veterans With Traumatic Brain Injury

Traumatic brain injury (TBI) is a family affair, affecting those with the injury and their families. Psychological distress, often measured as depression or depressive symptoms, is highly prevalent among family members. Predictors of depression in family members of civilians with TBI have been examined, but predictors of depression in family members of military veterans have received very little research attention and are poorly understood. To address the knowledge gap, this study explored factors related to depressive symptoms in family members of veterans in the United States, using an ecological framework. Baseline data from 83 family members were used. Family members with higher caregiver burden, presence of a veteran with posttraumatic stress disorder (PTSD), and greater financial difficulty experienced significantly more depressive symptoms. Findings suggest that efforts to support family members and decrease their depression should aim to reduce caregiver burden and financial difficulty, and help family members cope with veteran PTSD and TBI. Family-focused interventions are needed.

Posttraumatic Stress Disorder and Mobile Health: App Investigation and Scoping Literature Review

BACKGROUND

Posttraumatic stress disorder (PTSD) is a prevalent mental health issue among veterans. Access to PTSD treatment is influenced by geographic (ie, travel distance to facilities), temporal (ie, time delay between services), financial (ie, eligibility and cost of services), and cultural (ie, social stigma) barriers.

OBJECTIVE

The emergence of mobile health (mHealth) apps has the potential to bridge many of these access gaps by providing remote resources and monitoring that can offer discrete assistance to trauma survivors with PTSD and enhance patient-clinician relationships. In this study, we investigate the current mHealth capabilities relevant to PTSD.

METHODS

This study consists of two parts: (1) a review of publicly available PTSD apps designed to determine the availability of PTSD apps, which includes more detailed information about three dominant apps and (2) a scoping literature review performed using a systematic method to determine app usage and efforts toward validation of such mHealth apps. App usage relates to how the end users (eg, clinicians and patients) are interacting with the app, whereas validation is testing performed to ensure the app's purpose and specifications are met.

RESULTS

The results suggest that though numerous apps have been developed to aid in the diagnosis and treatment of PTSD symptoms, few apps were designed to be integrated with clinical PTSD treatment, and minimal efforts have been made toward enhancing the usability and validation of PTSD apps.

CONCLUSIONS

These findings expose the need for studies relating to the human factors evaluation of such tools, with the ultimate goal of increasing access to treatment and widening the app adoption rate for patients with PTSD.