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Fernandes IAM, Menezes ROA, Rego G. Communicating the diagnosis of spinal muscular atrophy in endogamous vs. non-endogamous regions. BMC Neurol 2024; 24:261. [PMID: 39060954 PMCID: PMC11282695 DOI: 10.1186/s12883-024-03718-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 06/07/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION The high prevalence of endogamy, or inbreeding, in northeastern Brazil, is due to historical and cultural factors, with large families living in cities far from the coast and subject to low socioeconomic and infrastructure levels. This breeding practice results in low genetic variability with an increased prevalence of rare autosomal recessive and neurodegenerative diseases, such as spinal muscular atrophy (SMA). OBJECTIVE Understanding the impact of communicating the diagnosis of SMA on the mental health of patients and their families and the differences between the Northeast (endogamous region) and the other regions of Brazil (non-endogamous ones). METHODS Cross-sectional study obtained through a structured questionnaire about the moment of receiving the SMA diagnosis, containing the Impact of Event Scale-Revised. RESULTS AND DISCUSSION The sample consisted of 100 volunteers from all regions of Brazil, 47 patients diagnosed with SMA and 53 family members present at the time of the diagnosis. There was a predominance of females (83%) and homogeneity between the groups for the variables gender, age, color, education, religion, and SMA subtype (1, 2, 3, and 4). The Northeast region, representing 43% of the sample, despite being less economically favored, showed greater satisfaction with medical care and inclusion in health services, with less self-reported psychological trauma and fewer signs of post-traumatic stress disorder (PTSD) related to the moment of receiving the diagnosis. The non-endogamous regions, in turn, reported the presence of strong waves of emotion, sleep problems, feelings of irritability, anger, and the presence of bad thoughts related to this situation. CONCLUSION The feeling of inclusion in health services and satisfaction with medical care in the endogamous region had a positive impact on the mental health of those involved, reducing psychological trauma and signs of PTSD arising from the communication of the SMA diagnosis.
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Affiliation(s)
- Isabella Araujo Mota Fernandes
- Faculty of Medicine, Lauro Wanderley University Hospital, University of Porto, Federal University of Paraíba, João Pessoa, Paraíba- Brazil, BR 230, Km 10 S /N Condomínio Villas do Atlântico casa 3 B. Intermares, Cabedelo, João Pessoa, CEP: 58102-202, Paraíba, Brazil.
| | - Renata Oliveira Almeida Menezes
- Federal University of Pernambuco and PhD in Legal and Social Sciences from the Federal University of Campina Grande, University of Rio Grande do Norte, Caicó, Brazil
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El-Menyar A, Khan NA, Asim M, Rizoli S, Al-Thani H. Beta-Adrenergic Receptor Polymorphism and Patho-Genetics of Trauma: A Transformational Frontier of Personalized Medicine in Neurotrauma. J Neurotrauma 2024; 41:771-788. [PMID: 38117124 DOI: 10.1089/neu.2023.0432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Trauma is a serious public health issue, and remains a major cause of mortality and disability worldwide. The notion that genetic factors contribute to an individual's response to traumatic injury has advanced significantly. Genetic variations in severely injured patients have been linked to mortality, morbidity, and psychological outcomes. We conducted a comprehensive review of beta-adrenergic receptor polymorphisms and their impact on the pathogenetics of traumatic injuries, which could pave the way for a transformational frontier of personalized medicine in neurotrauma. It remains unclear why some individuals are vulnerable to worse outcomes, whereas others are resilient. Although genetic factors may be significant, the intricate interplay between environmental and genetic factors may be responsible for variations in the presentation and outcome after injury. Recent advancements in genetic analysis and molecular physiology have helped to shed light on the causes of such variability. Although exposure to trauma can initiate a cascade of stress-related responses, these responses alone are insufficient to explain etiopathogenesis. Therefore, gaining insights into how trauma and genetic predispositions to adrenergic variations interact at the molecular level to affect an individual's susceptibility and recuperation could provide an essential understanding of the molecular pathogenesis of traumatic injuries. Therefore, it is imperative to identify potential genetic and physiological markers to guide early management and prognosis of trauma. Such knowledge could pave the way for the discovery of novel biomarkers that can identify a transdiagnostic subgroup that is at high risk and requires early intervention. This could lead to the adoption of personalized medical approaches in neurotrauma care.
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Affiliation(s)
- Ayman El-Menyar
- Trauma and Vascular Surgery, Clinical Research, and Hamad Medical Corporation, Doha, Qatar
- Clinical Medicine, Weill Cornell Medicine, Doha, Qatar
| | - Naushad Ahmad Khan
- Trauma and Vascular Surgery, Clinical Research, and Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Asim
- Trauma and Vascular Surgery, Clinical Research, and Hamad Medical Corporation, Doha, Qatar
| | - Sandro Rizoli
- Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
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Giannakopoulos A, Chrysis D. Reversibility of disturbed pituitary function in pediatric conditions with psychological stressors: implications for clinical practice. Hormones (Athens) 2024:10.1007/s42000-024-00536-z. [PMID: 38421589 DOI: 10.1007/s42000-024-00536-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
The complex communication network between the central nervous system and the hypothalamic-pituitary axis forms the basis of endocrine functional plasticity, which facilitates adaptation to changing internal and external conditions, but also makes it vulnerable to the negative effects of stressful psychological factors. Herein, clinical conditions such as functional hypothalamic amenorrhea, eating disorders, growth faltering, post-traumatic stress disorder, and pubertal disorders that may emerge during childhood or adolescence, their origin possibly including psychological stressors, are analyzed regarding their genetic susceptibility and reversibility of endocrine function. A discussion on the optimization of therapeutic management defined by managing stress and maximizing the degree and rate of reversibility follows.
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Affiliation(s)
- Aristeidis Giannakopoulos
- Division of Pediatric Endocrinology, Department of Pediatrics, Medical School of Patras, University Hospital, Rio, 26504, Patras, Greece.
| | - Dionisios Chrysis
- Division of Pediatric Endocrinology, Department of Pediatrics, Medical School of Patras, University Hospital, Rio, 26504, Patras, Greece
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Xu L, Zhang J, Yang H, Cao C, Fang R, Liu P, Luo S, Wang B, Zhang K, Wang L. Epistasis in neurotransmitter receptors linked to posttraumatic stress disorder and major depressive disorder comorbidity in traumatized Chinese. Front Psychiatry 2024; 15:1257911. [PMID: 38487579 PMCID: PMC10937445 DOI: 10.3389/fpsyt.2024.1257911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Abstract
Background Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) comorbidity occurs through exposure to trauma with genetic susceptibility. Neuropeptide-Y (NPY) and dopamine are neurotransmitters associated with anxiety and stress-related psychiatry through receptors. We attempted to explore the genetic association between two neurotransmitter receptor systems and the PTSD-MDD comorbidity. Methods Four groups were identified using latent profile analysis (LPA) to examine the patterns of PTSD and MDD comorbidity among survivors exposed to earthquake-related trauma: low symptoms, predominantly depression, predominantly PTSD, and PTSD-MDD comorbidity. NPY2R (rs4425326), NPY5R (rs11724320), DRD2 (rs1079597), and DRD3 (rs6280) were genotyped from 1,140 Chinese participants exposed to earthquake-related trauma. Main, gene-environment interaction (G × E), and gene-gene interaction (G × G) effects for low symptoms, predominantly depression, and predominantly PTSD were tested using a multinomial logistic model with PTSD-MDD comorbidity as a reference. Results The results demonstrated that compared to PTSD-MDD comorbidity, epistasis (G × G) NPY2R-DRD2 (rs4425326 × rs1079597) affects low symptoms (β = -0.66, OR = 0.52 [95% CI: 0.32-0.84], p = 0.008, pperm = 0.008) and predominantly PTSD (β = -0.56, OR = 0.57 [95% CI: 0.34-0.97], p = 0.037, pperm = 0.039), while NPY2R-DRD3 (rs4425326 × rs6280) impacts low symptoms (β = 0.82, OR = 2.27 [95% CI: 1.26-4.10], p = 0.006, pperm = 0.005) and predominantly depression (β = 1.08, R = 2.95 [95% CI: 1.55-5.62], p = 0.001, pperm = 0.001). The two G × G effects are independent. Conclusion NPY and dopamine receptor genes are related to the genetic etiology of PTSD-MDD comorbidity, whose specific mechanisms can be studied at multiple levels.
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Affiliation(s)
- Ling Xu
- Laboratory for Traumatic Stress Studies and Center for Genetics and BioMedical Informatics Research, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jingyi Zhang
- Laboratory for Traumatic Stress Studies and Center for Genetics and BioMedical Informatics Research, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Haibo Yang
- Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - Chengqi Cao
- Laboratory for Traumatic Stress Studies and Center for Genetics and BioMedical Informatics Research, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ruojiao Fang
- Laboratory for Traumatic Stress Studies and Center for Genetics and BioMedical Informatics Research, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ping Liu
- People’s Hospital of Deyang City, Deyang, Sichuan, China
| | - Shu Luo
- People’s Hospital of Deyang City, Deyang, Sichuan, China
| | - Binbin Wang
- Laboratory for Traumatic Stress Studies and Center for Genetics and BioMedical Informatics Research, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Kunlin Zhang
- Laboratory for Traumatic Stress Studies and Center for Genetics and BioMedical Informatics Research, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- Laboratory for Traumatic Stress Studies and Center for Genetics and BioMedical Informatics Research, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Yakovchik AY, Tolynyova DV, Kashtanova DA, Sutulova ER, Ivanov MV, Mamchur AA, Erema VV, Matkava LR, Terekhov MV, Rumyantseva AM, Blinova OI, Akinshina AI, Mitrofanov SI, Yudin VS, Makarov VV, Keskinov AА, Kraevoy SA, Yudin SM. Genetics of psycho-emotional well-being: genome-wide association study and polygenic risk score analysis. Front Psychiatry 2024; 14:1188427. [PMID: 38328521 PMCID: PMC10847277 DOI: 10.3389/fpsyt.2023.1188427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/28/2023] [Indexed: 02/09/2024] Open
Abstract
Background Psycho-emotional well-being is essential for living a life of satisfaction and fulfillment. However, depression and anxiety have become the leading mental health issues worldwide, according to the World Health Organization. Both disorders have been linked to stress and other psychological factors. Their genetic basis remains understudied. Methods In 2020-2021, the psycho-emotional well-being of 30,063 Russians with no known psychiatric history was assessed using the Hospital Anxiety and Depression Scale (HADS) for general mental health and the HADS subscale A (anxiety) for anxiety. Following the original instructions, an anxiety score of ≥11 points was used as the anxiety threshold. A genome-wide association study was performed to find associations between anxiety and HADS/HADS-A scores using linear and logistic regressions based on HADS/HADS-A scores as binary and continuous variables, respectively. In addition, the links between anxiety, sociodemographic factors (such as age, sex, and employment), lifestyle (such as physical activity, sleep duration, and smoking), and markers of caffeine and alcohol metabolism were analyzed. To assess the risk of anxiety, polygenic risk score modeling was carried out using open-access software and principal component analysis (PCA) to simplify the calculations (ROC AUC = 89.4 ± 2.2% on the test set). Results There was a strong positive association between HADS/HADS-A scores and sociodemographic factors and lifestyle. New single-nucleotide polymorphisms (SNPs) with genome-wide significance were discovered, which had not been associated with anxiety or other stress-related conditions but were located in genes previously associated with bipolar disorder, schizophrenia, or emotional instability. The CACNA1C variant rs1205787230 was associated with clinical anxiety (a HADS-A score of ≥11 points). There was an association between anxiety levels (HADS-A scores) and genes involved in the activity of excitatory neurotransmitters: PTPRN2 (rs3857647), DLGAP4 (rs8114927), and STK24 (rs9517326). Conclusion Our results suggest that calcium channels and monoamine neurotransmitters, as well as SNPs in genes directly or indirectly affecting neurogenesis and synaptic functions, may be involved in the development of increased anxiety. The role of some non-genetic factors and the clinical significance of physiological markers such as lifestyle were also demonstrated.
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Affiliation(s)
- Anna Yurievna Yakovchik
- Federal State Budgetary Institution Centre for Strategic Planning and Management of Biomedical Health Risks of the Federal Medical Biological Agency, Moscow, Russia
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Tseilikman VE, Shatilov VA, Zhukov MS, Buksha IA, Epitashvily AE, Lipatov IA, Aristov MR, Koshelev AG, Karpenko MN, Traktirov DS, Maistrenko VA, Kamel M, Buhler AV, Kovaleva EG, Kalinina TS, Pashkov AA, Kon’kov VV, Novak J, Tseilikman OB. Limited Cheese Intake Paradigm Replaces Patterns of Behavioral Disorders in Experimental PTSD: Focus on Resveratrol Supplementation. Int J Mol Sci 2023; 24:14343. [PMID: 37762647 PMCID: PMC10532287 DOI: 10.3390/ijms241814343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 08/27/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Currently, the efficacy of drug therapy for post-traumatic stress disorder or PTSD leaves much to be desired, making nutraceutical support a promising avenue for treatment. Recent research has identified the protective effects of resveratrol in PTSD. Here, we tested the behavioral and neurobiological effects of combining cheese consumption with resveratrol supplements in an experimental PTSD model. Using the elevated plus maze test, we observed that cheese intake resulted in a shift from anxiety-like behavior to depressive behavior, evident in increased freezing acts. However, no significant changes in the anxiety index value were observed. Interestingly, supplementation with cheese and resveratrol only led to the elimination of freezing behavior in half of the PTSD rats. We further segregated the rats into two groups based on freezing behavior: Freezing+ and Freezing0 phenotypes. Resveratrol ameliorated the abnormalities in Monoamine Oxidize -A and Brain-Derived Neurotrophic Factor gene expression in the hippocampus, but only in the Freezing0 rats. Moreover, a negative correlation was found between the number of freezing acts and the levels of Monoamine Oxidize-A and Brain-Derived Neurotrophic Factor mRNAs in the hippocampus. The study results show promise for resveratrol supplementation in PTSD treatment. Further research is warranted to better understand the underlying mechanisms and optimize the potential benefits of resveratrol supplementation for PTSD.
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Affiliation(s)
- Vadim E. Tseilikman
- Scientific and Educational Center ‘Biomedical Technologies’, School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (V.A.S.); (M.S.Z.); (M.R.A.); (V.A.M.); (A.V.B.)
| | - Vladislav A. Shatilov
- Scientific and Educational Center ‘Biomedical Technologies’, School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (V.A.S.); (M.S.Z.); (M.R.A.); (V.A.M.); (A.V.B.)
- Faculty of Fundamental Medicine, Chelyabinsk State University, 454001 Chelyabinsk, Russia; (I.A.B.); (I.A.L.); (A.G.K.)
| | - Maxim S. Zhukov
- Scientific and Educational Center ‘Biomedical Technologies’, School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (V.A.S.); (M.S.Z.); (M.R.A.); (V.A.M.); (A.V.B.)
- Faculty of Fundamental Medicine, Chelyabinsk State University, 454001 Chelyabinsk, Russia; (I.A.B.); (I.A.L.); (A.G.K.)
| | - Irina A. Buksha
- Faculty of Fundamental Medicine, Chelyabinsk State University, 454001 Chelyabinsk, Russia; (I.A.B.); (I.A.L.); (A.G.K.)
| | - Alexandr E. Epitashvily
- Faculty of Fundamental Medicine, Chelyabinsk State University, 454001 Chelyabinsk, Russia; (I.A.B.); (I.A.L.); (A.G.K.)
| | - Ilya A. Lipatov
- Faculty of Fundamental Medicine, Chelyabinsk State University, 454001 Chelyabinsk, Russia; (I.A.B.); (I.A.L.); (A.G.K.)
| | - Maxim R. Aristov
- Scientific and Educational Center ‘Biomedical Technologies’, School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (V.A.S.); (M.S.Z.); (M.R.A.); (V.A.M.); (A.V.B.)
- Faculty of Fundamental Medicine, Chelyabinsk State University, 454001 Chelyabinsk, Russia; (I.A.B.); (I.A.L.); (A.G.K.)
| | - Alexandr G. Koshelev
- Faculty of Fundamental Medicine, Chelyabinsk State University, 454001 Chelyabinsk, Russia; (I.A.B.); (I.A.L.); (A.G.K.)
| | - Marina N. Karpenko
- Pavlov Department of Physiology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia; (M.N.K.); (D.S.T.)
| | - Dmitrii S. Traktirov
- Pavlov Department of Physiology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia; (M.N.K.); (D.S.T.)
| | - Viktoriya A. Maistrenko
- Scientific and Educational Center ‘Biomedical Technologies’, School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (V.A.S.); (M.S.Z.); (M.R.A.); (V.A.M.); (A.V.B.)
- Pavlov Department of Physiology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia; (M.N.K.); (D.S.T.)
| | - Mustapha Kamel
- Scientific and Educational Center ‘Biomedical Technologies’, School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (V.A.S.); (M.S.Z.); (M.R.A.); (V.A.M.); (A.V.B.)
- Research, Educational and Innovative Center of Chemical and Pharmaceutical Technologies Chemical Technology Institute, Ural Federal University Named after the First President of Russia B.N. Yeltsin, 620002 Ekaterinburg, Russia;
| | - Alexey V. Buhler
- Scientific and Educational Center ‘Biomedical Technologies’, School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (V.A.S.); (M.S.Z.); (M.R.A.); (V.A.M.); (A.V.B.)
- Research, Educational and Innovative Center of Chemical and Pharmaceutical Technologies Chemical Technology Institute, Ural Federal University Named after the First President of Russia B.N. Yeltsin, 620002 Ekaterinburg, Russia;
| | - Elena G. Kovaleva
- Research, Educational and Innovative Center of Chemical and Pharmaceutical Technologies Chemical Technology Institute, Ural Federal University Named after the First President of Russia B.N. Yeltsin, 620002 Ekaterinburg, Russia;
| | - Tatyana S. Kalinina
- Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Science, 630090 Novosibirsk, Russia;
| | - Anton A. Pashkov
- Federal Neurosurgical Center, 630048 Novosibirsk, Russia;
- Department of Data Collection and Processing Systems, Novosibirsk State Technical University, 630087 Novosibirsk, Russia
| | - Vadim V. Kon’kov
- Zelman Institute of Medicine and Psychology, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Jurica Novak
- Department of Biotechnology, University of Rijeka, 51000 Rijeka, Croatia
- Center for Artificial Intelligence and Cyber Security, University of Rijeka, 51000 Rijeka, Croatia
| | - Olga B. Tseilikman
- Scientific and Educational Center ‘Biomedical Technologies’, School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia; (V.A.S.); (M.S.Z.); (M.R.A.); (V.A.M.); (A.V.B.)
- Faculty of Fundamental Medicine, Chelyabinsk State University, 454001 Chelyabinsk, Russia; (I.A.B.); (I.A.L.); (A.G.K.)
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Gizdic A, Baxter T, Barrantes-Vidal N, Park S. Social connectedness and resilience post COVID-19 pandemic: Buffering against trauma, stress, and psychosis. PSYCHIATRY RESEARCH COMMUNICATIONS 2023; 3:100126. [PMID: 37168290 PMCID: PMC10156379 DOI: 10.1016/j.psycom.2023.100126] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/13/2023]
Abstract
The present study investigated psychosocial predictors of psychosis-risk, depression, anxiety, and stress in Croatia two years after the onset of the COVID-19 pandemic. Given the existing transgenerational war trauma and associated psychiatric consequences in Croatian population, a significant pandemic-related deterioration of mental health was expected. Recent studies suggest that after an initial increase in psychiatric disorders during the pandemic in Croatia, depression, stress, and anxiety rapidly declined. These findings highlight the role of social connectedness and resilience in the face of the global pandemic. We examined resilience and psychiatric disorder risk in 377 Croatian adults using an anonymous online mental health survey. Results indicate that there was an exacerbation of all mental ill health variables, including depression, anxiety, stress, and a doubled risk for psychosis outcome post-COVID pandemic. Stress decreased levels of resilience, however, those exposed to previous traumatic experience and greater social connectedness had higher resilience levels. These findings suggest that individual differences in underlying stress sensitization of Croatian population due to past trauma may continue to influence mental health consequences two years after COVID-19 pandemic. It is essential to promote the importance of social connectedness and resilience in preventing the development of variety of mental health disorders.
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Affiliation(s)
- Alena Gizdic
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tatiana Baxter
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Neus Barrantes-Vidal
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
- Sant Pere Claver - Fundació Sanitària, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Liu MN, Tian XY, Fang T, Wu N, Li H, Li J. Insights into the Involvement and Therapeutic Target Potential of the Dopamine System in the Posttraumatic Stress Disorder. Mol Neurobiol 2023; 60:3708-3723. [PMID: 36933147 DOI: 10.1007/s12035-023-03312-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/09/2023] [Indexed: 03/19/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a neuropsychiatric disease closely related to life-threatening events and psychological stress. Re-experiencing, hyperarousal, avoidance, and numbness are the hallmark symptoms of PTSD, but their underlying neurological processes have not been clearly elucidated. Therefore, the identification and development of drugs for PTSD that targets brain neuronal activities have stalled. Considering that the persistent fear memory induced by traumatic stimulation causes high alertness, high arousal, and cognitive impairment of PTSD symptoms. While the midbrain dopamine system can affect physiological processes such as aversive fear memory learning, consolidation, persistence, and extinction, by altering the functions of the dopaminergic neurons, our viewpoint is that the dopamine system plays a considerable role in the PTSD occurrence and acts as a potential therapeutic target of the disorder. This paper reviews recent findings on the structural and functional connections between ventral tegmental area neurons and the core synaptic circuits involved in PTSD, gene polymorphisms related to the dopamine system that confer susceptibility to clinical PTSD. Moreover, the progress of research on medications that target the dopamine system as PTSD therapies is also discussed. Our goal is to offer some hints for early detection and assist in identifying novel, efficient approaches for treating PTSD.
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Affiliation(s)
- Meng-Nan Liu
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing, 100850, China
| | - Xiao-Yu Tian
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing, 100850, China.,Medical School of Chinese PLA, Beijing, 100853, China
| | - Ting Fang
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing, 100850, China
| | - Ning Wu
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing, 100850, China
| | - Hong Li
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing, 100850, China.
| | - Jin Li
- Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing, 100850, China.
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9
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Alonso L, Peeva P, Stasko S, Bader M, Alenina N, Winter Y, Rivalan M. Constitutive depletion of brain serotonin differentially affects rats' social and cognitive abilities. iScience 2023; 26:105998. [PMID: 36798444 PMCID: PMC9926123 DOI: 10.1016/j.isci.2023.105998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 09/30/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Central serotonin appears a promising transdiagnostic marker of psychiatric disorders and a modulator of some of their key behavioral symptoms. In adult male Tph2 -/- rats, constitutively lacking central serotonin, we tested individual's cognitive, social and non-social abilities and characterized group's social organization under classical and ethological testing conditions. Using unsupervised machine learning, we identified the functions most dependent on serotonin. Although serotonin depletion did not affect cognitive performances in classical testing, in the home-cage it induced compulsive aggression and sexual behavior, hyperactive and hypervigilant stereotyped behavior, reduced self-care and exacerbated corticosterone levels. This profile recalled symptoms of impulse control and anxiety disorders. Serotonin appeared essential for behavioral adaptation to dynamic social environments. Our animal model challenges the essential role of serotonin in decision-making, flexibility, impulsivity, and risk-taking. These findings highlight the importance of studying everyday life functions within the dynamic social living environment to model complexity in animal models.
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Affiliation(s)
- Lucille Alonso
- Humboldt-Universität zu Berlin, Berlin, Germany,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Polina Peeva
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | | | - Michael Bader
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Natalia Alenina
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany,Corresponding author
| | - York Winter
- Humboldt-Universität zu Berlin, Berlin, Germany,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marion Rivalan
- Humboldt-Universität zu Berlin, Berlin, Germany,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany,Corresponding author
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10
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Zarubin VC, Gupta T, Mittal VA. History of trauma is a critical treatment target for individuals at clinical high-risk for psychosis. Front Psychiatry 2023; 13:1102464. [PMID: 36683986 PMCID: PMC9846262 DOI: 10.3389/fpsyt.2022.1102464] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
People meeting criteria for a clinical high-risk (CHR) for psychosis syndrome frequently represent a heterogeneous, help-seeking, and dynamic population. Among the numerous symptoms and risk factors for psychosis, exposure to trauma stands out as both highly prevalent and poorly understood. Indeed, while up to 80% of individuals meeting criteria for a CHR syndrome report trauma histories, there is currently limited research dedicated to this specific area. This is particularly problematic as trauma is tied to risk for conversion, leads to a range of clinical issues, and contributes to disability and poor quality of life. Fortunately, recent research in the general population has led to a significant evolution in the way trauma is assessed and understood, and further, some studies have indicated that targeted trauma interventions in formal psychotic disorders are highly effective. However, direct adoption is challenging as the CHR syndrome holds a number of unique concerns (e.g., clinical heterogeneity, developmental trauma), and characteristically, involves a developing pediatric or young adult population that also comes with specific considerations (e.g., living with caregivers, transitionary period in roles). In this "perspective" we frame the issues around understanding trauma in CHR individuals, discuss viable treatments and unique considerations, and provide suggestions for future steps in developing and incorporating trauma-focused interventions in this population.
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Affiliation(s)
- Vanessa C. Zarubin
- Department of Psychology, Northwestern University, Evanston, IL, United States
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Chicago, IL, United States
| | - Tina Gupta
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Vijay A. Mittal
- Department of Psychology, Northwestern University, Evanston, IL, United States
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Chicago, IL, United States
- Department of Psychiatry, Northwestern University, Chicago, IL, United States
- Medical Social Sciences, Northwestern University, Chicago, IL, United States
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, United States
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11
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Tang X, Lin S, Fang D, Lin B, Yao L, Wang L, Xu Q, Lu L, Xu N. Efficacy and underlying mechanisms of acupuncture therapy for PTSD: evidence from animal and clinical studies. Front Behav Neurosci 2023; 17:1163718. [PMID: 37200784 PMCID: PMC10187757 DOI: 10.3389/fnbeh.2023.1163718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/28/2023] [Indexed: 05/20/2023] Open
Abstract
As a major public health problem, posttraumatic stress disorder (PTSD) has a substantial impact on individuals and society. The total excess economic burden of PTSD in the US is estimated to be more than $232.2 billion a year. Acupuncture is widely used in patients with PTSD, and an increasing number of studies have been undertaken to assess the efficacy and underlying mechanisms of acupuncture for the treatment of individuals with PTSD. However, there has not yet been a review that simultaneously elucidates the therapeutic efficacy and biological mechanisms of acupuncture. We wished to examine the efficacy and underlying mechanisms of acupuncture for the treatment of individuals with PTSD. We conducted this review in three sections as follows: a meta-analysis, an acupoint analysis, and mechanism research. PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI), WanFang Database, China Biology Medicine Database (CBM), Chinese Science and Technology Journals Database (VIP), and other databases were searched from 1 January 2012 to 27 November 2022. Based on the included studies, we first determined whether acupuncture is more effective than psychological treatment or pharmacological treatment for treating and improving the quality of life of individuals with PTSD by meta-analysis. Second, the most commonly used acupoints and parameters of acupuncture were summarized based on animal and clinical studies. Third, we attempt to summarize the current mechanisms of acupuncture in the treatment of PTSD. Finally, 56 acupoint analyses, eight meta-analyses, and 33 mechanistic studies were included. Acupuncture outperformed pharmacotherapy treatment in improving symptom scores by CAPS, HAMA, HAMD, PCL-C, and SCL-90 somatization for PTSD and outperformed psychotherapy treatment in improving symptom scores by CAPS PCL-C and HAMD, according to the meta-analysis. GV20 was the most frequently used acupuncture point in clinical studies and animal studies, with a 78.6% application rate. Acupuncture may be effective in treating PTSD by regulating the structure and components of several brain areas, regulating the neuroendocrine system, and involving signaling pathways. In conclusion, this finding indicates that acupuncture has promising potential for treating PTSD.
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Affiliation(s)
- Xiaorong Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shumin Lin
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Danwei Fang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Binjing Lin
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lulu Yao
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lin Wang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qin Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liming Lu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Liming Lu
| | - Nenggui Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Nenggui Xu
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12
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Szeleszczuk Ł, Frączkowski D. Propranolol versus Other Selected Drugs in the Treatment of Various Types of Anxiety or Stress, with Particular Reference to Stage Fright and Post-Traumatic Stress Disorder. Int J Mol Sci 2022; 23:ijms231710099. [PMID: 36077489 PMCID: PMC9456064 DOI: 10.3390/ijms231710099] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022] Open
Abstract
Propranolol, a non-cardioselective β1,2 blocker, is most commonly recognised for its application in the therapy of various cardiovascular conditions, such as hypertension, coronary artery disease, and tachyarrhythmias. However, due to its ability to cross the blood–brain barrier and affinity towards multiple macromolecules, not only adrenoreceptors, it has also found application in other fields. For example, it is one of the very few medications successfully applied in the treatment of stage fright. This review focuses on the application of propranolol in the treatment of various types of anxiety and stress, with particular reference to stage fright and post-traumatic stress disorder (PTSD). Both mechanisms of action as well as comparison with other therapies are presented. As those indications for propranolol are, in most countries, considered off-label, this review aims to gather information that can be useful while making a decision about the choice of propranolol as a drug in the treatment of those mental conditions.
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13
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Torales J, O’Higgins M, Barrios I, Amarilla D, Figueredo P, Almirón-Santacruz J, Ruiz-Díaz N, Melgarejo O, Castaldelli-Maia JM, Ventriglio A. The International Trauma Questionnaire: An assessment of the psychometric properties of its Spanish version. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/12389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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Fernandes IAM, Menezes ROA, Rego G. Communicating the Spinal Muscular Atrophy diagnosis to children and the principle of autonomy. BMC Pediatr 2022; 22:489. [PMID: 35978280 PMCID: PMC9386960 DOI: 10.1186/s12887-022-03552-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The trinomial relationship between physicians/children/guardians is essential in the process of communicating a disease and its prognosis. OBJECTIVE Analyzing the exercise of autonomy by this trinomial relationship in communicating the diagnosis of spinal muscular atrophy (SMA). METHODOLOGY: Caregivers of SMA patients answered a questionnaire containing a structured interview and the Event Impact Scale - Revised. RESULTS The sample comprised 50 volunteers, 94% of whom were female caregivers. Psychological trauma was predominantly reported when caregivers communicated the diagnosis to children. 22% have a high risk of post-traumatic stress, relating the feeling of unpreparedness in communicating this to the child. CONCLUSIONS It was identified that the failure in communication is the main factor for negative repercussions on the autonomy of children and their guardians, with self-reported psychological trauma, besides the high risk for post-traumatic stress syndrome.
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Affiliation(s)
- Isabella Araujo Mota Fernandes
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. .,Lauro Wanderley University Hospital, Federal University of Paraíba, Cidade Universitária Campus I, 58051-900, João Pessoa, Paraíba, Brasil.
| | | | - Guilhermina Rego
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
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15
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Wu S, Morgenstern A, Rice T, Coffey B. Psychopharmacological Strategies Employing Guanfacine in an Adolescent Girl with Postural Orthostatic Tachycardia Syndrome and Severe Posttraumatic Stress Disorder. J Child Adolesc Psychopharmacol 2022; 32:244-248. [PMID: 35587210 PMCID: PMC9545804 DOI: 10.1089/cap.2022.29221.bjc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Stephanie Wu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ari Morgenstern
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Timothy Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Barbara Coffey
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA.,Department of Psychiatry, Jackson Behavioral Health Hospital, Miami, Florida, USA.,Address correspondence to: Barbara J. Coffey, MD, MS, Clinical Research Center, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136, USA
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16
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Daddah D, Glèlè Ahanhanzo Y, Kpozehouen A, Hounkpe Dos Santos B, Ouendo EM, Levêque A. Prevalence and Risk Factors of Post-Traumatic Stress Disorder in Survivors of a Cohort of Road Accident Victims in Benin: Results of a 12-Month Cross-Sectional Study. J Multidiscip Healthc 2022; 15:719-731. [PMID: 35411148 PMCID: PMC8994593 DOI: 10.2147/jmdh.s358395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/25/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Post-traumatic stress disorder (PTSD) is a frequent psychiatric complication in road accident survivors. However, it remains under-explored and is not taken into account in health policies in Benin. The purpose of this study was to determine the prevalence and risk factors of PTSD after a road traffic accident. This will help to improve its diagnosis and management in Benin hospitals. Materials and Methods An institution-based cross-sectional study was conducted from November 2020 to January 2021. Consenting victims of road traffic accidents from three hospitals across Benin, aged 18 years and above, living in the south of the country, were administered various questionnaires at 12-month follow-up. Data on PTSD were collected using a pre-tested, structured and standardized post-traumatic stress disorder questionnaire, the PTSD Checklist (specific version) (PCL-S). A logistic regression model was fitted to identify factors associated with PTSD. An adjusted odds ratio (AOR) followed by a 95% confidence interval was calculated to determine the level of significance with a p-value less than 0.05. Results Out of 865 patients in the cohort eligible for the 12-month follow-up, 734 (85%) participated in the study. The prevalence of PTSD was 26.43% (95% CI: 23.36–29.75). Factors associated with PTSD on multivariate analysis were female gender (adjusted odds ratio (AOR) = 2.14, 95% CI: 1.38–3.33), hospitalization (AOR = 1.87, 95% CI 1.21–2.89), negative impact of the accident on income (AOR = 4.22, 95% CI: 2.16–8.25), and no return to work (AOR = 3.17, 95% CI: 1.99–5.06). Conclusion The prevalence of PTSD is high in road accident survivors in Benin. The results of this study highlight the need for early diagnosis and a multidisciplinary approach to the management of PTSD patients in Benin’s hospitals.
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Affiliation(s)
- Donatien Daddah
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
- Center for Research in Epidemiology, Biostatistics and Clinical Research, Public Health School, (Université Libre de Bruxelles), Brussels, Belgium
- Correspondence: Donatien Daddah, Epidemiology and Biostatistics Department, Regional Institute of Public Health, P.O. Box 384, Ouidah, Benin, Tel +229 97167245, Email
| | - Yolaine Glèlè Ahanhanzo
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
| | - Alphonse Kpozehouen
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
| | - Bella Hounkpe Dos Santos
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
- Center for Research in Epidemiology, Biostatistics and Clinical Research, Public Health School, (Université Libre de Bruxelles), Brussels, Belgium
| | - Edgard-Marius Ouendo
- Health Policies and Systems Department, Regional Institute of Public Health, Ouidah, Benin
| | - Alain Levêque
- Center for Research in Epidemiology, Biostatistics and Clinical Research, Public Health School, (Université Libre de Bruxelles), Brussels, Belgium
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17
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de Lima Silva AHB, Radulski DR, Pereira GS, Acco A, Zanoveli JM. A single injection of pregabalin induces short- and long-term beneficial effects on fear memory and anxiety-like behavior in rats with experimental type-1 diabetes mellitus. Metab Brain Dis 2022; 37:1095-1110. [PMID: 35239142 DOI: 10.1007/s11011-022-00936-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/14/2022] [Indexed: 12/25/2022]
Abstract
Anxiety Disorders and Posttraumatic Stress Disorders (PTSD) associated with type-1 diabetes mellitus (T1DM) are increasingly common comorbidities and the treatment is quite challenging. In that sense, evidence indicates that the anticonvulsant pregabalin is highly effective in treating severe cases of anxiety, as well as PTSD and diabetic neuropathic pain which is also very prevalent in T1DM. Herein, the short- and long-term effects of a single injection of pregabalin on the acquisition of a fear extinction memory and parameters of anxiety in induced-T1DM animals were investigated. For that, we used the contextual fear conditioning (CFC) and elevated plus maze paradigms, respectively. A putative antioxidant activity was also evaluated. Our findings demonstrated that induced-T1DM animals presented greater expression of fear memory, difficulty in extinguishing this fear memory, associated with a more pronounced anxiety-like response. Pregabalin was able to induce a short and long-lasting effect by facilitating the acquisition of the fear extinction memory and inducing a later anxiolytic-like effect. Also, the increased lipid peroxidation levels in the hippocampus and prefrontal cortex of induced-T1DM rats were reduced after pregabalin injection, while the decreased levels of reduced glutathione were increased in the hippocampus. Despite the need for more studies to understand the mechanism of action of pregabalin under these conditions, our data demonstrate for the first time that a single injection of pregabalin in a specific time window was able to improve behavioral parameters in addition to inducing neuroprotective effect. Thus, pregabalin has potential worth exploring for the treatment of PTSD and/or Anxiety associated with T1DM.
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Affiliation(s)
| | - Debora Rasec Radulski
- Department of Pharmacology, Biological Science Sector, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Gabriela Saidel Pereira
- Department of Pharmacology, Biological Science Sector, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Alexandra Acco
- Department of Pharmacology, Biological Science Sector, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Janaina Menezes Zanoveli
- Department of Pharmacology, Biological Science Sector, Federal University of Paraná, Curitiba, Paraná, Brazil.
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18
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Bock C, Zimmermann T, Kahl KG. The impact of post-traumatic stress on the mental state of university hospital physicians - a cross sectional study. BMC Psychiatry 2022; 22:85. [PMID: 35114970 PMCID: PMC8815118 DOI: 10.1186/s12888-022-03719-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/20/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Hospital physicians have an increased risk for post-traumatic stress caused by work-related trauma. This study examines the frequency of reported traumatic events (TE), post-traumatic stress (PTS) and its possible consequences for the mental state and work ability of physicians at a university hospital. METHODS As part of the mandatory psychological risk assessment, n = 145 physicians (n = 56 female; 38.6%) were examined at a university hospital in Germany in a cross sectional study. TE, PTS and symptoms of depression and anxiety were assessed using the self-report questionnaires "Freiburger Screening Fragebogen to identify patients at risk for the development of a post-traumatic stress disorder in the group of severely injured patients" (PTBS-13), the "Patient Health Questionnaire" (PHQ-2) and the "Generalized Anxiety Disorder scale" (GAD-2). Work ability was assessed using a modified version of the questionnaire for workplace analysis (KFZA). The response rate was 52%. RESULTS Traumatic events were experienced by n = 125 physicians (86.2%) throughout their whole career. Of these, 19 physicians (15.2%) reported PTS. PTS is reported by 12 of 56 female physicians (63.2%), compared to 7 of 89 reports of PTS by male physicians (36.8%). Physicians with PTS symptoms had higher depression scores (p = 0.007) compared to physicians without TE or with TE, but without PTS. Physicians with PTS reported significantly reduced work ability caused by constantly interrupted work (p = 0.03). Female gender was the greatest risk factor for the development of PTS. (p = 0.001). CONCLUSIONS Physicians - especially females - with PTS may have an increased risk of developing depressive symptoms. Therefore, interventions aimed at reducing trauma-related stress symptoms may be helpful in improving mental health of hospital physicians. Further studies with more physicians from different hospitals are necessary to support the results.
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Affiliation(s)
- Christian Bock
- Department of Occupational Safety, Hannover Medical School, Hannover, Germany.
| | - Tanja Zimmermann
- grid.10423.340000 0000 9529 9877Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kai G. Kahl
- grid.10423.340000 0000 9529 9877Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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19
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CANSEL N, UCUZ İ. Post-traumatic stress and associated factors among healthcare workers in the early stage following the 2020 Malatya-Elazığ earthquake. KONURALP TIP DERGISI 2022. [DOI: 10.18521/ktd.1000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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20
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Blum K, Modestino EJ, Baron D, Brewer R, Thanos P, Elman I, Badgaiyan RD, Downs BW, Bagchi D, McLaughlin T, Bowirrat A, Roy AK, Gold MS. Endorphinergic Enhancement Attenuation of Post-traumatic Stress Disorder (PTSD) via Activation of Neuro-immunological Function in the Face of a Viral Pandemic. ACTA ACUST UNITED AC 2021; 10:86-97. [PMID: 34466374 DOI: 10.2174/2211556009999210104221215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction Polymorphic gene variants, particularly the genetic determinants of low dopamine function (hypodopaminergia), are known to associate with Substance Use Disorder (SUD) and a predisposition to PTSD. Addiction research and molecular genetic applied technologies supported by the National Institutes of Health (NIH) have revealed the complex functions of brain reward circuitry and its crucial role in addiction and PTSD symptomatology. Discussion It is noteworthy that Israeli researchers compared mice with a normal immune system with mice lacking adaptive immunity and found that the incidence of PTSD increased several-fold. It is well established that raising endorphinergic function increases immune response significantly. Along these lines, Blum's work has shown that D-Phenylalanine (DPA), an enkephalinase inhibitor, increases brain endorphins in animal models and reduces stress in humans. Enkephalinase inhibition with DPA treats Post Traumatic Stress Disorder (PTSD) by restoring endorphin function. The Genetic Addiction Risk Severity (GARS) can characterize relevant phenotypes, genetic risk for stress vulnerability vs. resilience. GARS could be used to pre-test military enlistees for adaptive immunity or as part of PTSD management with customized neuronutrient supplementation upon return from deployment. Conclusion Based on GARS values, with particular emphasis on enhancing immunological function, pro-dopamine regulation may restore dopamine homeostasis. Recognition of the immune system as a "sixth sense" and assisting adaptive immunity with Precision Behavioral Management (PBM), accompanied by other supportive interventions and therapies, may shift the paradigm in treating stress disorders.
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Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Division of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA.,Division of Nutrigenomics, Victory Nutrition International, Lederoch, PA., USA
| | | | - David Baron
- Western University Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA
| | - Raymond Brewer
- Division of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - Panayotis Thanos
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addiction, Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, USA
| | - Igor Elman
- Department of Psychiatry, Harvard School of Medicine, Cambridge MA, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy I Memorial VA Hospital, San Antonio, TX. and Long School of Medicine, University of Texas Medical Center, San Antonio TX, USA
| | - B William Downs
- Division of Nutrigenomics, Victory Nutrition International, Lederoch, PA., USA
| | - Debasis Bagchi
- Division of Nutrigenomics, Victory Nutrition International, Lederoch, PA., USA.,Department of Pharmaceutical Sciences, University of Houston, School of Pharmacy, Houston, TX., USA
| | | | - Abdalla Bowirrat
- Department of Neuroscience and Genetics, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - A Kenison Roy
- Department of Psychiatry, University of Tulane School of Medicine, New Orleans, LA, USA
| | - Mark S Gold
- Department of Psychiatry, Washington University, School of Medicine, St. Louis, MO., USA
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21
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Nikitina VA, Zakharova MV, Trofimov AN, Schwarz AP, Beznin GV, Tsikunov SG, Zubareva OE. Neonatal Exposure to Bacterial Lipopolysaccharide Affects Behavior and Expression of Ionotropic Glutamate Receptors in the Hippocampus of Adult Rats after Psychogenic Trauma. BIOCHEMISTRY (MOSCOW) 2021; 86:761-772. [PMID: 34225597 DOI: 10.1134/s0006297921060134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
According to the two-hit hypothesis of psychoneuropathology formation, infectious diseases and other pathological conditions occurring during the critical periods of early ontogenesis disrupt normal brain development and increase its susceptibility to stress experienced in adolescence and adulthood. It is believed that these disorders are associated with changes in the functional activity of the glutamatergic system in the hippocampus. Here, we studied expression of NMDA (GluN1, GluN2a, GluN2b) and AMPA (GluA1, GluA2) glutamate receptor subunits, as well as glutamate transporter EAAT2, in the ventral and dorsal regions of the hippocampus of rats injected with LPS during the third postnatal week and then subjected to predator stress (contact with a python) in adulthood. The tests were performed 25 days after the stress. It was found that stress altered protein expression in the ventral, but not in the dorsal hippocampus. Non-stressed LPS-treated rats displayed lower levels of the GluN2b protein in the ventral hippocampus vs. control animals. Stress significantly increased the content of GluN2b in the LPS-treated rats, but not in the control animals. Stress also affected differently the exploratory behavior of LPS-injected and control rats. Compared to the non-stressed animals, stressed control rats demonstrated a higher locomotor activity during the 1st min of the open field test, while the stressed LPS-injected rats displayed lower locomotor activity than the non-stressed rats. In addition, LPS-treated stressed and non-stressed rats spent more time in the open arms of the elevated plus maze and demonstrated reduced blood levels of corticosterone. To summarize the results of our study, exposure to bacterial LPS in the early postnatal ontogenesis affects the pattern of stress-induced changes in the behavior and hippocampal expression of genes coding for ionotropic glutamate receptor subunits after psychogenic trauma suffered in adulthood.
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Affiliation(s)
| | - Maria V Zakharova
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, Saint Petersburg, 194223, Russia
| | | | - Alexander P Schwarz
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, Saint Petersburg, 194223, Russia
| | - Gleb V Beznin
- Institute of Experimental Medicine, Saint Petersburg, 197376, Russia
| | - Sergei G Tsikunov
- Institute of Experimental Medicine, Saint Petersburg, 197376, Russia
| | - Olga E Zubareva
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, Saint Petersburg, 194223, Russia.
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22
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Mundy J, Hübel C, Gelernter J, Levey D, Murray RM, Skelton M, Stein MB, Vassos E, Breen G, Coleman JRI. Psychological trauma and the genetic overlap between posttraumatic stress disorder and major depressive disorder. Psychol Med 2021; 52:1-10. [PMID: 34085609 PMCID: PMC8962503 DOI: 10.1017/s0033291721000830] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/19/2021] [Accepted: 02/24/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are commonly reported co-occurring mental health consequences of psychological trauma exposure. The disorders have high genetic overlap. Trauma is a complex phenotype but research suggests that trauma sensitivity has a heritable basis. We investigated whether sensitivity to trauma in those with MDD reflects a similar genetic component in those with PTSD. METHODS Genetic correlations between PTSD and MDD in individuals reporting trauma and MDD in individuals not reporting trauma were estimated, as well as with recurrent MDD and single-episode MDD, using genome-wide association study (GWAS) summary statistics. Genetic correlations were replicated using PTSD data from the Psychiatric Genomics Consortium and the Million Veteran Program. Polygenic risk scores were generated in UK Biobank participants who met the criteria for lifetime MDD (N = 29 471). We investigated whether genetic loading for PTSD was associated with reporting trauma in these individuals. RESULTS Genetic loading for PTSD was significantly associated with reporting trauma in individuals with MDD [OR 1.04 (95% CI 1.01-1.07), Empirical-p = 0.02]. PTSD was significantly more genetically correlated with recurrent MDD than with MDD in individuals not reporting trauma (rg differences = ~0.2, p < 0.008). Participants who had experienced recurrent MDD reported significantly higher rates of trauma than participants who had experienced single-episode MDD (χ2 > 166, p < 0.001). CONCLUSIONS Our findings point towards the existence of genetic variants associated with trauma sensitivity that might be shared between PTSD and MDD, although replication with better powered GWAS is needed. Our findings corroborate previous research highlighting trauma exposure as a key risk factor for recurrent MDD.
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Affiliation(s)
- Jessica Mundy
- Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley National Health Service (NHS) Trust, London, UK
| | - Christopher Hübel
- Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley National Health Service (NHS) Trust, London, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Joel Gelernter
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, Connecticut, USA
- Departments of Genetics and Neuroscience, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Daniel Levey
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, Connecticut, USA
| | - Robin M. Murray
- UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley National Health Service (NHS) Trust, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Megan Skelton
- Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley National Health Service (NHS) Trust, London, UK
| | - Murray B. Stein
- Psychiatry Service, VA San Diego Healthcare System, San Diego, California, USA
- Departments of Psychiatry and Family Medicine & Public Health, University of California San Diego, La Jolla, California, USA
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley National Health Service (NHS) Trust, London, UK
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley National Health Service (NHS) Trust, London, UK
| | - Jonathan R. I. Coleman
- Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley National Health Service (NHS) Trust, London, UK
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Janeway MG, Zhao X, Rosenthaler M, Zuo Y, Balasubramaniyan K, Poulson M, Neufeld M, Siracuse JJ, Takahashi CE, Allee L, Dechert T, Burke PA, Li F, Kalesan B. Clinical diagnostic phenotypes in hospitalizations due to self-inflicted firearm injury. J Affect Disord 2021; 278:172-180. [PMID: 32961413 DOI: 10.1016/j.jad.2020.09.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 07/07/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND . Hospitalized self-inflicted firearm injuries have not been extensively studied, particularly regarding clinical diagnoses at the index admission. The objective of this study was to discover the diagnostic phenotypes (DPs) or clusters of hospitalized self-inflicted firearm injuries. METHODS . Using Nationwide Inpatient Sample data in the US from 1993 to 2014, we used International Classification of Diseases, Ninth Revision codes to identify self-inflicted firearm injuries among those ≥18 years of age. The 25 most frequent diagnostic codes were used to compute a dissimilarity matrix and the optimal number of clusters. We used hierarchical clustering to identify the main DPs. RESULTS . The overall cohort included 14072 hospitalizations, with self-inflicted firearm injuries occurring mainly in those between 16 to 45 years of age, black, with co-occurring tobacco and alcohol use, and mental illness. Out of the three identified DPs, DP1 was the largest (n=10,110), and included most common diagnoses similar to overall cohort, including major depressive disorders (27.7%), hypertension (16.8%), acute post hemorrhagic anemia (16.7%), tobacco (15.7%) and alcohol use (12.6%). DP2 (n=3,725) was not characterized by any of the top 25 ICD-9 diagnoses codes, and included children and peripartum women. DP3, the smallest phenotype (n=237), had high prevalence of depression similar to DP1, and defined by fewer fatal injuries of chest and abdomen. LIMITATIONS . Claims data. CONCLUSIONS . There were three distinct diagnostic phenotypes in hospitalizations due to self-inflicted firearm injuries. Further research is needed to determine how DPs can be used to tailor clinical care and prevention efforts.
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Affiliation(s)
- Megan G Janeway
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Xiang Zhao
- Department of Medicine and Mathematics and Statistics, Boston University School of Medicine and Graduate School of Arts and Sciences, Boston, MA, USA
| | - Max Rosenthaler
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Yi Zuo
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | | | - Michael Poulson
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Miriam Neufeld
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Jeffrey J Siracuse
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | | | - Lisa Allee
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Tracey Dechert
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Peter A Burke
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Feng Li
- School of Statistics and Mathematics, Central University of Finance and Economics, Beijing, China
| | - Bindu Kalesan
- Department of Medicine and Community Health Sciences, Boston University, 72 E Concord St L-516, Boston, MA 02118, USA.
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Peng M, Song X, Liu L, Zhao W, Lai P, Bao G, Guo T, Zhang X. Comparison of Prevalence and Risk Factors of PTSS Between Chinese Patients With Depression and Non-depressed Controls During COVID-19 Outbreak. Front Psychiatry 2021; 12:719931. [PMID: 35046844 PMCID: PMC8761860 DOI: 10.3389/fpsyt.2021.719931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/06/2021] [Indexed: 12/23/2022] Open
Abstract
Background: COVID-19 pandemic is a traumatic event all over the world, and may lead to post-traumatic stress symptom (PTSS) in different population who are under the threat of novel corona virus. Therefore, the aim of our study was to compare the prevalence and risk factors of PTSS between Chinese patients with depression and non-depressed controls during the COVID-19 outbreak. Methods: 437 depressed patients and 2,940 non-depressed controls were enrolled in this cross-sectional study between February 14 and May 9, 2020.The Impact of Events Scale-Revised (IES-R), Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the psychological status of all the participants. Results: The prevalence of PTSS (IES-R ≥ 33) in depressed patients (45.08%) was higher than that in non-depressed controls (5.31%). Patients with depression were 16 times more likely to suffer from PTSS than those without depression. Correlation analyses showed that the IES-R total score was positively correlated with SDS, SAS, and PSQI scores in both depressed and non-depressed groups (Bonferroni corrected all p < 0.001). Multiple linear regression analysis showed that SAS score, and PSQI score were independently associated with IES-R total score in both depression and non-depression groups. In depressed patients, education level and duration of media exposure to COVID-19 were positively associated with PTSS, while in the non-depressed group, subjects who were married, in the 31-50 year group or with higher SDS score were more likely to develop PTSS. Conclusions: These results indicate that the prevalence rate of PTSS in patients with depression is very higher than that in subjects without depression. PTSS are associated with a number of socio-demographic and clinical variables.
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Affiliation(s)
- Min Peng
- Department of Psychiatry, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Xinran Song
- Department of Psychiatry, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Luyu Liu
- Department of Psychiatry, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Weifeng Zhao
- Department of Psychiatry, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Pingmei Lai
- Department of Psychiatry, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Guanglin Bao
- Department of Psychiatry, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Tianyou Guo
- School of Psychology Shenzhen University, Shenzhen, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Auxéméry Y, Gayraud F. Post-concussion syndrome: Still forgotten? From the disappearance of the DSM-5 to a multidisciplinary consultation. Encephale 2020; 47:491-494. [PMID: 33218667 DOI: 10.1016/j.encep.2020.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Following the presence of both post-traumatic stress disorder (PTSD) and post-concussion syndrome (PCS) in the nosography since the publication of DSM-IV, large-scale studies investigated the links between these two entities: exposure to a mild traumatic brain injury was correlated with the presence of PTSD and vice versa, and the strongest factor associated with PCS was the presence of PTSD. But PCS entity was recently suppressed from the 5th edition of the American diagnostic and statistical classification of neuropsychiatric disorders (DSM-5, 2013). In the 11th edition of the CIM, PCS is also likely to be omitted. This elimination raises more questions if we take into consideration the emancipation of PTSD, which now includes the full category of "disorders related to trauma and stressors" to which PCS could have legitimately been added. METHODS We discuss current scientific literature and clinical practices with a socio-anthropological point of view. RESULTS Post-concussion and post-traumatic clinical entities often show similar anamnestic temporalities, with an initial acute phase where memory (amnesia following TBI; dissociative post-traumatic amnesia) and consciousness (initial loss of consciousness secondary to TBI; peri-traumatic psychic dissociation) impairments predominate, followed by a pauci-symptomatic latency phase. Finally, a symptomatic phase occurs in which similar symptoms for both entities are observed (sleep disorders, anxiety and depression, irritability, fatigue, attention disorder, tendency to avoidance). If similar therapies (pharmacological and psychological) are effective in treating the clinical consequences of head and mental trauma, this suggests that they have common etiopathogenic origins. CONCLUSIONS Yet, post-concussion syndrome remains a clinical-biological reality. If a diffusion tensor imaging MRI in the acute phase is likely to provide predictive elements for subsequent cognitive dysfunctions, it would appear useful to consider combining biomarkers, and linguistics markers, with the creation of a clinical-radio-bio- neuropsychological score in order to differentiate benign outcomes from neuro- and/or psycho-traumatic disorders.
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Affiliation(s)
- Y Auxéméry
- Centre hospitalier de Jury-les-Metz, hôpital de jour, 12, rue des Treize, 57070 Metz, France; EA 4360 APEMAC « Adaptation, mesure et évaluation en santé. Approches interdisciplinaires » - Équipe EPSAM, université de Lorraine, Metz, France.
| | - F Gayraud
- Laboratoire dynamique du langage, UMR 5596, CNRS, Université Lyon-II, Lyon, France
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26
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Gualtieri G, Ferretti F, Masti A, Pozza A, Coluccia A. Post-traumatic Stress Disorder in Prisoners' Offspring: A Systematic Review and Meta-analysis. Clin Pract Epidemiol Ment Health 2020; 16:36-45. [PMID: 32508968 PMCID: PMC7254824 DOI: 10.2174/1745017902016010036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Parental incarceration can produce serious effects on the offspring's mental health. The presence of Post-Traumatic Stress Disorder (PTSD) in prisoners' offspring is understudied and the few literature data showed heterogeneous evidence, with some studies suggesting that about 25% of prisoners' offspring have PTSD and other reporting much lower prevalence rates around 2-3%. There is no systematic review and meta-analysis about PTSD in prisoners' offspring. OBJECTIVES The present systematic review and meta-analysis aimed to provide a first quantitative synthesis of the prevalence of the PTSD diagnosis in prisoners' offspring. Moderator variables of the effect sizes were assessed, including offspring's and parents' gender, offspring's generational cohort (children/adolescents versus adults), reasons for parental incarceration (political/war versus crime), and country type (Western versus Non-Western countries). METHODS A systematic review and a meta-analysis were conducted according to the PRISMA guidelines. Studies were included if they assessed the presence of a PTSD diagnosis in child, adolescent or adult offspring of prisoners through a diagnostic classification system, a clinician-administered interview or a self-report questionnaire, if they reported data necessary to calculate the effect sizes or the authors were available to provide them. Studies might have been based upon any design except review, single-case, case series, and case reports. Outcomes might have been measured at any time after parental incarceration. Parental imprisonment was defined as any kind of custodial confinement of a parent by the criminal justice system, including being held as a prisoner of war or for political reasons.Independent reviewers searched published/unpublished studies through electronic databases and additional sources and extracted the data. A random-effect meta-analysis was carried out by calculating the effect sizes as event rates. Heterogeneity was examined by the I2 and the Q statistics. Moderators were assessed through meta-regressions. RESULTS Six studies (2512 participants) were included. Fifteen percent of prisoners' offspring had PTSD, as shown by a significant mean effect size of 0.14 without evidence of publication bias (95% CI: 0.081 - 0.249, p< 0.001). There were no significant differences on the mean effect sizes between the studies on adults and those on children/adolescents [Q(1) = 0.00, p = .999], between the studies on parents incarcerated for political/war reasons and those for crime [Q(1) = 0.00, p = .979], and between the studies conducted in Western and non-Western countries [Q(1) = 0.854, p = .355]. While offspring's gender was not related to the effect sizes [β = -0.01, 95% CI: -0.02 - 0.02, p = .452], parents' gender was significantly and positively associated with the effect sizes suggesting that in studies with higher percentages of incarcerated mothers, the prevalence of offspring's PTSD was higher [β = 0.01, 95% CI: 0.0 - 0.01, p = .019]. CONCLUSION PTSD is a serious mental health condition among prisoners' offspring, particularly when mothers are incarcerated. The present findings point out the importance of thorough assessment and timely intervention/prevention strategies implemented by professionals of mental health settings and detention systems. The cross-sectional design of the studies does not allow causal conclusions to be drawn about the effect of parental incarceration as a risk factor for PTSD. Other variables related to parental incarceration may explain these findings. This limitation points out the importance of further longitudinal research.
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Affiliation(s)
- Giacomo Gualtieri
- Legal Medicine Unit, Santa Maria Alle Scotte University Hospital of Siena, Siena, Italy
| | - Fabio Ferretti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Alessandra Masti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Anna Coluccia
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
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27
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Kahl J, Holl J, Grundmann J, Lotzin A, Hiller P, Schroeder K, Schulte B, Barnow S, Schäfer I. Emotion Regulation as a Mediator between Childhood Abuse and Neglect and Posttraumatic Stress Disorder in Women with Substance Use Disorders. Subst Use Misuse 2020; 55:2184-2193. [PMID: 32835585 DOI: 10.1080/10826084.2020.1797805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A history of childhood abuse and neglect (CAN) is significantly associated with psychopathologies in adulthood, including comorbid posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Difficulties in emotion regulation (ER) might influence the association between CAN and PTSD. The aim of this study was to examine the relationship between CAN and PTSD symptom severity in women with SUD and to investigate the mediating role of general difficulties in ER and its specific dimensions. Method: We examined 320 women, with a current diagnosis of at least subsyndromal PTSD and SUD, using self-report measures of CAN, PTSD symptom severity, and ER difficulties. We conducted both simple and multiple bootstrapping-enhanced mediation analysis to investigate whether general difficulties in ER and its specific dimensions mediate the relationship between CAN and PTSD symptom severity. Results: General difficulties in ER mediated the association between CAN and PTSD symptom severity. CAN significantly predicted adult PTSD symptom severity, directly and indirectly, through ER difficulties. Difficulties engaging in goal directed behavior when distressed was the only ER dimension, which mediated the effect of CAN on PTSD symptoms. Conclusions: Our results suggest that difficulties in ER and specifically difficulties engaging in goal directed behavior when distressed might constitute an influential factor in the relationship between CAN and PTSD symptom severity in a sample of SUD patients, and highlight the importance of targeting ER as a potential treatment focus for patients with comorbid PTSD and SUD.
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Affiliation(s)
- Johanna Kahl
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Holl
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Johanna Grundmann
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annett Lotzin
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Philipp Hiller
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Schroeder
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Schulte
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Barnow
- Clinical Psychology and Psychotherapy, Institute of Psychology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Ingo Schäfer
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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28
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Azevedo H, Ferreira M, Mascarello A, Osten P, Werneck Guimarães CR. The serotonergic and alpha-1 adrenergic receptor modulator ACH-000029 ameliorates anxiety-like behavior in a post-traumatic stress disorder model. Neuropharmacology 2019; 164:107912. [PMID: 31843397 DOI: 10.1016/j.neuropharm.2019.107912] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 01/17/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a severe chronic mental illness that develops in individuals exposed to life-threatening trauma and is characterized by hyperarousal, flashbacks and nightmares. The serotonergic (5-HT) and noradrenergic (NE) systems are deeply involved in the pathogenesis of PTSD. We have previously reported a novel anxiolytic compound, ACH-000029, that modulates 5-HT and α1-adrenergic receptors and induces acute anxiolytic-like effects in rodents. Here, we investigated the potential of ACH-000029 to prevent anxiety-like behavior in the single prolonged stress (SPS) PTSD model. Mice were subjected to the SPS procedure, followed by a 7-day treatment with ACH-000029 and, for comparison, with the α1-adrenergic antagonist prazosin. Animals were behaviorally assessed using social interaction, elevated plus maze and open field tests. Interestingly, treatment with ACH-000029 but not with prazosin ameliorated the SPS-induced sociability impairment and anxiety-like behavior. The brain-wide c-fos mapping, used as a surrogate for brain activity, indicated the brain structures that were altered by SPS and putatively involved in the anxiolytic-like effect of ACH-000029. The SPS protocol produced long-lasting impairment of regions involved in stress-anxiety response, such as the amygdala, prefrontal cortex, globus pallidus and superior colliculus. ACH-000029 treatment reversed the SPS-induced c-fos changes in the globus pallidus, lateral septum and entorhinal cortex and exclusively modulated c-fos levels in subregions from the retrosplenial cortex, cerebellum, superior colliculus and ventromedial hypothalamus. These results support the hypothesis that the dual regulation of 5-HT and α1-adrenergic receptors is required to alleviate PTSD symptoms and suggest a possible role of ACH-000029 as a PTSD treatment.
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Affiliation(s)
- Hatylas Azevedo
- Aché Laboratórios Farmacêuticos, Guarulhos, São Paulo, Brazil.
| | - Marcos Ferreira
- Aché Laboratórios Farmacêuticos, Guarulhos, São Paulo, Brazil
| | | | - Pavel Osten
- Cold Spring Harbor Laboratories, Cold Spring Harbor, NY, USA; Certerra, Inc., Cold Spring Harbor, NY, USA
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[The Eyes Movement Desensitization and Reprocessing for children with traumatic traumatic stress disorder: A Tunisian experience]. Encephale 2019; 46:235-240. [PMID: 31540671 DOI: 10.1016/j.encep.2019.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 07/13/2019] [Accepted: 07/18/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Evaluate the effectiveness of the Eyes Movement Desensitization and Reprocessing psychotherapy for children with Post-Traumatic Stress Disorder. METHODS A retrospective study was conducted in the Child Psychiatry Department of CHU Mongi Slim, Marsa (Tunis, Tunisia). All Outpatients with a Post-Traumatic Stress Disorder diagnosis and who had Eyes Movement Desensitization and Reprocessing psychotherapy during the period from July 2016 to May 2018 were included. They were evaluated according to DSM 5 criteria in pre and post therapy. RESULTS The sample consisted of sixteen children with a sex-ratio of 1.6. Their age ranged from 3 to 17 years old with a mean age of 9.5±4.6 years. Five patients were less than six years old. Our patients were exposed to a sexual assault (4 cases), a death of a family member (3 cases), a road accident (3 cases), a physical assault (4 cases), an arrest of the father (1 case) and burglary of the house (1 case). In 15 cases, the traumatic event was unique while it was repeated in one sexual assault case. The total number of follow-up sessions ranged from one to seven sessions with an average of 3±2.4 sessions. The average number of sessions for preschool children was 2.6±0.5 sessions. Bilateral tactile stimulations were used with thirteen children in our population, including the five children younger than six years old. At the end of the therapy all patients no longer met the criteria for Post-Traumatic Stress Disorder diagnosis. All the preschool patients and eight children older than 6 years did not respond to any of the four Post-Traumatic Stress Disorder criteria. The difference between the scores of the DSM 5 criteria in pre and post EMDR was statistically significant. We found P=10-3 for children over six years and P<0.05 for children under six years old. CONCLUSION Eyes Movement Desensitization and Reprocessing is a therapy that has several advantages. First, it is effective in Post Traumatic Stress Disorder in children. Second, its protocol is flexible and adaptable to all ages and developmental level of the child. Third, the number of sessions is usually reduced, which is a great advantage over other trauma-focused psychotherapies.
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Brock MS, Powell TA, Creamer JL, Moore BA, Mysliwiec V. Trauma Associated Sleep Disorder: Clinical Developments 5 Years After Discovery. Curr Psychiatry Rep 2019; 21:80. [PMID: 31410580 DOI: 10.1007/s11920-019-1066-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW We review recent and growing evidence that provides support for a novel parasomnia, trauma associated sleep disorder (TASD). Based on these findings, we further develop the clinical and polysomnographic (PSG) characteristics of TASD. We also address factors that precipitate TASD, develop a differential diagnosis, discuss therapy, and propose future directions for research. RECENT FINDINGS Nightmares, classically a REM phenomenon, are prevalent and underreported, even in individuals with trauma exposure. When specifically queried, trauma-related nightmares (TRN) are frequently associated with disruptive nocturnal behaviors (DNB), consistent with TASD. Capture of DNB in the lab is rare but ambulatory monitoring reveals dynamic autonomic concomitants associated with disturbed dreaming. TRN may be reported in NREM as well as REM sleep, though associated respiratory events may confound this finding. Further, dream content is more distressing in REM. Therapy for this complex disorder likely requires addressing not only the specific TASD components of TRN and DNB but comorbid sleep disorders. TASD is a unique parasomnia developing after trauma. Trauma-exposed individuals should be specifically asked about their sleep and if they have nightmares with or without DNB. Patients who report TRN warrant in-lab PSG as part of their evaluation.
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Affiliation(s)
- Matthew S Brock
- Department of Sleep Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, USA.
| | - Tyler A Powell
- Department of Sleep Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, USA
| | - Jennifer L Creamer
- Sleep Medicine Center, Martin Army Community Hospital, Fort Benning, GA, USA
| | - Brian A Moore
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,University of Texas at San Antonio, San Antonio, TX, USA
| | - Vincent Mysliwiec
- Department of Sleep Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, USA
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Blum K, Gondré-Lewis MC, Modestino EJ, Lott L, Baron D, Siwicki D, McLaughlin T, Howeedy A, Krengel MH, Oscar-Berman M, Thanos PK, Elman I, Hauser M, Fried L, Bowirrat A, Badgaiyan RD. Understanding the Scientific Basis of Post-traumatic Stress Disorder (PTSD): Precision Behavioral Management Overrides Stigmatization. Mol Neurobiol 2019; 56:7836-7850. [PMID: 31124077 DOI: 10.1007/s12035-019-1600-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 04/02/2019] [Indexed: 12/20/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a severe polygenic disorder triggered by environmental factors. Many polymorphic genes, particularly the genetic determinants of hypodopaminergia (low dopamine function), associate with a predisposition to PTSD as well as substance use disorder. Support from the National Institutes of Health for neuroimaging research and molecular, genetic applied technologies has improved understanding of brain reward circuitry functions that have inspired the development of new innovative approaches to their early diagnosis and treatment of some PTSD symptomatology and addiction. This review presents psychosocial and genetic evidence that vulnerability or resilience to PTSD can theoretically be impacted by dopamine regulation. From a neuroscience perspective, dopamine is widely accepted as a major neurotransmitter. Questions about how to modulate dopamine clinically in order to treat and prevent PTSD and other types of reward deficiency disorders remain. Identification of genetic variations associated with the relevant genotype-phenotype relationships can be characterized using the Genetic Addiction Risk Score (GARS®) and psychosocial tools. Development of an advanced genetic panel is under study and will be based on a new array of genes linked to PTSD. However, for now, the recommendation is that enlistees for military duty be given the opportunity to voluntarily pre-test for risk of PTSD with GARS, before exposure to environmental triggers or upon return from deployment as part of PTSD management. Dopamine homeostasis may be achieved via customization of neuronutrient supplementation "Precision Behavioral Management" (PBM™) based on GARS test values and other pro-dopamine regulation interventions like exercise, mindfulness, biosensor tracking, and meditation.
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Affiliation(s)
- Kenneth Blum
- Graduate School of Biomedical Sciences, Western University Health Sciences, Pomona, CA, USA. .,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. .,Department of Psychiatry, Boonshoft School of Medicine, Wright University, Dayton, OH, USA. .,Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA. .,Division of Neurogenetic Research & Addiction Therapy, The Florida House Experience, Deerfield Beach, FL, USA. .,Division of Addiction Services, Dominion Diagnostics, North Kingston, RI, USA. .,Division of Neuroscience & Addiction Research, Pathway Healthcare, LLC., Burmingham, AL, USA.
| | - M C Gondré-Lewis
- Department of Anatomy, Developmental Neuropsychopharmacology Laboratory, Howard University College of Medicine, Washington, DC, USA
| | - E J Modestino
- Department of Psychology, Curry College, Milton, MA, USA
| | - L Lott
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - D Baron
- Graduate School of Biomedical Sciences, Western University Health Sciences, Pomona, CA, USA
| | - D Siwicki
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA.,Division of Addiction Services, Dominion Diagnostics, North Kingston, RI, USA
| | - T McLaughlin
- Center for Psychiatric Medicine, Lawrence, MA, USA
| | - A Howeedy
- Division of Neurogenetic Research & Addiction Therapy, The Florida House Experience, Deerfield Beach, FL, USA
| | - M H Krengel
- Department of Neurology, Boston University School of Medicine and VA Boston Healthcare System, Boston, MA, USA
| | - M Oscar-Berman
- Department of Neurology, Boston University School of Medicine and VA Boston Healthcare System, Boston, MA, USA
| | - P K Thanos
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addiction, Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, USA
| | - I Elman
- Department of Psychiatry, Cooper University School of Medicine, Camden, NJ, USA
| | - M Hauser
- Division of Addiction Services, Dominion Diagnostics, North Kingston, RI, USA
| | - L Fried
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA.,Transformations Treatment Center, Delray Beach, FL, USA
| | - A Bowirrat
- Division of Anatomy, Biochemistry and Genetics Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - R D Badgaiyan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Shrestha AK, Özlü-Erkilic Z, Popow C, Ohmann S, Akkaya-Kalayci T. Transcultural differences of psychologically traumatised children and adolescents. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2019; 33:61-71. [PMID: 30707405 PMCID: PMC6561986 DOI: 10.1007/s40211-019-0300-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/05/2019] [Indexed: 01/05/2023]
Abstract
Background The symptoms following a traumatic event as well as the coping strategies can be culture specific. The objective of the present study was to analyse the transcultural differences of psychologically traumatized children and adolescents with and without migration background. Methods The medical files of 199 psychologically traumatized children and adolescents (99 native Austrian, 100 Turkish-speaking) who were treated at the Department of Child and Adolescent Psychiatry in Vienna were retrospectively analysed. Results The most frequently observed causes of trauma in patients with Turkish migration background were intra-familial conflicts, forced separation from parent(s), and conforming to a new environment. In native Austrian patients, forced separation from parent(s) and divorce or separation of parents were the leading causes of trauma. Trauma-related symptoms like changed mood, cognitive and perceptual disturbance, social withdrawal, sleeping problems, somatisation and behavioural problems were similarly observed in both groups; “sleeping problems” were more often observed in Austrian patients, and “behavioural problems” were more often observed in Turkish patients. More Austrian patients (32.7%) obtained psychiatric and psychotherapeutic treatment. Turkish-speaking patients mostly obtained psychiatric treatment only. Patients with migration background were more compliant compared to indigenous patients. Conclusions Both study groups differed in type, causes and symptoms of trauma, and in preferred therapy. Turkish-speaking patients were more compliant with therapy, as they received culture and language-sensitive medical advice and treatment in their mother tongue. Considering the cultural background of patients can optimize service delivery and therapy outcomes among children and adolescents with stressful and traumatic experiences.
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Affiliation(s)
- Amesh K Shrestha
- Department of Urology, General Hospital of Feldkirch, Carinagasse 47, 6807, Feldkirch, Austria
| | - Zeliha Özlü-Erkilic
- Outpatient Clinic of Transcultural Psychiatry and Migration-Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Türkan Akkaya-Kalayci
- Outpatient Clinic of Transcultural Psychiatry and Migration-Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Thomas G. Intérêts et limites des hospitalisations séquentielles dans la prise en charge des états de stress post-traumatique. ANNALES MEDICO-PSYCHOLOGIQUES 2018. [DOI: 10.1016/j.amp.2018.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Gałecki P, Talarowska M. Neurodevelopmental theory of depression. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:267-272. [PMID: 28571776 DOI: 10.1016/j.pnpbp.2017.05.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/17/2017] [Accepted: 05/27/2017] [Indexed: 01/20/2023]
Abstract
The aim of research studies in the field of psychiatry conducted in recent years is to formulate a consistent theory that would exhaustively explain the aetiology of depression. So far, biochemical, genetic, anatomical and environmental factors, which may play a role in the occurrence of the first symptoms of depressive disorders, have been sought. The authors of this paper present a theory that combines the previously mentioned elements into one whole and links them to one another. We have called our theory "neurodevelopmental" to underline the importance and impact of earlier stages of human life, including the prenatal period, on the occurrence of depressive disorders. We will make an attempt to find an answer to why this time in the life of a human being is so important, what kind of biological mechanisms are activated then, and what aspects of our later functioning are affected by them.
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Affiliation(s)
- Piotr Gałecki
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, Poland
| | - Monika Talarowska
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, Poland.
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Császár-Nagy N, Bókkon I. Mother-newborn separation at birth in hospitals: A possible risk for neurodevelopmental disorders? Neurosci Biobehav Rev 2018; 84:337-351. [DOI: 10.1016/j.neubiorev.2017.08.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 06/23/2017] [Accepted: 08/20/2017] [Indexed: 12/11/2022]
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Scofield DE, Proctor SP, Kardouni JR, Hill OT, McKinnon CJ. Risk Factors for Mild Traumatic Brain Injury and Subsequent Post-Traumatic Stress Disorder and Mental Health Disorders among United States Army Soldiers. J Neurotrauma 2017; 34:3249-3255. [PMID: 28895451 DOI: 10.1089/neu.2017.5101] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The purpose of this study was to determine the association of mild traumatic brain injury (mTBI) with subsequent post-traumatic stress disorder (PTSD) and mental health disorders (MHD), and the intervening role of acute stress disorder (ASD). This matched case-control study utilized the Total Army Injury and Health Outcomes Database (TAIHOD) to analyze soldiers' (n = 1,261,297) medical encounter data between 2002 and 2011. International Classification of Diseases, Ninth Revision (ICD-9) codes were used to identify: mTBI (following Centers for Disease Control [CDC] surveillance definition for mTBI), MHD (ICD-9 codes for depression and anxiety, excluding PTSD), PTSD (ICD-9 309.81), and ASD (ICD-9 308.3). Incident cases of mTBI (n = 79,505), PTSD (n = 71,454), and MHD (n = 285,731) were identified. Overall incidence rates per 1000 soldier years were: mTBI = 17.23, PTSD = 15.37, and MHD = 67.99. mTBI was associated with increased risk for PTSD (risk ratio [RR] 5.09, 95% confidence interval [CI] 4.82-5.37) and MHD (RR 2.94, 95% CI 2.84-3.04). A sub-analysis of the mTBI-only soldiers found that a diagnosis ASD, compared with a diagnosis of no ASD, was associated with greater risk for subsequent PTSD (RR 2.13, 95% CI 1.96-2.32) and MHD (RR 1.90, 95% CI 1.72-2.09) following mTBI. Results indicate that soldiers with previous mTBI have a higher risk for PTSD and MHD, and that ASD may also mediate PTSD and MHD risk subsequent to mTBI. These data may help guide important surveillance and clinical rehabilitation considerations for high-risk populations.
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Affiliation(s)
- Dennis E Scofield
- 1 US Army Research Institute of Environmental Medicine , Military Performance Division, Natick, Massachusetts
| | - Susan P Proctor
- 1 US Army Research Institute of Environmental Medicine , Military Performance Division, Natick, Massachusetts.,2 VA Boston Healthcare System , Boston, Massachusetts.,3 Boston University School of Public Health , Boston, Massachusetts
| | - Joseph R Kardouni
- 1 US Army Research Institute of Environmental Medicine , Military Performance Division, Natick, Massachusetts
| | - Owen T Hill
- 4 MEDCOM AMEDD C&S , HR CoE, JBSA/Fort Sam Houston, Texas
| | - Craig J McKinnon
- 1 US Army Research Institute of Environmental Medicine , Military Performance Division, Natick, Massachusetts
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Nwulia EA, Rai N, Sartip K, Hipolito MS, McLean CK, Flanagan K, Hamilton F, Lambert S, Le HN, VanMeter J, Kapetanovic S. A Pilot Study of Reduced Olfactory Bulb Volume as a Marker of PTSD in Childhood Trauma-Exposed Adult HIV-Infected Patients. J Trauma Stress 2017; 30:537-544. [PMID: 29077998 PMCID: PMC5679296 DOI: 10.1002/jts.22222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 06/22/2017] [Accepted: 06/30/2017] [Indexed: 12/25/2022]
Abstract
Evidence suggests that olfactory bulb (OB), a key structure in odor processing, may also be involved in mechanisms of traumatic stress. In animals, chronic stress reduces OB plasticity, and olfactory bulbectomy results in stress-enhanced startle reflex and autonomic dysregulation. However, OB morphometry has not been adequately studied in the development of stress disorders following childhood trauma in humans. The researchers conducted a pilot study evaluating the relationships between OB volume, childhood trauma, and lifetime posttraumatic stress disorder (PTSD) in a sample of 16 HIV-positive individuals, 13 of whom were exposed to childhood trauma of 9 developed PTSD. Participants were recruited from a larger cohort of inner city-dwelling HIV-positive populations in Washington, DC. Mean OB volumes were significantly reduced when PTSD and non-PTSD groups were compared, p = .019, as well as when trauma-exposed PTSD-positive and trauma-exposed PTSD-negative groups were compared, p = .008. No significant difference was observed when trauma-exposed and nonexposed participants were compared. The association between PTSD and right OB volume remained strong p = 0.002 after adjusting for group differences in sex, age, depression, hippocampal volume, and total intracranial volume. Because this study is limited by small sample size, further elucidation of relationships between OB, trauma, and PTSD should be investigated in larger cross-sectional and prospective studies and in diverse cohorts.
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Affiliation(s)
- Evaristus A. Nwulia
- Department of Psychiatry and Behavioral Sciences, Howard University, Washington, DC, USA
| | - Narayan Rai
- Department of Psychiatry and Behavioral Sciences, Howard University, Washington, DC, USA
| | - Kamyar Sartip
- Department of Radiology, Howard University, Washington, DC, USA
| | | | - Charlee K. McLean
- Department of Psychiatry and Behavioral Sciences, Howard University, Washington, DC, USA
| | - Kyla Flanagan
- Family and Medical Counseling Service, Inc., Washington, DC, USA
| | - Flora Hamilton
- Family and Medical Counseling Service, Inc., Washington, DC, USA
| | - Sharon Lambert
- Department of Psychology, George Washington University, Washington, DC, USA
| | - Huynh-Nhu Le
- Department of Psychology, George Washington University, Washington, DC, USA
| | - John VanMeter
- Department of Neurology, Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, USA
| | - Suad Kapetanovic
- Department of Psychiatry, University of Southern California, Los Angeles, California, USA
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When bullets cause psychological injuries… An essential continuity of care from debriefing to follow-up. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2017. [DOI: 10.1016/j.ejtd.2017.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mazoyer AV, Ricard A, Brulin L, Mary A. Répercussions psychiques du traumatisme de guerre sur la relation affective et amoureuse. ACTA ACUST UNITED AC 2017. [DOI: 10.3917/bupsy.549.0215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Liu C, Zhang Y, Jiang H, Wu H. Association between social support and post-traumatic stress disorder symptoms among Chinese patients with ovarian cancer: A multiple mediation model. PLoS One 2017; 12:e0177055. [PMID: 28475593 PMCID: PMC5419605 DOI: 10.1371/journal.pone.0177055] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 04/23/2017] [Indexed: 12/28/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) symptoms can develop after person experiences one or more traumatic events. Little research, however, has been done on PTSD symptoms of patients with ovarian cancer. The present study aimed to estimate the prevalence of PTSD symptoms in patients with ovarian cancer in China; the effects of demographic and clinical variables on PTSD symptoms; multiple mediation roles in the association between social support and PTSD symptoms in patients with ovarian cancer in China. We collected demographic and clinical information of patients with ovarian cancer in the first and second hospitals of China Medical University between January 1, 2014 and December 31, 2015. Qualified patients were asked to complete the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Duke-UNC Functional Social Support Questionnaire, Herth Hope Index (HHI), and Resilience Scale-14 (RS-14). 201 patients provided responses. We performed hierarchical linear regression to assess the correlation between social support and PTSD symptoms and bootstrapping to test the mediating role of hope and resilience as potential mediators. After controlling demographic and clinical characteristics, social support negatively correlated with PTSD symptoms (β = -0.406, P < 0.01). Social support explained 14.7% of the variance in PTSD symptoms. Hope and resilience explained 17.0% of the variance in PTSD symptoms. The proportion of the hope mediating effect was 43.37% for social support and the proportion of the resilience mediating effect was 10.64% for social support. Hope and resilience partly mediated the correlation between social support and PTSD symptoms despite accounting for different proportions of the mediating effect. Future intervention plans should pay more attention to social support as well as hope and resilience to prevent, relieve and treat PTSD symptoms.
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Affiliation(s)
- Chunli Liu
- Library of China Medical University, Shenyang, Liaoning, China
- Department of Social Medicine, College of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Yi Zhang
- The First Affiliated Hospital of China Medical University, Heping District, Shenyang, Liaoning, China
| | - Hong Jiang
- School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Hui Wu
- Department of Social Medicine, College of Public Health, China Medical University, Shenyang, Liaoning, China
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Simon PYR, Rousseau PF. Treatment of Post-Traumatic Stress Disorders with the Alpha-1 Adrenergic Antagonist Prazosin. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2017; 62:186-198. [PMID: 27432823 PMCID: PMC5317016 DOI: 10.1177/0706743716659275] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The present review aims to assess the clinical efficacy and safety of the α-1-adrenergic antagonist prazosin as primary pharmacologic treatment for post-traumatic stress disorder (PTSD). METHOD A systematic review was performed using keywords (i.e., prazosin, α-1-adrenergic antagonist, α-1-blocker, post-traumatic stress disorder) in the databases PubMed/Medline (1966-May 2016), Embase (1966-May 2016), ScienceDirect (1823-May 2016), OvidSP (1946-May 2016) and Nature (1845-May 2016). To be considered for inclusion, studies had to test the efficacy of prazosin either alone or added to ongoing treatment in adults with PTSD, use validated tools to assess and monitor the disorders, allow comparisons on the basis of univariate analyses (i.e., p-values of t-tests and effect sizes) and list the identified adverse reactions. RESULTS 12 studies were included: 5 randomized controlled trials, 4 open-label prospective trials and 3 retrospective file reviews. The evaluation concerned 276 patients exposed to civilian trauma (19%) or war trauma (81%). Prazosin significantly decreases trauma nightmares, avoidance, hypervigilance and improves patient status in all studies. No significant difference of blood pressure was observed at the end of trials. CONCLUSIONS Beyond the methodological and clinical biases of these studies, the present review not only confirms the effectiveness and good tolerability of prazosin, but also suggests its possible use as primary pharmacologic treatment for PTSD. Uncertainties remain, however, regarding the prescription modalities and dosages.
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Affiliation(s)
- Philippe Yves Rémy Simon
- Recherche clinique, Hôpital d’Instruction des Armées Sainte-Anne, Toulon, France
- Philippe Yves Rémy Simon, PhD, HIA Sainte-Anne, Recherche clinique, BP 20545, 83041 Toulon cedex 9, France. Courriel:
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Chang JC, Yen AMF, Chen HH, Chen SLS, Chiu SYH, Fann JCY, Lee CS. Comorbid diseases as risk factors for incident posttraumatic stress disorder (PTSD) in a large community cohort (KCIS no.PSY4). Sci Rep 2017; 7:41276. [PMID: 28128220 PMCID: PMC5269576 DOI: 10.1038/srep41276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 12/16/2016] [Indexed: 11/19/2022] Open
Abstract
Nature disasters and terrorist attacks have occurred globally in recent years. Posttraumatic stress disorder (PTSD) has gained increasing attention, but its incidence and comorbidities in the general population are different from those inside the disaster areas. The present study estimated incident PTSD and comorbid diseases for over a decade in a cohort from a community-based integrated screening program. Factors associated with the incidence of PTSD were analyzed using Cox regression models. PTSD incidence was estimated as 81 per 105 person-years. Incidence was higher in females than in males and one-year increments in age lowered the risk for PTSD by 3%. Adjusting for other factors, cardiovascular heart disease (adjusted hazard ratio (aHR) = 1.45, 95% confidence interval (CI): 1.03–2.04), bipolar disorder (aHR = 1.86, 95% CI: 1.07–3.24) and major depressive disorder (aHR = 7.03, 95% CI: 5.02–9.85) all significantly increased 45%, 86% and 603%, respectively, the risk of developing PTSD. The low rate of people with incident PTSD receiving treatment in this community health screening population implies there is room for improvement in terms of early detection and intervention. Clinical preventive efforts may be made for patients seeking general medical help, especially those with cardiovascular disorders or mood disorders.
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Affiliation(s)
- Jung-Chen Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; National Taiwan University Hospital, Taipei, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiu-Hsi Chen
- Division of Biostatistics, Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sherry Yueh-Hsia Chiu
- Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan
| | - Jean Ching-Yuan Fann
- Department of Health Industry Management, College of Healthcare Management, Kainan University, Taoyuan County, Taiwan
| | - Chau-Shoun Lee
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
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Ribeton M, Houbre B, Andréani B, Kahn JP, Tarquinio C, Fidelle G, Auxéméry Y. « Reconnaissance » et « réparation » des troubles psychiques de guerre : le point de vue des patients. Partie 1 : analyse lexicale du discours de 15 militaires blessés psychiques de guerre. ANNALES MEDICO-PSYCHOLOGIQUES 2016. [DOI: 10.1016/j.amp.2016.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bandelow B, Baldwin D, Abelli M, Altamura C, Dell'Osso B, Domschke K, Fineberg NA, Grünblatt E, Jarema M, Maron E, Nutt D, Pini S, Vaghi MM, Wichniak A, Zai G, Riederer P. Biological markers for anxiety disorders, OCD and PTSD - a consensus statement. Part I: Neuroimaging and genetics. World J Biol Psychiatry 2016; 17:321-65. [PMID: 27403679 DOI: 10.1080/15622975.2016.1181783] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). METHODS Findings in biomarker research were reviewed by a task force of international experts in the field, consisting of members of the World Federation of Societies for Biological Psychiatry Task Force on Biological Markers and of the European College of Neuropsychopharmacology Anxiety Disorders Research Network. RESULTS The present article (Part I) summarises findings on potential biomarkers in neuroimaging studies, including structural brain morphology, functional magnetic resonance imaging and techniques for measuring metabolic changes, including positron emission tomography and others. Furthermore, this review reports on the clinical and molecular genetic findings of family, twin, linkage, association and genome-wide association studies. Part II of the review focuses on neurochemistry, neurophysiology and neurocognition. CONCLUSIONS Although at present, none of the putative biomarkers is sufficient and specific as a diagnostic tool, an abundance of high-quality research has accumulated that will improve our understanding of the neurobiological causes of anxiety disorders, OCD and PTSD.
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Affiliation(s)
- Borwin Bandelow
- a Department of Psychiatry and Psychotherapy , University of Göttingen , Germany
| | - David Baldwin
- b Faculty of Medicine , University of Southampton , Southampton , UK
| | - Marianna Abelli
- c Department of Clinical and Experimental Medicine , Section of Psychiatry, University of Pisa , Italy
| | - Carlo Altamura
- d Department of Psychiatry , University of Milan; Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Bernardo Dell'Osso
- d Department of Psychiatry , University of Milan; Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Katharina Domschke
- e Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Germany
| | - Naomi A Fineberg
- f Hertfordshire Partnership University NHS Foundation Trust and University of Hertfordshire , Rosanne House, Parkway , Welwyn Garden City , UK
| | - Edna Grünblatt
- e Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Germany ;,g Neuroscience Center Zurich , University of Zurich and the ETH Zurich , Zürich , Switzerland ;,h Department of Child and Adolescent Psychiatry and Psychotherapy , Psychiatric Hospital, University of Zurich , Zürich , Switzerland ;,i Zurich Center for Integrative Human Physiology , University of Zurich , Switzerland
| | - Marek Jarema
- j Third Department of Psychiatry , Institute of Psychiatry and Neurology , Warszawa , Poland
| | - Eduard Maron
- k North Estonia Medical Centre, Department of Psychiatry , Tallinn , Estonia ;,l Department of Psychiatry , University of Tartu , Estonia ;,m Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences , Imperial College London , UK
| | - David Nutt
- m Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences , Imperial College London , UK
| | - Stefano Pini
- c Department of Clinical and Experimental Medicine , Section of Psychiatry, University of Pisa , Italy
| | - Matilde M Vaghi
- n Department of Psychology and Behavioural and Clinical Neuroscience Institute , University of Cambridge , UK
| | - Adam Wichniak
- j Third Department of Psychiatry , Institute of Psychiatry and Neurology , Warszawa , Poland
| | - Gwyneth Zai
- n Department of Psychology and Behavioural and Clinical Neuroscience Institute , University of Cambridge , UK ;,o Neurogenetics Section, Centre for Addiction & Mental Health , Toronto , Canada ;,p Frederick W. Thompson Anxiety Disorders Centre, Department of Psychiatry, Sunnybrook Health Sciences Centre , Toronto , Canada ;,q Institute of Medical Science and Department of Psychiatry, University of Toronto , Toronto , Canada
| | - Peter Riederer
- e Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Germany ;,g Neuroscience Center Zurich , University of Zurich and the ETH Zurich , Zürich , Switzerland ;,h Department of Child and Adolescent Psychiatry and Psychotherapy , Psychiatric Hospital, University of Zurich , Zürich , Switzerland
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Starcevic A, Petricevic S, Radojicic Z, Djulejic V, Ilankovic A, Starcevic B, Filipovic B. Glucocorticoid levels after exposure to predator odor and chronic psychosocial stress with dexamethasone application in rats. Kaohsiung J Med Sci 2016; 32:235-40. [PMID: 27316581 DOI: 10.1016/j.kjms.2016.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022] Open
Abstract
This study was conducted to explore the effects of specific psychosocial paradigm on predator animal posttraumatic stress model and to test the hypothesis that psychosocially stressed rats would exibit abnormal levels of cortisol and a larger suppression of cortisol levels after the application of dexamethasone. Animals were divided in two groups: experimental and control groups. The experimental group was exposed to two types of stressors: acute immobilization stress, and combined predator stress and daily social stress with application of dexamethasone. Blood sampling was performed at three different times. We found statistically significant results after analyzing the differences between cortisol levels in different times of blood sampling in the group of animals exposed to stress with dexamethasone application. Statistical significance was found when we compared the experimental group with the control group in terms of elevated cortisol levels during blood sampling after stress paradigm exposition. Many significant disruptions in the functioning of the hypothalamic-pituitary-adrenal axis were observed, such as decrease in basal cortisol levels and enhanced dexamethasone-induced inhibition of cortisol levels. These findings are important because their impact can translate to human individuals with posttraumatic stress disorder, which is the most important role of every animal model in research.
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Affiliation(s)
- Ana Starcevic
- Institute of Anatomy, Medical Faculty, University of Belgrade, Belgrade, Serbia.
| | - Sasa Petricevic
- Institute for Biochemistry, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Zoran Radojicic
- Faculty for Organisational Sciences, University of Belgrade, Belgrade, Serbia
| | - Vuk Djulejic
- Institute of Anatomy, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Andrej Ilankovic
- Psychiatry Clinic, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Branislav Starcevic
- Orthopaedic Clinic, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Branislav Filipovic
- Institute of Anatomy, Medical Faculty, University of Belgrade, Belgrade, Serbia
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Delannoy J, Mandai O, Honoré J, Kobayashi T, Sequeira H. Diurnal Emotional States Impact the Sleep Course. PLoS One 2015; 10:e0142721. [PMID: 26606526 PMCID: PMC4659651 DOI: 10.1371/journal.pone.0142721] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 10/26/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Diurnal emotional experiences seem to affect several characteristics of sleep architecture. However, this influence remains unclear, especially for positive emotions. In addition, electrodermal activity (EDA), a sympathetic robust indicator of emotional arousal, differs depending on the sleep stage. The present research has a double aim: to identify the specific effects of pre-sleep emotional states on the architecture of the subsequent sleep period; to relate such states to the sympathetic activation during the same sleep period. METHODS Twelve healthy volunteers (20.1 ± 1.0 yo.) participated in the experiment and each one slept 9 nights at the laboratory, divided into 3 sessions, one per week. Each session was organized over three nights. A reference night, allowing baseline pre-sleep and sleep recordings, preceded an experimental night before which participants watched a negative, neutral, or positive movie. The third and last night was devoted to analyzing the potential recovery or persistence of emotional effects induced before the experimental night. Standard polysomnography and EDA were recorded during all the nights. RESULTS Firstly, we found that experimental pre-sleep emotional induction increased the Rapid Eye Movement (REM) sleep rate following both negative and positive movies. While this increase was spread over the whole night for positive induction, it was limited to the second half of the sleep period for negative induction. Secondly, the valence of the pre-sleep movie also impacted the sympathetic activation during Non-REM stage 3 sleep, which increased after negative induction and decreased after positive induction. CONCLUSION Pre-sleep controlled emotional states impacted the subsequent REM sleep rate and modulated the sympathetic activity during the sleep period. The outcomes of this study offer interesting perspectives related to the effect of diurnal emotional influences on sleep regulation and open new avenues for potential practices designed to alleviate sleep disturbances.
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Affiliation(s)
- Julien Delannoy
- SCALab, CNRS UMR 9193, Université de Lille, Lille, France
- * E-mail: or (JD); (HS)
| | - Osamu Mandai
- Sleep Research Center, Ashikaga Institute of Technology, Ashikaga, Japan
| | - Jacques Honoré
- SCALab, CNRS UMR 9193, Université de Lille, Lille, France
| | | | - Henrique Sequeira
- SCALab, CNRS UMR 9193, Université de Lille, Lille, France
- Neurosciences, UFR Biologie, Université de Lille, Lille, France
- * E-mail: or (JD); (HS)
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Vitriol V, Cancino A, Weil K, Salgado C, Asenjo MA, Potthoff S. Depression and psychological trauma: an overview integrating current research and specific evidence of studies in the treatment of depression in public mental health services in chile. DEPRESSION RESEARCH AND TREATMENT 2014; 2014:608671. [PMID: 24695633 PMCID: PMC3948592 DOI: 10.1155/2014/608671] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 11/02/2013] [Accepted: 11/18/2013] [Indexed: 12/20/2022]
Abstract
In the last two decades, different research has demonstrated the high prevalence of childhood trauma, including sexual abuse, among depressive women. These findings are associated with a complex, severe, and chronic psychopathology. This can be explained considering the neurobiological changes secondary to early trauma that can provoke a neuroendocrine failure to compensate in response to challenge. It suggests the existence of a distinguishable clinical-neurobiological subtype of depression as a function of childhood trauma that requires specific treatments. Among women with depression and early trauma receiving treatment in a public mental health service in Chile, it was demonstrated that a brief outpatient intervention (that screened for and focused on childhood trauma and helped patients to understand current psychosocial difficulties as a repetition of past trauma) was effective in reducing psychiatric symptoms and improving interpersonal relationships. However, in this population, this intervention did not prevent posttraumatic stress disorder secondary to the extreme earthquake that occurred in February 2010. Therefore in adults with depression and early trauma, it is necessary to evaluate prolonged multimodal treatments that integrate pharmacotherapy, social support, and interpersonal psychotherapies with trauma focused interventions (specific interventions for specific traumas).
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Affiliation(s)
- Verónica Vitriol
- Department of Psychiatry, Medical School, Universidad de Talca, Chile
- Mental Unit Hospital de Curicó, Curicó, Chile
| | - Alfredo Cancino
- Communal Mental Health Program, Communal Health Department of Curicó, Chile
- Mental Health Formative Practices, Medical School, Universidad de Talca, Chile
| | - Kristina Weil
- Department of Psychiatry, Medical School, Universidad de los Andes, Santiago de Chile, Chile
| | - Carolina Salgado
- Department of Psychiatry, Universidad de Talca, Chile
- Mental Health Unit, Hospital de Talca, Chile
| | | | - Soledad Potthoff
- Department of Psychiatry, Universidad de Talca, Chile
- Mental Health Unit, Hospital de Talca, Chile
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Auxéméry Y. Vers une possible évolution fiable et valide de la nosographie psychiatrique moderne ? Analyse critique des origines du DSM-III aux hypothèses actuelles. EVOLUTION PSYCHIATRIQUE 2014. [DOI: 10.1016/j.evopsy.2013.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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L’exposition traumatique du sujet dit « névrosé » : destinée ou rencontre fortuite ? Aller au-devant et au-delà de l’évènement traumatique : de la confrontation traumatique désertifiée par le langage à la voie psychothérapique. EVOLUTION PSYCHIATRIQUE 2013. [DOI: 10.1016/j.evopsy.2013.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Schoedl AF, Costa MP, Fossaluza V, Mari JJ, Mello MF. Specific traumatic events during childhood as risk factors for posttraumatic stress disorder development in adults. J Health Psychol 2013; 19:847-57. [PMID: 23520354 DOI: 10.1177/1359105313481074] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
To evaluate differences in early life events (ELE) on adult victims of severe interpersonal violence among patients who developed posttraumatic stress disorder (PTSD) and control group. Adult victims of interpersonal violence were evaluated to diagnose the presence of PTSD and ELE. 308 subjects were included, 141 in patient's group (PTSD+) and 167 in control group (PSTD-). PTSD+ group had more severe PTSD, depressive symptoms and higher ETI scores than PTSD- group. Patients in PTSD+ group had a more frequent history of ELE. Some ELE were more significant for the development of this predisposition.
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