1
|
O'Donohue MP, Amir Hamzah K, Nichols D, Ney LJ. Trauma film viewing and intrusive memories: Relationship between salivary alpha amylase, endocannabinoids, and cortisol. Psychoneuroendocrinology 2024; 164:107007. [PMID: 38503195 DOI: 10.1016/j.psyneuen.2024.107007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/14/2024] [Accepted: 02/26/2024] [Indexed: 03/21/2024]
Abstract
The endogenous cannabinoid (ECB) system is a small molecule lipid signalling system that is involved in stress response activation and is associated with PTSD, but it is unclear whether salivary ECBs are part of the sympathetic nervous system response to stress. We conducted an adapted trauma film paradigm, where participants completed a cold pressor test (or control) while watching a 10-minute trauma film. We also collected saliva and hair samples and tested them for ECBs, cortisol, and salivary alpha amylase (sAA). As hypothesised, there were significant positive correlations between sAA activity and salivary ECB levels, particularly 2-arachidonoyl glycerol (2-AG), though ECBs were not correlated with sAA stress reactivity. Participants who had a significant cortisol response to the trauma film/stressor reported less intrusive memories, which were also less distressing and less vivid. This effect was moderated by arachidonoyl ethanolamide (AEA), where decreases in AEA post-stress were associated with more intrusive memories in cortisol non-responders only. This study provides new evidence for the role of ECBs in the sympathetic nervous system.
Collapse
Affiliation(s)
- Matthew P O'Donohue
- School of Psychology and Counselling, Queensland University of Technology, Australia
| | - Khalisa Amir Hamzah
- School of Psychology and Counselling, Queensland University of Technology, Australia
| | - David Nichols
- Central Science Laboratory, University of Tasmania, Australia
| | - Luke J Ney
- School of Psychology and Counselling, Queensland University of Technology, Australia.
| |
Collapse
|
2
|
Soares LA, Nascimento LMM, Guimarães FS, Gazarini L, Bertoglio LJ. Dual-step pharmacological intervention for traumatic-like memories: implications from D-cycloserine and cannabidiol or clonidine in male and female rats. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06596-8. [PMID: 38691149 DOI: 10.1007/s00213-024-06596-8] [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: 01/11/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Abstract
RATIONALE Therapeutic approaches to mitigating traumatic memories have often faced resistance. Exploring safe reconsolidation blockers, drugs capable of reducing the emotional valence of the memory upon brief retrieval and reactivation, emerges as a promising pharmacological strategy. Towards this objective, preclinical investigations should focus on aversive memories resulting in maladaptive outcomes and consider sex-related differences to enhance their translatability. OBJECTIVES After selecting a relatively high training magnitude leading to the formation of a more intense and generalized fear memory in adult female and male rats, we investigated whether two clinically approved drugs disrupting its reconsolidation remain effective. RESULTS We found resistant reconsolidation impairment by the α2-adrenergic receptor agonist clonidine or cannabidiol, a major non-psychotomimetic Cannabis sativa component. However, pre-retrieval administration of D-cycloserine, a partial agonist at the glycine-binding site of the N-methyl-D-aspartate (NMDA) receptor complex, facilitated their impairing effects on reconsolidation. A similar reconsolidation blockade by clonidine or cannabidiol was achieved following exposure to a non-conditioned but generalized context after D-cycloserine administration. This suggests that sufficient memory destabilization can accompany generalized fear expression. Combining clonidine with cannabidiol without potentiating memory destabilization by D-cycloserine was ineffective. CONCLUSIONS These findings highlight the importance of NMDA receptor signaling in memory destabilization and underscore the efficacy of a dual-step pharmacological intervention in attenuating traumatic-like memories, even in a context different from the original learning environment.
Collapse
Affiliation(s)
- Luciane A Soares
- Departamento de Farmacologia, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Laura M M Nascimento
- Departamento de Farmacologia, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | | | - Lucas Gazarini
- Universidade Federal de Mato Grosso Do Sul, Três Lagoas, MS, Brazil
| | - Leandro J Bertoglio
- Universidade Federal de Mato Grosso Do Sul, Três Lagoas, MS, Brazil.
- Depto. de Farmacologia, CCB, UFSC, Campus Universitário S/N, Florianópolis, SC, 88049-900, Brazil.
| |
Collapse
|
3
|
Peltier MR, Verplaetse TL, Altemus M, Zakiniaeiz Y, Ralevski EA, Mineur YS, Gueorguieva R, Picciotto MR, Cosgrove KP, Petrakis I, McKee SA. The role of neurosteroids in posttraumatic stress disorder and alcohol use disorder: A review of 10 years of clinical literature and treatment implications. Front Neuroendocrinol 2024; 73:101119. [PMID: 38184208 PMCID: PMC11185997 DOI: 10.1016/j.yfrne.2023.101119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/08/2023] [Accepted: 12/31/2023] [Indexed: 01/08/2024]
Abstract
Rates of alcohol use disorder (AUD) are increasing in men and women and there are high rates of concurrent posttraumatic stress disorder (PTSD) and AUD. AUD and PTSD synergistically increase symptomatology and negatively affect treatment outcomes; however, there are very limited pharmacological treatments for PTSD/AUD. Neurosteroids have been implicated in the underlying neurobiological mechanisms of both PTSD and AUD and may be a target for treatment development. This review details the past ten years of research on pregnenolone, progesterone, allopregnanolone, pregnanolone, estradiol, testosterone and dehydroepiandrosterone/dehydroepiandrosterone-sulfate (DHEA/DHEA-S) in the context of PTSD and AUD, including examination of trauma/alcohol-related variables, such as stress-reactivity. Emerging evidence that exogenous pregnenolone, progesterone, and allopregnanolone may be promising, novel interventions is also discussed. Specific emphasis is placed on examining the application of sex as a biological variable in this body of literature, given that women are more susceptible to both PTSD diagnoses and stress-related alcohol consumption.
Collapse
Affiliation(s)
- MacKenzie R Peltier
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA; National Center for PTSD, Clinical Neuroscience Division, West Haven, CT 06516, USA.
| | | | - Margaret Altemus
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA
| | - Yasmin Zakiniaeiz
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| | - Elizabeth A Ralevski
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA
| | - Yann S Mineur
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| | - Ralitza Gueorguieva
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Department of Biostatistics, School of Public Health, Yale University, New Haven, CT, USA
| | - Marina R Picciotto
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| | - Kelly P Cosgrove
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; National Center for PTSD, Clinical Neuroscience Division, West Haven, CT 06516, USA; Department of Radiology and Biomedical Imaging, School of Medicine, Yale University, New Haven, CT, USA
| | - Ismene Petrakis
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; VA Connecticut Healthcare System, Mental Health Service, West Haven, CT 06516, USA; National Center for PTSD, Clinical Neuroscience Division, West Haven, CT 06516, USA
| | - Sherry A McKee
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| |
Collapse
|
4
|
Valdés-Badilla P, Guzmán-Muñoz E, Herrera-Valenzuela T, Branco BHM, Hernandez-Martinez J, Nobari H. Impact of adapted taekwondo vs. multicomponent training on health status in independent older women: a randomized controlled trial. Front Public Health 2023; 11:1236402. [PMID: 37886049 PMCID: PMC10598459 DOI: 10.3389/fpubh.2023.1236402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/29/2023] [Indexed: 10/28/2023] Open
Abstract
This study, called the TKD and Aging Project, aimed to analyze and compare the effects of an adapted taekwondo program concerning multicomponent training on blood pressure, morphological variables, food consumption frequency, health-related quality of life (HRQoL), physical fitness, handgrip strength, and postural balance in independent older women. A randomized controlled trial study was conducted with parallel groups for 8 weeks (24 sessions of 60 min each), employing a double-blind design and incorporating repeated measures. Twenty-eight older women initially participated in the intervention. Three participants were excluded because they did not participate in the re-assessments. Thus, 14 older women from the adapted taekwondo group (TKD; age: 62.86 ± 2.38 years) and 11 from the multicomponent training group (MCT; age: 63.18 ± 1.94 years) participated in the final analysis. A two-factor mixed analysis of variance (ANOVA) model with repeated measures was performed to measure the time × group effect. The TKD showed significant improvements in the mental health (p = 0.024; ES = 0.91) and general health (p < 0.001; ES = 0.75) dimensions of the HRQoL, as well as in the chair stand (p = 0.001; ES = 1.18), arm curl (p < 0.001; ES = 2.10), 2-min step (p < 0.001; ES = 1.73), and chair sit-and-reach (p = 0.001; ES = 0.91) tests. Additionally, it showed a significant reduction in postural balance for the eyes-closed condition in the center of the pressure area (p = 0.021; ES = 0.89), mean velocity (p = 0.004; ES = 0.79), and mediolateral velocity (p < 0.001; ES = 1.26). However, the MCT showed significant increases in the general health (p = 0.013; ES = 0.95) dimension of the HRQoL and a significant reduction (p = 0.039; ES = 0.28) in the mediolateral velocity of postural balance for the eyes-closed condition. Multiple comparisons showed that the TKD scored significantly higher in the chair stand (p = 0.017; ES = 1.79), arm curl (p = 0.003; ES = 1.77), and 2-min step (p = 0.018; ES = 0.91) tests than the MCT. Compared to multicomponent training, taekwondo improves postural balance and provides better benefits in terms of physical fitness and HRQoL for older women. Therefore, it is possible to recommend it as a safe physical activity strategy, as long as it is well-dosed, since it showed high adherence to intervention in older women.
Collapse
Affiliation(s)
- Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar, Chile
| | - Eduardo Guzmán-Muñoz
- School of Kinesiology, Faculty of Health, Universidad Santo Tomás, Talca, Chile
- School of Kinesiology, Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
| | - Tomás Herrera-Valenzuela
- Department of Physical Activity, Sports and Health Sciences, Faculty of Medical Sciences, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | | | - Jordan Hernandez-Martinez
- Programa de Investigación en Deporte, Sociedad y Buen Vivir, Universidad de los Lagos, Osorno, Chile
- Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno, Chile
| | - Hadi Nobari
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| |
Collapse
|
5
|
Lami A, Giacomelli G, Lenzi J, Alvisi S, Seracchioli R, Meriggiola MC. The COVID-19 Pandemic Impact on the Psychophysical Health of Post-Menopausal Women: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1154. [PMID: 37374358 DOI: 10.3390/medicina59061154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/30/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: The aim of this study was to investigate lifestyle, menopausal symptoms, depression, post-traumatic stress disorder (PTSD) and sleep disorders in post-menopausal women throughout the first wave of the COVID-19 pandemic, including the impact of menopause hormonal therapy (HT). Materials and Methods: Post-menopausal women were given the following questionnaires: socio-demographic characteristics; lifestyle; history of COVID-19; menopause-specific quality of life (MENQOL), the first part of which refers to the pre-pandemic period ("pre COVID-19") and the second refers to the current period ("during COVID-19"); Beck's depression inventory (BDI); the impact of event scale-revised (IES-R); and the Pittsburgh sleep quality index (PSQI). Results: One hundred and twenty-six women completed all questionnaires, with a mean age of 55.5 ± 6.0 years. The mean menopause duration was 5.7 ± 5.6 years. Twenty-four women were taking HT. A significant mean weight gain, a reduction in physical activity (respectively p < 0.001) and worsened quality of romantic relationships (p = 0.001) were reported during the pandemic. Menopausal symptoms did not vary significantly throughout the pandemic; however, women taking menopausal HT had lower physical (p = 0.003) and sexual (p = 0.049) MENQOL domain scores, lower depressive symptoms (p = 0.039) and better romantic relationships (p = 0.008). Conclusions: The COVID-19 pandemic caused reduced physical activity, worsened food habits and weight gain in post-menopausal women. They also reported a high rate of severe-moderate PTSD and a negative influence on their romantic relationships. Menopausal HT seems to be a potential protective factor for sexual and physical status and for symptoms of depression.
Collapse
Affiliation(s)
- Alessandra Lami
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Giulia Giacomelli
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Stefania Alvisi
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Renato Seracchioli
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Maria Cristina Meriggiola
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| |
Collapse
|
6
|
Slompo NR, Alves AM, Chociay Junior S, Feitosa GT, Dos Santos EM, Luchesi BM, Martins TCR. Factors Associated with Symptoms of Posttraumatic Stress in Mothers During the COVID-19 Pandemic. Matern Child Health J 2023:10.1007/s10995-023-03723-3. [PMID: 37273138 DOI: 10.1007/s10995-023-03723-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The objective of the study was to evaluate the factors associated with symptoms of posttraumatic stress in mothers during the COVID-19 pandemic. METHODS Cross-sectional study conducted with mothers of children and adolescents living in Brazil, who answered an online questionnaire containing sociodemographic variables and the Impact of Events Scale-Revised. The Poisson regression model with robust variance was used to identify the factors associated with posttraumatic stress. RESULTS A percentage of 83.82% of mothers reported an overload in caring for their children during the pandemic. The prevalence of posttraumatic stress symptoms was 39.05%, and this condition was associated with younger age, living in the northern region of the country, using medications, presenting neuropsychiatric comorbidities and being little/more or less satisfied with life. CONCLUSIONS FOR PRACTICE The mental health situation of mothers during and after the pandemic must be monitored, in order to guarantee public policies capable of optimizing the coping with the situation.
Collapse
Affiliation(s)
- Nayara Ribeiro Slompo
- Federal University of Mato Grosso do Sul, Undergraduate Medical School, Três Lagoas Campus, Três Lagoas, MS, Brazil
| | - Aline Martins Alves
- Federal University of Mato Grosso do Sul, Undergraduate Medical School, Três Lagoas Campus, Três Lagoas, MS, Brazil
| | - Sergio Chociay Junior
- Faculdade de Medicina (FAMED), Federal University of Mato Grosso do Sul, Undergraduate Medical School, Campo Grande, MS, Brazil
| | - Guilherme Tosi Feitosa
- Federal University of Mato Grosso do Sul, Undergraduate Medical School, Três Lagoas Campus, Três Lagoas, MS, Brazil
| | - Edirlei Machado Dos Santos
- Graduate Program in Nursing, Federal University of Mato Grosso do Sul, Três Lagoas Campus, Três Lagoas, MS, Brazil
| | - Bruna Moretti Luchesi
- Federal University of Mato Grosso do Sul, Undergraduate Medical School, Três Lagoas Campus, Três Lagoas, MS, Brazil
- Graduate Program in Nursing, Federal University of Mato Grosso do Sul, Três Lagoas Campus, Três Lagoas, MS, Brazil
| | - Tatiana Carvalho Reis Martins
- Federal University of Mato Grosso do Sul, Undergraduate Medical School, Três Lagoas Campus, Três Lagoas, MS, Brazil.
- Graduate Program in Nursing, Federal University of Mato Grosso do Sul, Três Lagoas Campus, Três Lagoas, MS, Brazil.
| |
Collapse
|
7
|
Maslahati T, Wingenfeld K, Hellmann-Regen J, Kraft J, Lyu J, Keinert M, Voß A, Cho AB, Ripke S, Otte C, Schultebraucks K, Roepke S. Oxytocin vs. placebo effects on intrusive memory consolidation using a trauma film paradigm: a randomized, controlled experimental study in healthy women. Transl Psychiatry 2023; 13:42. [PMID: 36739422 PMCID: PMC9899212 DOI: 10.1038/s41398-023-02339-z] [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: 10/14/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 02/06/2023] Open
Abstract
Oxytocin administration during a trauma analogue has been shown to increase intrusive memories, which are a core symptom of post-traumatic stress disorder (PTSD). However, it is unknown whether oxytocin influences the acquisition or the consolidation of the trauma. The current study investigates the effect of the activation of the oxytocin system during the consolidation of an analogue trauma on the formation of intrusive memories over four consecutive days and whether this effect is influenced by individual neurobiological, genetic, or psychological factors. We conducted a randomized double-blind placebo-controlled study in 217 healthy women. They received either a single dose of intranasal oxytocin (24 IU) or placebo after exposure to a trauma film paradigm, which reliably induces intrusive memories. We used a general random forest to examine a potential heterogeneous treatment effect of oxytocin on the consolidation of intrusive memories. Furthermore, we used a poisson regression to examine whether salivary alpha amylase activity (sAA) as a marker of noradrenergic activity and cortisol response to the film, polygenic risk score (PRS) for psychiatric disorders, and psychological factors influence the number of intrusive memories. We found no significant effect of oxytocin on the formation of intrusive memories (F(2, 543.16) = 0.75, p = 0.51, ηp2 = 0.00) and identified no heterogeneous treatment effect. We replicated previous associations of the PRS for PTSD, sAA and the cortisol response on intrusive memories. We further found a positive association between high trait anxiety and intrusive memories, and a negative association between the emotion regulation strategy reappraisal and intrusive memories. Data of the present study suggest that the consolidation of intrusive memories in women is modulated by genetic, neurobiological and psychological factors, but is not influenced by oxytocin. Trial registration: NCT03875391.
Collapse
Affiliation(s)
- Tolou Maslahati
- Department of Psychiatry and Psychotherapy, CBF, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - Katja Wingenfeld
- Department of Psychiatry and Psychotherapy, CBF, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Julian Hellmann-Regen
- Department of Psychiatry and Psychotherapy, CBF, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Julia Kraft
- Department of Psychiatry and Psychotherapy, CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jing Lyu
- Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, NY, USA
| | - Marie Keinert
- Department of Psychiatry and Psychotherapy, CBF, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Aline Voß
- Department of Psychiatry and Psychotherapy, CBF, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - An Bin Cho
- Department of Psychiatry and Psychotherapy, CBF, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Christian Otte
- Department of Psychiatry and Psychotherapy, CBF, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Katharina Schultebraucks
- Department of Psychiatry and Psychotherapy, CBF, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA.,Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Stefan Roepke
- Department of Psychiatry and Psychotherapy, CBF, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
8
|
Sürme Y, Özmen N, Ertürk Arik B. Fear of COVID-19 and Related Factors in Emergency Department Patients. Int J Ment Health Addict 2023; 21:28-36. [PMID: 34220384 PMCID: PMC8241404 DOI: 10.1007/s11469-021-00575-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
This study was aimed to determine the fear of COVID-19 and related factors in patients. This study was conducted with 639 patients who were admitted to the emergency department. Data were collected using the sociodemographic characteristics form, Fear of COVID-19 scale (FCV-19S). The data were evaluated with Student's t-test to compare two groups and one-way ANOVA and post hoc Tukey's honestly significant difference (HSD) more than two groups. Multiple linear regression analysis was used to determine the relationship between dependent and independent variables. The mean age of patients was 46.12 ± 17.02, 53.4% were male, 70.7% were married, 42.4% had a chronic disease, 18.3% stated that they had symptoms of COVID-19, and 38.0% stated that they experienced economic difficulties due to COVID-19. The COVID-19 fear scores were significantly higher in 57 ages and over, female, had lung disease, had COVID-19 symptoms, and had children. Having a lung disease, female gender, and fear of COVID-19 were statistically significantly correlated with FCV-19S scores. As a result, it was determined that patients admitted to the emergency department had fear of COVID-19. Further research is recommended to support our study findings. As an emergency nurse, strategies must be developed to cope with these fears.
Collapse
Affiliation(s)
- Yeliz Sürme
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Nurten Özmen
- Emergency Room Nurse, Tomarza Yaşar Karayel State Hospital, Kayseri, Turkey
| | | |
Collapse
|
9
|
Cawley E, Piazza G, Das RK, Kamboj SK. A systematic review of the pharmacological modulation of autobiographical memory specificity. Front Psychol 2022; 13:1045217. [PMID: 36452391 PMCID: PMC9703074 DOI: 10.3389/fpsyg.2022.1045217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/27/2022] [Indexed: 08/31/2023] Open
Abstract
Background Over-general autobiographical memory (AM) retrieval is proposed to have a causal role in the maintenance of psychological disorders like depression and PTSD. As such, the identification of drugs that modulate AM specificity may open up new avenues of research on pharmacological modeling and treatment of psychological disorders. Aim The current review summarizes randomized, placebo-controlled studies of acute pharmacological modulation of AM specificity. Method A systematic search was conducted of studies that examined the acute effects of pharmacological interventions on AM specificity in human volunteers (healthy and clinical participants) measured using the Autobiographical Memory Test. Results Seventeen studies were identified (986 total participants), of which 16 were judged to have low risk of bias. The presence and direction of effects varied across drugs and diagnostic status of participants (clinical vs. healthy volunteers). The most commonly studied drug-hydrocortisone-produced an overall impairment in AM specificity in healthy volunteers [g = -0.28, CI (-0.53, -0.03), p = 0.03], although improvements were reported in two studies of clinical participants. In general, studies of monoamine modulators reported no effect on specificity. Conclusion Pharmacological enhancement of AM specificity is inconsistent, although monaminergic modulators show little promise in this regard. Drugs that reduce AM specificity in healthy volunteers may be useful experimental-pharmacological tools that mimic an important transdiagnostic impairment in psychological disorders. Systematic review registration PROSPERO, identifier CRD42020199076, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020199076.
Collapse
Affiliation(s)
- Emma Cawley
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | | | | | | |
Collapse
|
10
|
Valdés-Badilla P, Alarcón-Rivera M, Hernandez-Martinez J, Herrera-Valenzuela T, Branco BHM, Núñez-Espinosa C, Guzmán-Muñoz E. Factors Associated with Poor Health-Related Quality of Life in Physically Active Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13799. [PMID: 36360685 PMCID: PMC9655056 DOI: 10.3390/ijerph192113799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to associate morphological variables and physical fitness with health-related quality of life (HRQoL) in physically active older people. A cross-sectional study was carried out that evaluated 470 older people (89.57% female) with a mean age of 70.13 ± 6.57 years, residing in two regions of Chile. Morphological variables (body weight, bipedal height, waist circumference, body mass index, and waist to height ratio), physical fitness through the Senior Fitness Test protocol, and HRQoL using the SF-36 questionnaire were obtained. Logistic regression analysis was used to identify risk factors between morphological variables and physical fitness associated with HRQoL. The main results indicated that overweight (OR = 1.52; p = 0.034), a waist circumference with risk (OR = 1.56; p = 0.021), poor performance in the back scratch tests (OR = 1.02; p = 0.008) and timed up-and-go (OR = 1.19; p = 0.040) increased the probability of having a low general HRQoL. Also, the low performance of chair stand and arm curl tests was associated with poor physical and social dimensions of HRQoL (p < 0.05). In conclusion, a low HRQoL in physically active older people is associated with both morphological and physical fitness factors.
Collapse
Affiliation(s)
- Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3460000, Chile
- School of Education, Universidad Viña del Mar, Viña del Mar 2520000, Chile
| | | | - Jordan Hernandez-Martinez
- Programa de Investigación en Deporte, Sociedad y Buen Vivir, Universidad de los Lagos, Osorno 5290000, Chile
- Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno 5290000, Chile
| | - Tomás Herrera-Valenzuela
- Department of Physical Activity, Sports and Health Sciences, Faculty of Medical Sciences, Universidad de Santiago de Chile (USACH), Santiago 8370003, Chile
| | | | - Cristian Núñez-Espinosa
- School of Medicine, University of Magallanes, Punta Arenas 6200000, Chile
- Centro Asistencial Docente y de Investigación, Universidad de Magallanes, Punta Arenas 6200000, Chile
- Interuniversity Center for Healthy Aging, Punta Arenas 6200000, Chile
| | - Eduardo Guzmán-Muñoz
- School of Kinesiology, Faculty of Health, Universidad Santo Tomás, Talca 3460000, Chile
- School of Kinesiology, Faculty of Health Sciences, Universidad Autónoma de Chile, Talca 3460000, Chile
| |
Collapse
|
11
|
Kibria MG, Islam T, Islam MT, Kabir R, Ahmed S, Sultana P. Stigma and its associated factors among patients with COVID-19 in Dhaka City: evidence from a cross-sectional investigation. PeerJ 2022; 10:e14092. [PMID: 36221262 PMCID: PMC9548314 DOI: 10.7717/peerj.14092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/30/2022] [Indexed: 01/20/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has become a significant disease pandemic. Dhaka City alone has contributed about one-third to the total COVID-19 cases in Bangladesh. Globally, patients with infectious diseases, including COVID-19, experience stigma. There was no quantitative estimate of stigma experienced by patients with COVID-19 in the country. Therefore, this study aimed to assess the prevalence of stigma and its associated factors among patients with COVID-19 in Dhaka. Methods A cross-sectional study was conducted among 384 respondents aged 18 years or older who had been hospitalized or had stayed at home and were tested negative 15 days to 6 months before the day of data collection. Data collection was done through in-person and telephone interviews using a semi-structured survey questionnaire. A 15-item COVID-19-related stigma scale questionnaire was used to assess stigma. Binary logistic regression analysis was performed to identify the predictors of stigma. Results More than half (53.1%) of the respondents experienced stigma when they were COVID-19 positive. Females were at a 3.24 times higher risk of experiencing stigma than their male counterparts. Respondents from the 60+ age group and 40-59 age group were 63.0% and 48.0% less likely to experience stigma than those from the 18-39 age group. Non-hospitalised patients had 1.67 times higher odds of facing stigma than those hospitalised. Conclusions This study reported a high prevalence of stigma among the patients with COVID-19 in Dhaka City. The current evidence base of stigma experience among patients with COVID-19 offers a solid foundation for creating effective strategies and policies and designing appropriate interventions to counter stigma, which will improve the psychological well-being of patients with COVID-19 in Bangladesh.
Collapse
Affiliation(s)
- Md. Golam Kibria
- Department of Research, Centre for Development Action, Dhaka, Bangladesh
| | - Taslima Islam
- Department of Research, Centre for Development Action, Dhaka, Bangladesh
| | - Md. Tajul Islam
- Department of Research, Centre for Development Action, Dhaka, Bangladesh,Department of Public Health, North South University, Dhaka, Bangladesh
| | - Russell Kabir
- Department of Research, Centre for Development Action, Dhaka, Bangladesh,School of Allied Health, Anglia Ruskin University, Chelmsford, Essex, UK
| | - Shakil Ahmed
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Papia Sultana
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| |
Collapse
|
12
|
Accelerated forgetting of a trauma-like event in healthy men and women after a single dose of hydrocortisone. Transl Psychiatry 2022; 12:354. [PMID: 36045119 PMCID: PMC9433412 DOI: 10.1038/s41398-022-02126-2] [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: 12/02/2021] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/23/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is characterised by dysregulated hypothalamic-pituitary-adrenal axis activity and altered glucocorticoid receptor sensitivity. Early treatment with glucocorticoids may reduce PTSD risk, although the effect of such treatment on the aetiologically critical step of traumatic-memory-formation remains unclear. Here we examine the effects of exogenous cortisol (hydrocortisone) in a preclinical model of PTSD, using a factorial (Drug × Sex), randomised-controlled, double-blind design. Healthy men and women (n = 120) were randomised to receive 30 mg oral hydrocortisone or matched placebo immediately after watching a stressful film. Effects on film-related intrusions were assessed acutely in the lab, and ecologically using daily memory diaries for one week. We found that participants receiving hydrocortisone showed a faster reduction in daily intrusion frequency. Voluntary memory was assessed once, at the end of the week, but was unaffected by hydrocortisone. Exploratory analyses indicated sex-dependent associations between intrusions and baseline estradiol and progesterone levels. In men receiving hydrocortisone, higher baseline estradiol levels were associated with fewer intrusions, whereas women exhibited the opposite pattern. By contrast, progesterone levels were positively associated with intrusions only in men treated with hydrocortisone. The findings suggest that hydrocortisone promotes an accelerated degradation of sensory-perceptual representations underlying traumatic intrusive memories. In addition, while sex alone was not an important moderator, the combination of sex and sex-hormone levels (especially estradiol) influenced hydrocortisone's effects on involuntary aversive memories. Future well-powered experimental studies may provide a basis for a precision-psychiatry approach to optimising early post-traumatic glucocorticoid treatments that target intrusive memories, based on individual endocrinological profiles.
Collapse
|
13
|
Velasco ER, Florido A, Flores Á, Senabre E, Gomez-Gomez A, Torres A, Roca A, Norrholm S, Newman EL, Das P, Ross RA, Lori A, Pozo OJ, Ressler KJ, Garcia-Esteve LL, Jovanovic T, Andero R. PACAP-PAC1R modulates fear extinction via the ventromedial hypothalamus. Nat Commun 2022; 13:4374. [PMID: 35902577 PMCID: PMC9334354 DOI: 10.1038/s41467-022-31442-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/16/2022] [Indexed: 12/14/2022] Open
Abstract
Exposure to traumatic stress can lead to fear dysregulation, which has been associated with posttraumatic stress disorder (PTSD). Previous work showed that a polymorphism in the PACAP-PAC1R (pituitary adenylate cyclase-activating polypeptide) system is associated with PTSD risk in women, and PACAP (ADCYAP1)-PAC1R (ADCYAP1R1) are highly expressed in the hypothalamus. Here, we show that female mice subjected to acute stress immobilization (IMO) have fear extinction impairments related to Adcyap1 and Adcyap1r1 mRNA upregulation in the hypothalamus, PACAP-c-Fos downregulation in the Medial Amygdala (MeA), and PACAP-FosB/ΔFosB upregulation in the Ventromedial Hypothalamus dorsomedial part (VMHdm). DREADD-mediated inhibition of MeA neurons projecting to the VMHdm during IMO rescues both PACAP upregulation in VMHdm and the fear extinction impairment. We also found that women with the risk genotype of ADCYAP1R1 rs2267735 polymorphism have impaired fear extinction.
Collapse
Affiliation(s)
- E R Velasco
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - A Florido
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Á Flores
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - E Senabre
- Laboratory of Neuropharmacology-NeuroPhar, Department of Experimental and Health Sciences, University Pompeu Fabra, Barcelona, Spain
| | - A Gomez-Gomez
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - A Torres
- Perinatal Mental health Unit, Department of Psychiatry and Clinical Psychology, Institute of Neuroscience, Hospital Clínic, IDIBAPS, Barcelona, Spain
- Programme for the Prevention and Treatment of Psychic Effects in Sexually Assaulted Women. Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Roca
- Perinatal Mental health Unit, Department of Psychiatry and Clinical Psychology, Institute of Neuroscience, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - S Norrholm
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, MI, USA
| | - E L Newman
- McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - P Das
- Department of Neuroscience, Albert Einstein College of Medicine, Psychiatry Research Institute of Montefiore and Einstein, New York, NY, USA
| | - R A Ross
- Department of Neuroscience, Albert Einstein College of Medicine, Psychiatry Research Institute of Montefiore and Einstein, New York, NY, USA
| | - A Lori
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
- American Cancer Society, Inc., Atlanta, GA, USA
| | - O J Pozo
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - K J Ressler
- McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - L L Garcia-Esteve
- Perinatal Mental health Unit, Department of Psychiatry and Clinical Psychology, Institute of Neuroscience, Hospital Clínic, IDIBAPS, Barcelona, Spain
- Programme for the Prevention and Treatment of Psychic Effects in Sexually Assaulted Women. Hospital Clínic de Barcelona, Barcelona, Spain
| | - T Jovanovic
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, MI, USA
| | - R Andero
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain.
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
- Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
- ICREA, Barcelona, Spain.
| |
Collapse
|
14
|
The psychological distress and COVID-19 pandemic during lockdown: A cross-sectional study from United Arab Emirates (UAE). Heliyon 2022; 8:e09422. [PMID: 35647360 PMCID: PMC9133578 DOI: 10.1016/j.heliyon.2022.e09422] [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: 11/04/2021] [Revised: 01/12/2022] [Accepted: 05/10/2022] [Indexed: 12/01/2022] Open
Abstract
Background The pandemic resulted in the societal changes as conflicts and instability were the common concerns experienced by families because of the lockdown. However, the psychological impact of the COVID-19 on the United Arab Emirates (UAE) population is not studied extensively. Objective The study evaluates the psychological impact of lockdown during the pandemic on the people in the UAE. Material and methods This study was cross-sectional in nature and was conducted using a questionnaire consisting of 35-items. The questions were related to social, psychological, and personal aspects. Multivariate Linear regression was used to find the outcomes between independent variables. Results The mean value of social phobia was 2.56 ± .620, followed by the mean score of anxiety (2.47 ± .666), stress (2.44 ± .631), and depression (2.42 ± .682). The higher the respondents experienced the scores, the more depression, anxiety, and stress. Demographics such as marital status, age, and occupation and education level have a statistically significant association with social phobia, anxiety, depression, and stress. Conclusion The study concludes that the lockdown more psychologically impacted males, older people, and unemployed individuals during the pandemic.
Collapse
|
15
|
Edeh NI, Ugwoke EO, Anaele EN, Madusaba BM, Naboth-Odums A, Isiwu EA, Olinya TO, Enyi C, David AO, Yumma DC, Yeldim TP, Odunukwe MC, Victor SN, Abubakar A. Supporting business educators and students against COVID-19 trauma using trauma-focused cognitive behavioral therapy. Medicine (Baltimore) 2022; 101:e29133. [PMID: 35446296 PMCID: PMC9276341 DOI: 10.1097/md.0000000000029133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 01/13/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The outbreak of COVID-19 manifests in peoples' mental health and psychological dispositions and may also result to acute distress, depression, anxiety and post-traumatic stress disorder (PTSD) on victims. The objective of this study was to support business educators' and students' mental health against coronavirus trauma using trauma-focused cognitive behavioral therapy (TF-CBT). METHODS The participants (n = 74 - educators and students) who indicated PTSD symptoms based on the self-reporting questionnaire they filled, were randomly assigned to treatment and waitlist control groups. The TF-CBT manual was used for the intervention. The intervention was a 14-week treatment with 2 weeks follow-up meeting. Using repeated measures of Analysis of Variance, we determined the level of improvement of each participant in the treatment group against Coronavirus trauma at the end of the intervention. RESULTS The study established that gender has no significant difference in determining the effects of Coronavirus trauma on participants. Through intervention, the PTSDs and depression arising from Coronavirus event were significantly reduced in the treatment group. Again, there was a significant improvement in the participants' general mental health at the end of the intervention. Hence, we established the implication for research and practice in line with the outcome of the study. The study advocates that TF-CBT should be employed by educational institutions in Nigeria to cushion the traumatic effects of coronavirus and future disasters on both workers and students. CONCLUSION We conclude that mental health problems remain a serious challenge among business educators and students in this COVID-19 pandemic era. The study established that low educational qualifications, PTSD symptoms and negative coping strategies are the factors aggravating the general low mental health of the study participants. Finally, we advocate that the educational institutions in Nigeria should adopt TF-CBT interventions to support staff and students' mental health against adverse effects of COVID-19.
Collapse
Affiliation(s)
| | - Ernest O. Ugwoke
- Department of Business Education, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Eunice N. Anaele
- South-East Biotechnology Center/Microbiology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Babalulu M. Madusaba
- Department of Business Education, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Augustine Naboth-Odums
- School of Business Education, Federal College of Education (Technical) Omoku, Cross River State, Nigeria
| | - Evelyn A. Isiwu
- Department of Business Education, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Timothy O. Olinya
- Department of Business Education, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chinwe Enyi
- Department of Educational Foundation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Adeleye Olaide David
- Department of Business Education, University of Nigeria, Nsukka, Enugu State, Nigeria
| | | | | | | | - Sandra Nkoliko Victor
- Department of Vocational and Entrepreneurship Education, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Ahmed Abubakar
- Department of Art and Social Science Education, Federal University, Kashere, Gombe State, Nigeria
| |
Collapse
|
16
|
Fischer S, Schumacher S, Daniels J. Neurobiological Changes in Posttraumatic Stress Disorder and Their Reversibility by Psychotherapy. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2022. [DOI: 10.1026/1616-3443/a000650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract. Background: Posttraumatic stress disorder (PTSD) is a debilitating illness associated with distressing symptoms and a high societal burden. Objective: To investigate the neurobiological underpinnings of PTSD to improve our understanding of this disorder and its treatment. Methods: This article reviews currently researched mechanisms that can explain the development of PTSD symptoms. It presents key findings on neural (i. e., brain functioning and brain structure), neuroendocrine (i. e., noradrenergic and hypothalamic-pituitary-adrenal axis activity), and related (epi)genetic changes in individuals with PTSD. Furthermore, it presents preliminary research examining the reversibility of these alterations during psychotherapeutic treatment. Results: PTSD is characterized by specific neurobiological alterations, with preliminary findings indicating that at least some of these may normalize during psychotherapy. Discussion: A multidimensional perspective on the development, maintenance, and treatment of PTSD has the potential to improve our understanding of the causal processes underlying the disorder and may ultimately inform the conception of novel treatments.
Collapse
Affiliation(s)
- Susanne Fischer
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Switzerland
| | - Sarah Schumacher
- Clinical Psychology and Psychotherapy, Faculty of Health, Health and Medical University, Potsdam, Germany
| | - Judith Daniels
- Clinical Psychology, Faculty of Behavioral and Social Sciences, University of Groningen, The Netherlands
| |
Collapse
|
17
|
Rieder JK, Kleshchova O, Weierich MR. Trauma Characteristics Moderate the Relation Between Estradiol and Trauma-Related Symptoms. J Trauma Stress 2022; 35:246-256. [PMID: 34390027 PMCID: PMC8840997 DOI: 10.1002/jts.22725] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/10/2021] [Accepted: 06/20/2021] [Indexed: 02/03/2023]
Abstract
Women are more likely to develop posttraumatic stress disorder (PTSD) than men, and fluctuations in gonadal hormones might contribute to this vulnerability. Low-estradiol states are associated with aversive affective experiences, including trauma-related symptoms. However, the impact of trauma characteristics on the relation between estradiol and trauma-related symptoms is unknown. We used a clinical interview and 10-day ecological momentary assessment (EMA) that spanned low- and high-estradiol menstrual cycle phases to test trauma type, chronicity, and timing as moderators of the association between estradiol and trauma-related symptoms in 40 naturally cycling young women. We tested interactions between trauma characteristics and (a) estradiol on self-reported symptoms and (b) menstrual cycle-related change in estradiol on change in symptoms. Sexual, chronic, and earlier trauma was associated with more severe symptoms as reported during the interview, rs = .51-.33, but not mean symptoms across the EMA. Estradiol at the time of the interview was inversely associated with symptoms in women with sexual but not nonsexual trauma, interaction: B = -12.62 (SE = 5.28), p = .022. Menstrual cycle-related change in estradiol was inversely associated with change in symptoms in women with chronic trauma, B = -9.65 (SE = 3.49), p = .006, and earlier trauma, B = 0.71 (SE = 0.34), p = .036, but not discrete or later trauma. Sexual, chronic, or early trauma exposure might confer higher symptom vulnerability in low-estradiol states. Clinicians who work with women with particular trauma histories might anticipate menstrual cycle-related variation in symptoms.
Collapse
Affiliation(s)
- Jenna K. Rieder
- College of Humanities and Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Olena Kleshchova
- Department of Psychology, University of Nevada, Reno, Reno, Nevada, USA
| | | |
Collapse
|
18
|
Krinke E, Held U, Steigmiller K, Felmingham K, Kleim B. Sex hormones and cortisol during experimental trauma memory consolidation: Prospective association with intrusive memories. Eur J Psychotraumatol 2022; 13:2040818. [PMID: 35386732 PMCID: PMC8979510 DOI: 10.1080/20008198.2022.2040818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background Trauma- and stress-related disorders, such as post-traumatic stress disorder (PTSD), are more common in females than in males. Sex hormones affect learning and emotional memory formation and may be associated with the development of PTSD. Most previous studies have indexed these hormones in isolation. Objectives: To investigate associations of sex hormones and cortisol during memory consolidation on the development of intrusive memories. Methods: We employed an experimental trauma film paradigm in 61 healthy women and indexed salivary testosterone, progesterone, estradiol, and cortisol on day one and day two post experimental trauma exposure and their effects on intrusion frequency, distress, and vividness. Intrusive trauma memories were indexed by means of a diary in which participants documented intrusion frequency, distress, and vividness. Results and conclusion: Participants reported an average of 5.3 intrusions over the course of seven days (SD = 4.6, range 0-26). Progesterone, and estradiol indexed on day one predicted intrusion frequency, with higher progesterone and lower estradiol predicting more intrusive memories (p-values AUC progesterone 0.01 and estradiol 0.02). There was no evidence for associations between hormone concentration indices on day two and intrusion outcomes. Further research on the roles of gonadal and adrenal hormones in trauma memory formation is needed to advance our efforts to understand their influence on PTSD development.
Collapse
Affiliation(s)
- Eileen Krinke
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ulrike Held
- Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Klaus Steigmiller
- Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Kim Felmingham
- Department of Psychology, University of Melbourne, Parkville, Melbourne, Australia
| | - Birgit Kleim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Department of Psychology, University of Zurich (UZH), Zurich, Switzerland.,Zurich Neuroscience Centre, ZNZ University of Zurich (UZH), Zurich, Switzerland
| |
Collapse
|
19
|
Using Translational Models of Fear Conditioning to Uncover Sex-Linked Factors Related to PTSD Risk. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2022; 7:e220010. [PMID: 36506701 PMCID: PMC9731144 DOI: 10.20900/jpbs.20220010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating neuropsychiatric disorder that follows exposure to a traumatic event; however, not every person who experiences trauma will develop PTSD. Women are more likely to be diagnosed with PTSD than men even when controlling for type and amount of trauma exposure. Circulating levels of gonadal hormones such as estradiol, progesterone, and testosterone may contribute to differential risk for developing PTSD. In this review, we briefly consider the influence of gonadal hormones on fear conditioning processes including fear acquisition, fear inhibition, extinction learning, and extinction recall within translational neuroscience models. We discuss findings from human studies incorporating samples from both community and traumatized clinical populations to further understand how these hormones might interact with exposure to trauma. Additionally, we propose that special attention should be paid to the specific measure used to examine fear conditioning processes as there is evidence that common psychophysiological indices such as skin conductance response and fear-potentiated startle can reveal quite different results and thus necessitate nuanced interpretations. Continued research to understand the influence of gonadal hormones in fear learning and extinction processes will provide further insight into the increased risk women have of developing PTSD and provide new targets for the treatment and prevention of this disorder.
Collapse
|
20
|
Abstract
LEARNING OBJECTIVE After participating in this activity, learners should be better able to:• Discuss and outline the general and overlapping effects of the menstrual cycle on women's mental health. ABSTRACT A growing body of research demonstrates menstrual cycle-dependent fluctuations in psychiatric symptoms; these fluctuations can therefore be considered as prevalent phenomena. Possible mechanisms underlying these fluctuations posit behavioral, psychological, and neuroendocrine influences. Recent reviews document cyclic exacerbation of symptoms and explore these mechanisms in the context of specific and often single disorders. The question remains, however, as to whether there are general and overlapping effects of the menstrual cycle on women's mental health. To address this gap, we synthesized the literature examining the exacerbation of a variety of psychiatric symptoms across the menstrual cycle in adult women. Results show that the premenstrual and menstrual phases are most consistently implicated in transdiagnostic symptom exacerbation. Specifically, strong evidence indicates increases in psychosis, mania, depression, suicide/suicide attempts, and alcohol use during these phases. Anxiety, stress, and binge eating appear to be elevated more generally throughout the luteal phase. The subjective effects of smoking and cocaine use are reduced during the luteal phase, but fewer data are available for other substances. Less consistent patterns are demonstrated for panic disorder, symptoms of posttraumatic stress disorder, and borderline personality disorder, and it is difficult to draw conclusions for symptoms of generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and trichotillomania because of the limited data. Future research should focus on developing standardized approaches to identifying menstrual cycle phases and adapting pharmacological and behavioral interventions for managing fluctuations in psychiatric symptoms across the menstrual cycle.
Collapse
|
21
|
Mao J, Wang C, Teng C, Wang M, Zhou S, Zhao K, Ye X, Wang Y. Prevalence and Associated Factors of PTSD Symptoms After the COVID-19 Epidemic Outbreak in an Online Survey in China: The Age and Gender Differences Matter. Neuropsychiatr Dis Treat 2022; 18:761-771. [PMID: 35414744 PMCID: PMC8994999 DOI: 10.2147/ndt.s351042] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/17/2022] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The COVID-19 is a highly contagious disease belonging to the family of coronaviruses which can affect a great deal of people shortly. As a devastating event in the world, many people suffer the PTSD from this severe disease. The aim of study is to explore the prevalence and severity of post-traumatic stress disorder (PTSD) symptoms, and discuss the possible factors among the general public in China after the COVID-19 epidemic outbreak. METHODS This is a cross-sectional study. We used the self-designed demographic questionnaire and the Posttraumatic Stress Checklist-Civilian Version (PCL-C) of Chinese version as our screening tools to investigate 4872 subjects living in the communities in China from Nov. 8th, 2020 to Dec. 8th, 2020. RESULTS Finally, we received 3705 effective respondents. The response rates of the questionnaire can reach 76.97 percentage. Peculiarly, the prevalence of PTSD mild and severe symptoms after the COVID-19 epidemic outbreak was 53.2%. Mild PTSD symptoms accounted for 24.9%, and severe PTSD symptoms (scores above 38) accounted for 28.3%. PCL-C mean scores were 41.4±14.7. The females accounted for 67.7% of the total samples. Participants' mean age was 30.5±11.2 years old. The PCL-C gross scores of females were all higher than males in four subject groups. Meantime, gender and age made differences not only in total PCL-C points but also in the four aspects of PCL-C (P<0.001). The middle-aged group (ages from 45 to 60) got the lowest scores among the four groups. CONCLUSION COVID-19 brought tremendous psychological pressure on the public in many ways, including people's work, social contact, study, and daily life. Results of our research discover that symptoms of the PTSD are severe, including the re-experiencing, avoidance/numbing, flashbacks, and hyper-arousal. Actions should be taken at society level to prevent and protect individuals from PTSD suffering. Special attention should be paid to females and young people. Further studies should be conducted to explore the dynamic and other risk and protection factors to prevent PTSD.
Collapse
Affiliation(s)
- Jiankai Mao
- Tongde Hospital of Zhejiang Province, Hangzhou, People's Republic of China
| | - Chaoyue Wang
- Department of Psychiatry, School of Mental Health, Wenzhou Medical University, Wenzhou, People's Republic of China.,The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Chao Teng
- The 4th Clinical College of Zhejiang Chinese Medicine University, Hangzhou, People's Republic of China
| | - Mengpu Wang
- Department of Psychiatry, School of Mental Health, Wenzhou Medical University, Wenzhou, People's Republic of China.,The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Siyao Zhou
- Department of Psychiatry, School of Mental Health, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Ke Zhao
- Department of Psychiatry, School of Mental Health, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Xiangming Ye
- Zhejiang Provincial People's Hospital, Hangzhou, People's Republic of China
| | - Yijia Wang
- Wenzhou Seventh People's Hospital, Wenzhou, People's Republic of China
| |
Collapse
|
22
|
Ney LJ, Crombie KM, Mayo LM, Felmingham KL, Bowser T, Matthews A. Translation of animal endocannabinoid models of PTSD mechanisms to humans: Where to next? Neurosci Biobehav Rev 2021; 132:76-91. [PMID: 34838529 DOI: 10.1016/j.neubiorev.2021.11.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 12/11/2022]
Abstract
The endocannabinoid system is known to be involved in mechanisms relevant to PTSD aetiology and maintenance, though this understanding is mostly based on animal models of the disorder. Here we review how human paradigms can successfully translate animal findings to human subjects, with the view that substantially increased insight into the effect of endocannabinoid signalling on stress responding, emotional and intrusive memories, and fear extinction can be gained using modern paradigms and methods for assessing the state of the endocannabinoid system in PTSD.
Collapse
Affiliation(s)
- Luke J Ney
- School of Psychological Sciences, University of Tasmania, Australia; School of Psychology and Counselling, Queensland University of Technology, Australia.
| | - Kevin M Crombie
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, United States
| | - Leah M Mayo
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Science, Linköping University, Sweden
| | - Kim L Felmingham
- Department of Psychological Sciences, University of Melbourne, Australia
| | | | - Allison Matthews
- School of Psychological Sciences, University of Tasmania, Australia
| |
Collapse
|
23
|
Rieder JK, Kleshchova O, Weierich MR. Estradiol, stress reactivity, and daily affective experiences in trauma-exposed women. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2021; 14:738-746. [PMID: 34726450 DOI: 10.1037/tra0001113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Women experience higher risk for PTSD following trauma compared with men. Fluctuations in ovarian hormones might contribute to this greater vulnerability, given that estradiol is associated with affect and stress reactivity. Our objective was to test the relations between menstrual cycle-related changes in estradiol, affect, stress reactivity, and trauma-related symptoms. METHOD We assessed trauma-related symptoms in ethnically diverse naturally cycling women with a history of trauma during a clinical interview. Participants also completed a 10-day ecological momentary assessment (EMA) that included lower- and higher-estradiol phases. We tested associations between estradiol and PTSD symptoms and stress reactivity to a trauma reminder using Spearman correlation and Wilcoxon rank-sum tests. We tested the effect of menstrual cycle day on daily affect using multilevel modeling. RESULTS Estradiol was negatively associated with symptom severity (rs = -.36), and participants in low- versus high-estradiol cycle phases at interview had higher sympathetic (r = .35) and lower hypothalamic-pituitary-adrenal axis (r = .41) reactivity. Across the EMA period, participants showed a decrease in daily PTSD symptoms (b = -.39), negative (b = -.11) and positive (b = -.24) affect, and variability in daily valence (b = -.07) and arousal (b = -.08), from the low- to high-estradiol phase. CONCLUSIONS Consistent with prior evidence of more aversive affective experiences in low-estradiol states, lower estradiol was associated with higher trauma-related symptoms. In addition, trauma-exposed women showed a discordant pattern of stress reactivity to a trauma reminder, higher daily symptoms, and greater affective lability in a low-estradiol phase. Given that our sample consisted of high-functioning trauma-exposed women, these results should be replicated in women with PTSD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
|
24
|
Kosovali BD, Mutlu NM, Gonen CC, Peker TT, Yavuz A, Soyal OB, Cakır E, Akan B, Gokcinar D, Erdem D, Turan IO. Does hospitalisation of a patient in the intensive care unit cause anxiety and does restriction of visiting cause depression for the relatives of these patients during COVID-19 pandemic? Int J Clin Pract 2021; 75:e14328. [PMID: 33960085 PMCID: PMC8236937 DOI: 10.1111/ijcp.14328] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/03/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES During the pandemic, anxiety and depression may occur increasingly in the whole society. The aim of this study was to evaluate the possible cause, incidence and levels of anxiety and depression in the relatives of the patients in the intensive care unit (ICU) in accordance with the patients' SARS-CoV-2 polymerase chain reaction (PCR) result. MATERIALS AND METHOD The study was prospectively conducted on relatives of patients admitted to tertiary intensive care units during COVID-19 pandemic. Sociodemographic characteristics of the patients and their relatives were recorded. "The Turkish version of the Hospital Anxiety and Depression Scale" was applied twice to the relatives of 120 patients to determine the symptoms of anxiety and depression in accordance with the PCR results of the patients (PCR positive n = 60, PCR negative n = 60). RESULTS The ratios above cut-off values for anxiety and depression among relatives of the patients were 45.8% and 67.5% for the first questionnaire and 46.7% and 62.5% for the second questionnaire, respectively. The anxiety and depression in the relatives of PCR-positive patients was more frequent than the PCR negative (P < .001 for HADS-A and P = .034 for HADS-D). The prevalence of anxiety and depression was significantly higher in female relatives (P = .046 for HADS-A and P = .009 for HADS-A). There was no significant correlation between HADS and age of the patient or education of the participants. The fact that the patients were hospitalised in the ICU during the pandemic was an independent risk factor for anxiety (AUC = 0.746) while restricted visitation in the ICU was an independent risk factor for depression (AUC = 0.703). CONCLUSION Positive PCR and female gender were associated with both anxiety and depression while hospitalisation in the ICU due to COVID-19 was an independent risk factor for anxiety and restricted visitation in the ICU is an independent risk factor for depression.
Collapse
Affiliation(s)
| | | | - Canan Cam Gonen
- Department of Critical Care UnitAnkara City HospitalAnkaraTurkey
| | | | - Asiye Yavuz
- Department of Critical Care UnitAnkara City HospitalAnkaraTurkey
| | - Ozlem Balkiz Soyal
- Department of Anesthesiology and ReanimationAnkara City HospitalAnkaraTurkey
| | - Esra Cakır
- Department of Critical Care UnitAnkara City HospitalAnkaraTurkey
| | - Belgin Akan
- Department of Critical Care UnitAnkara City HospitalAnkaraTurkey
| | - Derya Gokcinar
- Department of Critical Care UnitAnkara City HospitalAnkaraTurkey
| | - Deniz Erdem
- Department of Critical Care UnitAnkara City HospitalAnkaraTurkey
| | | |
Collapse
|
25
|
Hsu CMK, Ney LJ, Honan C, Felmingham KL. Gonadal steroid hormones and emotional memory consolidation: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 130:529-542. [PMID: 34517034 DOI: 10.1016/j.neubiorev.2021.09.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/19/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
Anxiety and stress-related disorders are more prevalent in women and associated with negative emotional memory consolidation as well as impaired fear extinction recall. Recent research has identified a role of gonadal steroid hormones in influencing emotional memories and fear extinction, however most individual studies have small samples and employed various protocols. A systematic review and meta-analysis were conducted on studies that examined sex hormones (estrogen, progesterone, testosterone, allopregnanolone, dehydroepiandrosterone) on four aspects of memory, namely, intentional recall (k = 13), recognition memory (k = 7), intrusive memories (k = 9), and extinction recall (k = 11). The meta-analysis on natural cycling women revealed that progesterone level was positively associated with negative recall and negative intrusive memories, and this effect on intentional recall was enhanced under stress induction. Estradiol level was positively associated with extinction recall. This study reveals an important role of progesterone and estradiol in influencing emotional memory consolidation. It highlights the need to control for these hormonal effects and examine progesterone and estradiol concurrently across all menstrual phases in future emotional memory paradigms.
Collapse
Affiliation(s)
- Chia-Ming K Hsu
- School of Psychological Sciences, University of Tasmania, Australia.
| | - Luke J Ney
- School of Psychological Sciences, University of Tasmania, Australia
| | - Cynthia Honan
- School of Psychological Sciences, University of Tasmania, Australia
| | - Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, Australia
| |
Collapse
|
26
|
Increased occurrence of PTSD symptoms in adolescents with major depressive disorder soon after the start of the COVID-19 outbreak in China: a cross-sectional survey. BMC Psychiatry 2021; 21:395. [PMID: 34372807 PMCID: PMC8352150 DOI: 10.1186/s12888-021-03400-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 07/29/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The Coronavirus Disease 2019 (COVID-19) pandemic continues to threaten the physical and mental health of people across the world. This study aimed to understand the psychological impact of this disease on adolescents with major depressive disorder (MDD) at 1 month after the start of the outbreak in China. METHODS Using the Children's Impact of Event Scale (CRIES-13) questionnaire, we investigated the occurrence of posttraumatic stress disorder (PTSD) in two groups of adolescents: MDD patients who were in continuous antidepressant therapy and healthy controls. Total scores and factor subscores were compared between the two groups and subgroups stratified by sex and school grade. Logistic regression was used to identify variables associated with high total CRIES-13 scores. RESULTS Compared to controls (n = 107), the MDD group (n = 90) had higher total CRIES-13 scores and a higher proportion with a total score ≥ 30. They also had a lower intrusion subscore and a higher arousal subscore. In the MDD group, males and females did not differ significantly in total CRIES-13 scores or factor subscores, but junior high school students had higher avoidance subscores than senior high school students. Logistic regression showed high total CRIES-13 scores to be associated with MDD and the experience of "flashbacks" or avoidance of traumatic memories associated with COVID-19. CONCLUSIONS It is crucial to understand the psychological impact of COVID-19 on adolescents with MDD in China, especially females and junior high school students. Long-term monitoring of adolescents with a history of mental illness is required to further understand these impacts. TRIAL REGISTRATION ChiCTR, ChiCTR2000033402 , Registered 31 May 2020.
Collapse
|
27
|
Abir T, Osuagwu UL, Kalimullah NA, Yazdani DMNA, Husain T, Basak P, Goson PC, Mamun AA, Permarupan PY, Milton AH, Rahman MA, Rahman ML, Agho KE. Psychological Impact of COVID-19 Pandemic in Bangladesh: Analysis of a Cross-Sectional Survey. Health Secur 2021; 19:468-478. [PMID: 34348050 DOI: 10.1089/hs.2020.0205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic has generated fear, panic, distress, anxiety, and depression among many people in Bangladesh. In this cross-sectional study, we examined factors associated with different levels of psychological impact as a result of COVID-19 in Bangladesh. From April 1 to 30, 2020, we used a self-administered online questionnaire to collect data from 10,609 respondents. Using the Impact of Event Scale-Revised to assess the psychological impact of the COVID-19 pandemic on respondents, we categorized the levels of impact as normal, mild, moderate, or severe. Ordinal logistic regression was used to examine the associated factors. The prevalence of mild, moderate, and severe psychological impact was 10.2%, 4.8%, and 45.5%, respectively. Multivariate analysis revealed that the odds of reporting normal vs mild, moderate, or severe psychological impact were 5.9 times higher for people living in the Chittagong Division, 1.7 times higher for women with lower education levels, 3.0 times higher among those who were divorced or separated, 1.8 times higher for those working full time, and 2.4 times higher for those living in shared apartments. The odds of reporting a psychological impact were also higher among people who did not enforce protective measures inside the home, those in self-quarantine, those who did not wear face masks, and those who did not comply with World Health Organization precautionary measures. Increased psychological health risks due to COVID-19 were significantly higher among people who experienced chills, headache, cough, breathing difficulties, dizziness, and sore throat before data collection. Our results showed that 1 in 2 respondents experienced a significant psychological impact as a result of the COVID-19 pandemic. Public health researchers should consider these factors when targeting interventions that would have a protective effect on the individual's psychological health during a pandemic or future disease outbreak.
Collapse
Affiliation(s)
- Tanvir Abir
- Tanvir Abir, PhD, is an Associate Professor, College of Business Administration, International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | - Uchechukwu L Osuagwu
- Uchechukwu L. Osuagwu, PhD, is a Research Fellow, Translational Health Research Institute, School of Medicine; Western Sydney University, Campbelltown, Australia. affiliated with the Discipline of Optometry, African Vision Research Institute, Westville Campus, University of KwaZulu-Natal, Durban, South Africa
| | - Nazmul Ahsan Kalimullah
- Nazmul Ahsan Kalimullah, PhD, is Vice-Chancellor Department of Gender and Development Studies; both at Begum Rokeya University, Rangpur, Bangladesh
| | - Dewan Muhammad Nur-A Yazdani
- Dewan Muhammad Nur-A Yazdani, MSc, is an Assistant Professor, College of Business Administration, International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | - Taha Husain
- Taha Husain, MSS, is a Lecturer, Department of Gender and Development Studies; Begum Rokeya University, Rangpur, Bangladesh
| | - Palash Basak
- Palash Basak, MSc, is a PhD Researcher, School of Environment and Life Sciences, University of Newcastle, Callaghan, Australia
| | - Piwuna Christopher Goson
- Piwuna Christopher Goson, MBBS, MSc, is a Reader and Head, Department of Psychiatry, College of Health Science, University of Jos, Plateau State, Nigeria
| | - Abdullah Al Mamun
- Abdullah Al Mamun, PhD, is an Associate Professor, Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia
| | - P Yukthamarani Permarupan
- P. Yukthamarani Permarupan, PhD, is [title], Faculty of Entrepreneurship and Business, Universiti Malaysia Kelantan, Kota Bharu, Malaysia
| | - Abul Hasnat Milton
- Abul Hasnat Milton, PhD, is Chief Executive Officer, Research International, Dhaka, Bangladesh & Epidemiology Resource Centre, NSW, Australia
| | - Md Adnan Rahman
- Md Adnan Rahman, MSc, is a Senior Lecturer, College of Business Administration, International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | - Md Lutfar Rahman
- Md Lutfar Rahman, PhD, is a Professor, College of Business Administration, International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | - Kingsley Emwinyore Agho
- Kingsley Emwinyore Agho, PhD, is an Associate Professor of Biostatistics, School of Health Sciences; both at Western Sydney University, Campbelltown, Australia. affiliated with the Discipline of Optometry, African Vision Research Institute, Westville Campus, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
28
|
Gamsakhurdashvili D, Antov MI, Stockhorst U. Facial Emotion Recognition and Emotional Memory From the Ovarian-Hormone Perspective: A Systematic Review. Front Psychol 2021; 12:641250. [PMID: 34093322 PMCID: PMC8174660 DOI: 10.3389/fpsyg.2021.641250] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/19/2021] [Indexed: 12/27/2022] Open
Abstract
Background We review original papers on ovarian-hormone status in two areas of emotional processing: facial emotion recognition and emotional memory. Ovarian-hormone status is operationalized by the levels of the steroid sex hormones 17β-estradiol (E2) and progesterone (P4), fluctuating over the natural menstrual cycle and suppressed under oral contraceptive (OCs) use. We extend previous reviews addressing single areas of emotional processing. Moreover, we systematically examine the role of stimulus features such as emotion type or stimulus valence and aim at elucidating factors that reconcile the inconsistent results. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included papers published until September 2020 indexed in PubMed and Web of Science databases. Search terms were MeSH terms (emotional OR emotion) AND (X) AND (estrogen OR progesterone OR menstrual cycle OR oral contraceptives) with (X) representing our separately searched areas, resulting in (processing OR recognition OR empathy), and (memory OR recall). To be included, articles had to (1) be written and published in English, (2) examine healthy, non-pregnant adult women in their reproductive age, and (3) measure or at least estimate levels of E2 and P4. In PubMed, the search was (4) limited to humans and (5) to the search term present in the title or abstract. Results Features of the provided stimulus material (emotion type and/or valence) constitute a relevant influence that interacts with E2- and P4-related ovarian-hormone status. For instance, recognition of basic emotions appears to be more related to P4- than E2-levels. Quite consistent, OC intake (vs. natural menstrual cycling) was accompanied by impaired recognition accuracy of basic and also complex emotions, although not in a recent large-sample study assessing complex emotions. Memory recall of negative content was mainly enhanced by P4, especially after having been stressed. Discussion and Conclusion We document the methodological diversity in the field, presumably contributing to the heterogeneity of results. More studies explicitly contrasting the early follicular phase, mid-cycle phase, mid-luteal, and OC intake while standardizing tasks are needed. Research would take advantage of using within-subject designs and accounting for the recognition of complex emotions.
Collapse
Affiliation(s)
- Dali Gamsakhurdashvili
- Experimental Psychology II and Biological Psychology, Institute of Psychology, University of Osnabrück, Osnabrück, Germany
| | - Martin I Antov
- Experimental Psychology II and Biological Psychology, Institute of Psychology, University of Osnabrück, Osnabrück, Germany
| | - Ursula Stockhorst
- Experimental Psychology II and Biological Psychology, Institute of Psychology, University of Osnabrück, Osnabrück, Germany
| |
Collapse
|
29
|
Al Dhaheri AS, Bataineh MF, Mohamad MN, Ajab A, Al Marzouqi A, Jarrar AH, Habib-Mourad C, Abu Jamous DO, Ali HI, Al Sabbah H, Hasan H, Stojanovska L, Hashim M, Abd Elhameed OA, Shaker Obaid RR, ElFeky S, Saleh ST, Osaili TM, Cheikh Ismail L. Impact of COVID-19 on mental health and quality of life: Is there any effect? A cross-sectional study of the MENA region. PLoS One 2021; 16:e0249107. [PMID: 33765015 PMCID: PMC7993788 DOI: 10.1371/journal.pone.0249107] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/12/2021] [Indexed: 01/10/2023] Open
Abstract
The COVID-19 pandemic is a major health crisis that has changed the life of millions globally. The purpose of this study was to assess the effect of the pandemic on mental health and quality of life among the general population in the Middle East and North Africa (MENA) region. A total of 6142 adults from eighteen countries within the MENA region completed an online questionnaire between May and June 2020. Psychological impact was assessed using the Impact of Event Scale-Revised (IES-R) and the social and family support impact was assessed with questions from the Perceived Support Scale (PSS). The IES-R mean score was 29.3 (SD = 14.8), corresponding to mild stressful impact with 30.9% reporting severe psychological impact. Most participants (45%-62%) felt horrified, apprehensive, or helpless due to COVID-19. Furthermore, over 40% reported increased stress from work and financial matters. Higher IES-R scores were found among females, participants aged 26-35 years, those with lower educational level, and participants residing in the North Africa region (p<0.005). About 42% reported receiving increased support from family members, 40.5% were paying more attention to their mental health, and over 40% reported spending more time resting since the pandemic started. The COVID-19 pandemic was associated with mild psychological impact while it also encouraged some positive impact on family support and mental health awareness among adults in the MENA region. Clinical interventions targeted towards vulnerable groups such as females and younger adults are needed.
Collapse
Affiliation(s)
- Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mo’ath F. Bataineh
- Department of Sport Rehabilitation, Faculty of Physical Education and Sport Sciences, The Hashemite University, Zarqa, Jordan
| | - Maysm N. Mohamad
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Abir Ajab
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Amina Al Marzouqi
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Amjad H. Jarrar
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Carla Habib-Mourad
- Faculty of Agricultural and Food Sciences, Nutrition Department, American University of Beirut, Riad El-Solh, Beirut, Lebanon
| | - Dima O. Abu Jamous
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Haleama Al Sabbah
- College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Nutrition and Dietetics Program, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | | | - Reyad R. Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Samar ElFeky
- Community-Based Initiatives and Health for Older People, World Health Organization, Regional Office for Eastern Mediterranean Region, Cairo, Egypt
| | - Sheima T. Saleh
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Tareq M. Osaili
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
30
|
Zakeri MA, Hossini Rafsanjanipoor SM, Sedri N, Kahnooji M, Sanji Rafsanjani M, Zakeri M, Zakeri Bazmandeh A, Talebi A, Dehghan M. Psychosocial status during the prevalence of COVID-19 disease: the comparison between healthcare workers and general population. CURRENT PSYCHOLOGY 2021; 40:6324-6332. [PMID: 33746463 PMCID: PMC7963465 DOI: 10.1007/s12144-021-01582-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 12/13/2022]
Abstract
The prevalence of COVID-19 disease continues to be a significant psychosocial status among health care workers (HCWs) and the general population worldwide. This cross sectional study aimed to compare the psychosocial status between healthcare workers and general population during the prevalence of COVID-19 disease in southeast Iran. Totally 415 health care workers of a medical service center for COVID-19 patients and 1023 people of general population participated in the study. An online socio-demographic characteristics questionnaire, General Health Questionnaire (GHQ −28), and Generalized Anxiety Disorder 7-item (GAD-7) were utilized to evaluate psychosocial status. According to GHQ, the psychological disorders of the HCWs were significantly higher than that of the general population (P < 0.001). According to GAD-7, no significant difference was found between general population and HCWs. Multivariate logistic analysis showed no difference between general population and HCWs in the psychological disorder. Although HCWs suffered from psychological disorders more than general population, nearly one third to half of the participants in both groups had psychosocial disorders.
Collapse
Affiliation(s)
- Mohammad Ali Zakeri
- Determinants of Health Research Centre, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Nadia Sedri
- Student Research Committee, Zarand faculty of Nursing, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahmood Kahnooji
- Department of internal medicine, Faculty of medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mojtaba Sanji Rafsanjani
- Emergency Department, Ali Ebn Abitaleb Hospital, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Maryam Zakeri
- Physiology-Pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Abbas Zakeri Bazmandeh
- Department of Medical Nanotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Talebi
- Student Research Committee, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
31
|
Cheikh Ismail L, Mohamad MN, Bataineh MF, Ajab A, Al-Marzouqi AM, Jarrar AH, Abu Jamous DO, Ali HI, Al Sabbah H, Hasan H, Stojanovska L, Hashim M, Shaker Obaid RR, Saleh ST, Osaili TM, Al Dhaheri AS. Impact of the Coronavirus Pandemic (COVID-19) Lockdown on Mental Health and Well-Being in the United Arab Emirates. Front Psychiatry 2021; 12:633230. [PMID: 33796033 PMCID: PMC8007782 DOI: 10.3389/fpsyt.2021.633230] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/16/2021] [Indexed: 12/20/2022] Open
Abstract
United Arab Emirates (UAE) has taken unprecedented precautionary measures including complete lockdowns against COVID-19 to control its spread and ensure the well-being of individuals. This study investigated the impact of COVID-19 and societal lockdown measures on the mental health of adults in the UAE. A cross-sectional study was conducted using an English and Arabic online questionnaire between May and June 2020. The psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and the social and family support impact was evaluated using questions from the Perceived Support Scale (PSS). A total of 4,426 participants (3,325 females and 1,101 males) completed the questionnaire. The mean IES-R score was 28.0 ± 14.6, reflecting a mild stressful impact with 27.3% reporting severe psychological impact. Over 36% reported increased stress from work, home and financial matters. Also, 43-63% of the participants felt horrified, apprehensive or helpless due to COVID-19. Females, younger participants, part-timers, and college or University graduates were more likely to have a high IES-R score (p < 0.05). The majority of participants reported receiving increased support from family members, paying more attention to their mental health, and spending more time to rest and relax. The results of this study demonstrate the impact of the COVID-19 pandemic on mental health among the UAE residents and highlight the need to adopt culturally appropriate interventions for the general population and vulnerable groups, such as females and younger adults.
Collapse
Affiliation(s)
- Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Maysm N Mohamad
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mo'ath F Bataineh
- Department of Sport Rehabilitation, Faculty of Physical Education and Sport Sciences, The Hashemite University, Zarqa, Jordan
| | - Abir Ajab
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Amina M Al-Marzouqi
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Department of Health Services Administration, College of Health Sciences, Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Amjad H Jarrar
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Dima O Abu Jamous
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Habiba I Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Haleama Al Sabbah
- College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad R Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Sheima T Saleh
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Tareq M Osaili
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Ayesha S Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| |
Collapse
|
32
|
Magdy DM, Metwally A, Magdy O. Assessment of community psycho-behavioral responses during the outbreak of novel coronavirus (2019-nCoV): a cross-sectional study. AIMS Public Health 2021; 9:26-40. [PMID: 35071666 PMCID: PMC8755960 DOI: 10.3934/publichealth.2022003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/01/2021] [Indexed: 12/19/2022] Open
Abstract
<abstract>
<p>The novel coronavirus 2019 (2019-nCoV) is a public health emergency of international concern resulting in adverse psychological impacts during the epidemic.</p>
<sec>
<title>Methods</title>
<p>From 1 to 10 April 2020, we conducted an online survey. The online survey collected information on demographic data, precautionary measures against (2019-nCoV), self-health evaluation, knowledge, and concerns about (2019-nCoV), and appraisal of crisis management. The psychological impact was assessed by the General Anxiety Disorder 7-item (GAD-7) scale. The designed questionnaire was answered by participants, and collected data were statistically analyzed.</p>
</sec><sec>
<title>Results</title>
<p>This study included 1200 respondents. In total, 80% of respondents rated the psychological impact; 18% reported minimal anxiety; 34% reported mild anxiety, and 48% with moderate anxiety symptoms. A large proportion (74%) believed that they were very or somewhat likely to contract (2019-nCoV) while only (35%) believed they were unlikely to survive if they contracted the disease. (58%) of the respondents, practiced the precautionary measures directed against person-to-person droplet spread. Respondents with a moderate level of anxiety were most likely to take comprehensive precautionary measures against the infection. Also, older, female, more educated people as well as those who are more likely to contract the infection.</p>
</sec><sec>
<title>Conclusions</title>
<p>During the outbreak, more than half of the respondents rated the psychological impact as moderate anxiety. Thus, the psychological needs during the outbreak should be addressed appropriately. Our results highlight the need to promote protective personal health practices to interrupt the transmission of the (2019-nCoV) in the community. Therefore, educational public programs about preventive measures should be targeted at the identified groups with low current uptake of precautions.</p>
</sec></abstract>
Collapse
Affiliation(s)
- Doaa M Magdy
- Department of Chest Diseases, Faculty of Medicine, Assuit University, Egypt
- * Correspondence: ; Tel: +201006261010
| | - Ahmed Metwally
- Department of Chest Diseases, Faculty of Medicine, Assuit University, Egypt
| | - Omar Magdy
- Medical student Faculty of Medicine, Assuit University, Egypt
| |
Collapse
|
33
|
Shen X, Yan S, Jiang H, Cao H, Dowling R, Feng J, Lei Z, Li J, Han X, Lv C, Gan Y. Post-traumatic Stress Disorder and Associated Factors 1 Year After the Beginning of the COVID-19 Pandemic Among Chinese Residents. Front Psychiatry 2021; 12:766127. [PMID: 34803773 PMCID: PMC8595276 DOI: 10.3389/fpsyt.2021.766127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: By investigating the incidence of post-traumatic stress disorder (PTSD) among residents during a period of low transmission, this study reflects the long-term impact of coronavirus disease 2019 (COVID-19) and identify which categories of residents are more likely to develop PTSD due to an acute infectious disease crisis, facilitating the development of targeted strategies to protect mental health after outbreaks of similar acute infectious diseases in the future. Methods: A cross-sectional survey was conducted in China from 4 to 26 February 2021. A convenience sampling strategy was adopted to recruit participants. Participants were asked to complete the PTSD Checklist for DSM-5 (PCL-5). A multivariable linear stepwise regression analysis model was used to identify which factors were associated with PTSD in residents of China. Results: A total of 2,361 Chinese residents completed the questionnaire. The mean PCL-5 score for the respondents was 13.65 (SD = 8.66), with 219 (9.28%) patients having probable PTSD symptoms. Respondents who were female (β = 0.038), had a relative or friend who had contracted COVID-19 (β = 0.041), and had poor health (β = 0.184) had higher PCL-5 scores, while the population aged over 60 years (β = -0.063), who agreed that COVID-19 information was released in a timely manner (β = -0.347), who had experienced a relatively limited impact of COVID-19 on their life (β = -0.069), and who agreed that the local prevention initiatives were sophisticated (β = -0.165) had lower PTSD scores. Conclusions: Outbreaks of acute infectious diseases can have long-term psychological health effects in the general population. In addition, health policy makers need to be concerned about and implement measures to support the mental health of vulnerable groups.
Collapse
Affiliation(s)
- Xin Shen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shijiao Yan
- School of Public Health, Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Hui Cao
- Department of Labor Economics and Management, Beijing Vocational College of Labour and Social Security, Beijing, China
| | - Rowan Dowling
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Jing Feng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zihui Lei
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingru Li
- Department of Psychology, School of Education and Human Development, Hong Kong Education University, Hong Kong, China
| | - Xiaotong Han
- Department of Emergency Medicine, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, China
| | - Chuanzhu Lv
- Emergency Medicine Centre, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.,Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences, Hainan Medical University, Haikou, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
34
|
Yang X, Xiong Z, Li Z, Li X, Xiang W, Yuan Y, Li Z. Perceived psychological stress and associated factors in the early stages of the coronavirus disease 2019 (COVID-19) epidemic: Evidence from the general Chinese population. PLoS One 2020; 15:e0243605. [PMID: 33275635 PMCID: PMC7717525 DOI: 10.1371/journal.pone.0243605] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/20/2020] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is an acute respiratory infection caused by novel coronavirus 2019. Many individuals suffered psychological symptoms in the early stage when the epidemic was uncertain. We explored the perceived psychological stress and associated factors in the early stage of COVID-19 epidemic. METHOD The Perceived Stress Scale, Simplified Coping Style Questionnaire, Social Support Rating Scale and a general information questionnaire were integrated in an on-line survey conducted from February 1, 2020 until February 4, 2020. Multiple linear regression analysis was performed to explore whether coping style, social support or other factors contributed to psychological stress. RESULTS A total of 1638 participants were included, of whom 44.3% showed moderate psychological stress. Individuals who were younger, female, unmarried, spent more time on the disease, felt more concern about it, reported lower social support (Subjective Social support; Objective social support; Utilization social support), or showed a negative coping style were more likely to suffer higher psychological stress in the early stages of the COVID-19 epidemic. CONCLUSION Psychological interventions may be targeted to individuals with the risk characteristics identified in this study. It may be helpful to promote social support and positive coping style in the early stage of infectious disease epidemics. This initial evidence from the general Chinese population may be relevant to interventions in other countries for dealing with the COVID-19 and other epidemics.
Collapse
Affiliation(s)
- Xiao Yang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenzhen Xiong
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Zhixiong Li
- The Third Department of Clinical Psychology, Karamay Municipal People's Hospital, Karamay, Xinjiang, China
| | - Xiao Li
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Weiyi Xiang
- The West China College of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yiwen Yuan
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhe Li
- The Mental Health Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- * E-mail:
| |
Collapse
|
35
|
Franceschini C, Musetti A, Zenesini C, Palagini L, Scarpelli S, Quattropani MC, Lenzo V, Freda MF, Lemmo D, Vegni E, Borghi L, Saita E, Cattivelli R, De Gennaro L, Plazzi G, Riemann D, Castelnuovo G. Poor Sleep Quality and Its Consequences on Mental Health During the COVID-19 Lockdown in Italy. Front Psychol 2020; 11:574475. [PMID: 33304294 PMCID: PMC7693628 DOI: 10.3389/fpsyg.2020.574475] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/15/2020] [Indexed: 02/05/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) seriously affected the whole of Italy. The extreme virulence and the speed of propagation resulted in restrictions and home confinement. This change was immediately perceived by people who found themselves exposed to feelings of uncertainty, fear, anger, stress, and a drastic change in the diurnal but above all nocturnal lifestyle. For these reasons, we aimed to study the quality of sleep and its connection to distress levels and to evaluate how lifestyle changed in the Italian population during the lockdown. Methods By means of an Internet survey we recruited 6,519 adults during the whole of the COVID-19 lockdown (from March 10–1st phase to May 4–2nd phase). We investigated the sociodemographic and COVID-19-related information and assessed sleep quality using the Medical Outcomes Study–sleep scale (MOS-SS) and mental health with the short form of Depression, Anxiety, and Stress Scales–21 Items (DASS-21). Multiple logistic regression model was used to evaluate the multivariate association between the dependent variable (good sleeper vs. poor sleeper) and all the variables that were significant in the univariate analysis. Results A total of 3,562 (55.32%) participants reported poor sleep quality according to the MOS-Sleep Index II score. The multiple binary logistic regression results of poor sleepers revealed several risk factors during the outbreak restrictions: female gender, living in Central Italy, having someone close who died because of COVID-19, markedly changed sleep–wake rhythms characterized by earlier or postponed habitual bedtime, earlier habitual awakening time and reduced number of afternoon naps, and extremely severe levels of stress, anxiety, and depression. Conclusion This is the first study designed to understand sleep quality and sleep habits during the whole of the lockdown period in the Italian population that provides more than 6,000 participants in a survey developed specifically for the health emergency related to COVID-19. Our study found that more than half of the Italian population had impaired sleep quality and sleep habits due to elevated psychological distress during the COVID-19 lockdown containment measures. A multidisciplinary action should be undertaken in order to plan appropriate responses to the current crisis caused by the lockdown for the COVID-19 outbreak.
Collapse
Affiliation(s)
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Laura Palagini
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | | | | | - Vittorio Lenzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Roberto Cattivelli
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano IRCCS, Verbania, Italy
| | | | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Dieter Riemann
- Medical Center, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano IRCCS, Verbania, Italy
| |
Collapse
|
36
|
Compère L, Charron S, Gallarda T, Rari E, Lion S, Nys M, Anssens A, Coussinoux S, Machefaux S, Oppenheim C, Piolino P. Gender identity better than sex explains individual differences in episodic and semantic components of autobiographical memory: An fMRI study. Neuroimage 2020; 225:117507. [PMID: 33127480 DOI: 10.1016/j.neuroimage.2020.117507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 10/02/2020] [Accepted: 10/21/2020] [Indexed: 12/22/2022] Open
Abstract
Advances in the literature of sex-related differences in autobiographical memory increasingly tend to highlight the importance of psychosocial factors such as gender identity, which may explain these differences better than sex as a biological factor. To date, however, none of these behavioral studies have investigated this hypothesis using neuroimaging. The purpose of this fMRI study is to examine for the first time sex and gender identity-related differences in episodic and semantic autobiographical memory in healthy participants (M=19, W=18). No sex-related differences were found; however, sex-related effects of masculine and feminine gender identity were identified in men and women independently. These results confirm the hypothesis that differences in episodic and semantic autobiographical memory are best explained by gender but are an interaction between biological sex and gender identity and extend these findings to the field of neuroimaging. We discuss the importance of hormonal factors to be taken into consideration in the future.
Collapse
Affiliation(s)
- Laurie Compère
- Université de Paris, MC(2)Lab, F-92100 Boulogne-Billancourt, Ile de France, France; Department of Psychiatry, University of Pittsburgh School of Medicine, United States.
| | | | - Thierry Gallarda
- «Consultation dysphorie de genre», hôpital Sainte-Anne, groupe hospitalier universitaire (GHU) Paris Psychiatrie et Neuroscience, France
| | - Eirini Rari
- «Consultation dysphorie de genre», hôpital Sainte-Anne, groupe hospitalier universitaire (GHU) Paris Psychiatrie et Neuroscience, France
| | - Stéphanie Lion
- Université de Paris, IPNP, INSERM, F-75005 Paris, France
| | - Marion Nys
- Université de Paris, MC(2)Lab, F-92100 Boulogne-Billancourt, Ile de France, France
| | - Adèle Anssens
- Université de Paris, MC(2)Lab, F-92100 Boulogne-Billancourt, Ile de France, France
| | - Sandrine Coussinoux
- «Consultation dysphorie de genre», hôpital Sainte-Anne, groupe hospitalier universitaire (GHU) Paris Psychiatrie et Neuroscience, France
| | - Sébastien Machefaux
- «Consultation dysphorie de genre», hôpital Sainte-Anne, groupe hospitalier universitaire (GHU) Paris Psychiatrie et Neuroscience, France
| | | | - Pascale Piolino
- Université de Paris, MC(2)Lab, F-92100 Boulogne-Billancourt, Ile de France, France; Institut Universitaire de France (IUF), Paris, France.
| |
Collapse
|
37
|
Verma K, Amitabh, Prasad DN, Kumar B, Kohli E. Brain and COVID-19 Crosstalk: Pathophysiological and Psychological Manifestations. ACS Chem Neurosci 2020; 11:3194-3203. [PMID: 33006881 DOI: 10.1021/acschemneuro.0c00446] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The world is experiencing one of the major viral outbreaks of this millennium, caused by a plus sense single-stranded RNA virus belonging to the Coronaviridae family, COVID-19, declared as pandemic by WHO. The clinical manifestations vary from asymptomatic to mild symptoms like fever, dry cough, and diarrhea, with further increase in severity leading to the development of acute respiratory distress syndrome. Though primary manifestations are respiratory and cardiac, various studies have shown the neuroinvasive capability of this virus resulting in neurological complications, which sometimes can precede common typical symptoms like fever and cough. Common neurological symptoms are headache, dizziness, anosmia, dysgeusia, confusion, and muscle weakening, progressing toward severe complications like cerebrovascular disease, seizures, or paralysis. Older adults and critically ill people are in the high risk group and have shown severe neurological symptoms upon infection. COVID-19 also has a profound impact on the mental health of people across the world. In this review, we briefly discuss the neurological pathologies and psychological impact due to COVID-19, which has not only stressed the physical health of people but has also created social and economic problems resulting in mental health issues.
Collapse
Affiliation(s)
- Kalyani Verma
- Neurobiology Division, Defence Institute of Physiology and Allied Sciences, Delhi 110054, India
| | - Amitabh
- Neurobiology Division, Defence Institute of Physiology and Allied Sciences, Delhi 110054, India
| | - Dipti N. Prasad
- Neurobiology Division, Defence Institute of Physiology and Allied Sciences, Delhi 110054, India
| | - Bhuvnesh Kumar
- Defence Institute of Physiology and Allied Sciences, Delhi 110054, India
| | - Ekta Kohli
- Neurobiology Division, Defence Institute of Physiology and Allied SciencesDefence Research and Development Organization, Ministry of Defence, Lucknow Road, Timarpur, Delhi 110054, India
| |
Collapse
|
38
|
Joshi N, Chandler D. Sex and the noradrenergic system. HANDBOOK OF CLINICAL NEUROLOGY 2020; 175:167-176. [PMID: 33008523 DOI: 10.1016/b978-0-444-64123-6.00012-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
The central noradrenergic system comprises multiple brainstem nuclei whose cells synthesize and release the catecholamine transmitter norepinephrine (NE). The largest of these nuclei is the pontine locus coeruleus (LC), which innervates the vast majority of the forebrain. NE interacts with a number of pre- and postsynaptically expressed G protein-coupled receptors to affect a wide array of functions, including sensory signal processing, waking and arousal, stress responsiveness, mood, attention, and memory. Given the myriad functions ascribed to the locus coeruleus-noradrenergic (LC-NE) system, it is unsurprising that it is implicated in many disease states, including various mood, cognitive, neuropsychiatric, and neurodegenerative diseases. The LC-NE system is also notably sexually dimorphic with regard to its morphologic and anatomical features as well as how it responds to the peptide transmitter corticotropin releasing hormone (CRH), a major mediator of the central stress response. The sex-biased morphology and signaling that is observed in the LC could then be considered a potential contributor to the differential prevalence of various diseases between men and women. This chapter summarizes the primary differences between the male and female LC, based primarily on preclinical observations and how these disparities may relate to differential diagnoses of several diseases between men and women.
Collapse
Affiliation(s)
- Neal Joshi
- Department of Cell Biology and Neuroscience, Rowan University School of Osteopathic Medicine, Stratford, NJ, United States
| | - Daniel Chandler
- Department of Cell Biology and Neuroscience, Rowan University School of Osteopathic Medicine, Stratford, NJ, United States.
| |
Collapse
|
39
|
Psychological status and fatigue of frontline staff two months after the COVID-19 pandemic outbreak in China: A cross-sectional study. J Affect Disord 2020; 275:247-252. [PMID: 32734915 PMCID: PMC7330556 DOI: 10.1016/j.jad.2020.06.032] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 12/19/2022]
|
40
|
Le XTT, Dang AK, Toweh J, Nguyen QN, Le HT, Do TTT, Phan HBT, Nguyen TT, Pham QT, Ta NKT, Nguyen QT, Nguyen AN, Van Duong Q, Hoang MT, Pham HQ, Vu LG, Tran BX, Latkin CA, Ho CSH, Ho RCM. Evaluating the Psychological Impacts Related to COVID-19 of Vietnamese People Under the First Nationwide Partial Lockdown in Vietnam. Front Psychiatry 2020; 11:824. [PMID: 32982807 PMCID: PMC7492529 DOI: 10.3389/fpsyt.2020.00824] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/30/2020] [Indexed: 01/09/2023] Open
Abstract
This is the first time in Vietnam that people have undergone "social distancing" to minimize the spreading of infectious disease, COVID-19. These deliberate preemptive strategies may have profound impacts on the mental health of the population. Therefore, this study aimed to identify the psychological impacts of COVID-19 on Vietnamese people and associated factors. We conducted a cross-sectional study during a one-week social distancing and isolation from April 7 to 14, 2020, in Vietnam. A snowball sampling technique was carried out to recruit participants. Impact of Event Scale-Revised (IES-R) was utilized to assess the psychological impacts of the COVID-19. Of all participants, 233 (16.4%) reported low level of PTSS; 76 (5.3%) rated as moderate, and 77 (5.4%) reported extreme psychological conditions. Being female, above 44 years old, or having a higher number of children in the family were positively associated with a higher level of psychological distress. Being self-employed/unemployed/retired was associated with a higher score of intrusion and hyperarousal subscale. Individuals who have a history of touching objects with the possibility of spreading coronavirus (utensils) were related to a higher level of avoidance. There were relatively high rates of participants suffering from PTSS during the first national lockdown related to COVID-19. Comprehensive strategies for the screen of psychological problems and to support high-risk groups are critical, especially females, middle-aged adults and the elderly, affected laborers, and health care professionals.
Collapse
Affiliation(s)
- Xuan Thi Thanh Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Kim Dang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Jayson Toweh
- Office of Inspector General Department, U.S. Environmental Protection Agency, Atlanta, GA, United States
| | - Quang Nhat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- UFR Biosciences Department, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Toan Thi Thanh Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hanh Bich Thi Phan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Thao Thanh Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Quan Thi Pham
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Nhung Kim Thi Ta
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Quynh Thi Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Ngoc Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Quan Van Duong
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Men Thi Hoang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Linh Gia Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, United States
| | - Carl A. Latkin
- Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, United States
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| |
Collapse
|
41
|
Engel S, van Zuiden M, Frijling JL, Koch SBJ, Nawijn L, Yildiz RLW, Schumacher S, Knaevelsrud C, Bosch JA, Veltman DJ, Olff M. Early posttraumatic autonomic and endocrine markers to predict posttraumatic stress symptoms after a preventive intervention with oxytocin. Eur J Psychotraumatol 2020; 11:1761622. [PMID: 32922686 PMCID: PMC7448939 DOI: 10.1080/20008198.2020.1761622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Efficient prevention of posttraumatic stress disorder (PTSD) needs to target individuals with an increased risk for adverse outcome after trauma. Prognostic or prescriptive biological markers assessed early posttrauma may inform personalized treatment recommendations. OBJECTIVE To test prognostic and prescriptive effects of early (posttraumatic) autonomic and endocrine markers on PTSD symptom development. METHOD Autonomic and endocrine markers were assessed within 12 days posttrauma and before treatment initiation within a randomized placebo-controlled trial investigating repeated oxytocin administration as preventive intervention for PTSD. Linear mixed effects models were used to test the effects of heart rate (variability), resting cortisol, morning cortisol and cortisol awakening response (CAR), cortisol suppression by dexamethasone and resting oxytocin on PTSD symptoms 1.5, 3 and 6 months posttrauma in men (n = 54), women using hormonal contraception (n = 27) and cycling women (n = 19). RESULTS We found significant prognostic effects of resting oxytocin and cortisol suppression. In women using hormonal contraception, higher oxytocin was associated with higher PTSD symptoms across follow-up. Stronger cortisol suppression by dexamethasone, reflecting increased glucocorticoid receptor feedback sensitivity, was associated with lower PTSD symptoms across follow-up in men, but with higher symptoms at 1.5 months in women using hormonal contraception. These effects were independent of treatment condition. No further significant prognostic or prescriptive effects were detected. CONCLUSION Our exploratory study indicates that resting oxytocin and glucocorticoid receptor feedback sensitivity early posttrauma are associated with subsequent PTSD symptom severity. Notably, prognostic effects depended on sex and hormonal contraception use, emphasizing the necessity to consider these factors in biomedical PTSD research.
Collapse
Affiliation(s)
- Sinha Engel
- Amsterdam University Medical Centers, Location Academic Medical Center, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands.,Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Mirjam van Zuiden
- Amsterdam University Medical Centers, Location Academic Medical Center, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Jessie L Frijling
- Amsterdam University Medical Centers, Location Academic Medical Center, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Saskia B J Koch
- Amsterdam University Medical Centers, Location Academic Medical Center, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Laura Nawijn
- Amsterdam University Medical Centers, Location Academic Medical Center, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Rinde L W Yildiz
- Amsterdam University Medical Centers, Location Academic Medical Center, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Sarah Schumacher
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Christine Knaevelsrud
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Jos A Bosch
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Miranda Olff
- Amsterdam University Medical Centers, Location Academic Medical Center, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands.,Arq Psychotrauma Expert Group, Diemen, The Netherlands
| |
Collapse
|
42
|
Kamboj SK, Gong AT, Sim Z, Rashid AA, Baba A, Iskandar G, Das RK, Curran HV. Reduction in the occurrence of distressing involuntary memories following propranolol or hydrocortisone in healthy women. Psychol Med 2020; 50:1148-1155. [PMID: 31084640 DOI: 10.1017/s0033291719001028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Pharmacological treatments targeting the neuroendocrine stress response may hold special promise in secondary prevention of posttraumatic stress disorder (PTSD). However, findings from clinical trials have been inconsistent and the efficacy of specific drugs, their temporal window of efficacy, effective doses and the characteristics of likely treatment responders remain unclear. METHOD Using an experimental human model of distressing involuntary memory formation, we compare the effects of two drugs that have theoretical or empirical support as secondary preventive agents in PTSD. Eighty-eight healthy women (average age: 23.5 years) received oral propranolol (80 mg), hydrocortisone (30 mg), or matched placebo immediately after viewing a 'trauma film'. They then completed daily, time-stamped intrusion diaries for 1 week, at the end of which, voluntary memory was tested. RESULTS While neither drug affected voluntary memory for the trauma narrative, propranolol treatment was associated with 42% fewer, and hydrocortisone with 55% fewer intrusions across the week, relative to placebo. Additionally, propranolol reduced general trauma-like symptoms, and post-drug cortisol levels were negatively correlated with intrusion frequency in the hydrocortisone group. CONCLUSIONS Overall, this study shows substantial reductions in intrusive memories and preserved voluntary narrative-declarative memory following either propranolol or hydrocortisone in an experimental model of psychological trauma. As such, despite some inconsistencies in clinical trials, our findings support continued investigation of propranolol and hydrocortisone as secondary preventive agents for re-experiencing symptoms of PTSD. The findings also suggest that it is critical for future research to identify the conditions governing the preventive efficacy of these drugs in PTSD.
Collapse
Affiliation(s)
| | - An Tong Gong
- Clinical Psychopharmacology Unit, UCL, LondonWC1E 6BT, UK
| | - ZhiHui Sim
- Clinical Psychopharmacology Unit, UCL, LondonWC1E 6BT, UK
| | | | - Ami Baba
- Clinical Psychopharmacology Unit, UCL, LondonWC1E 6BT, UK
| | - Georges Iskandar
- Department of Anaesthesia and Perioperative Medicine, UCLH, London, UK
| | - Ravi K Das
- Clinical Psychopharmacology Unit, UCL, LondonWC1E 6BT, UK
| | | |
Collapse
|
43
|
Liu N, Zhang F, Wei C, Jia Y, Shang Z, Sun L, Wu L, Sun Z, Zhou Y, Wang Y, Liu W. Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psychiatry Res 2020; 287:112921. [PMID: 32240896 PMCID: PMC7102622 DOI: 10.1016/j.psychres.2020.112921] [Citation(s) in RCA: 839] [Impact Index Per Article: 209.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 03/15/2020] [Indexed: 12/11/2022]
Abstract
The outbreak of COVID-19 in China in December 2019 has been identified as a pandemic and a health emergency of global concern. Our objective was to investigate the prevalence and predictors of posttraumatic stress symptoms (PTSS) in China hardest-hit areas during COVID-19 outbreak, especially exploring the gender difference existing in PTSS. One month after the December 2019 COVID-19 outbreak in Wuhan China, we surveyed PTSS and sleep qualities among 285 residents in Wuhan and surrounding cities using the PTSD Checklist for DSM-5 (PCL-5) and 4 items from the Pittsburgh Sleep Quality Index (PSQI). Hierarchical regression analysis and non-parametric test were used to analyze the data. Results indicated that the prevalence of PTSS in China hardest-hit areas a month after the COVID-19 outbreak was 7%. Women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. Participants with better sleep quality or less frequency of early awakenings reported lower PTSS. Professional and effective mental health services should be designed in order to aid the psychological wellbeing of the population in affected areas, especially those living in hardest-hit areas, females and people with poor sleep quality.
Collapse
Affiliation(s)
- Nianqi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Fan Zhang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Cun Wei
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yanpu Jia
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Zhilei Shang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Luna Sun
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Lili Wu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Zhuoer Sun
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yaoguang Zhou
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yan Wang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Weizhi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China.
| |
Collapse
|
44
|
Liu N, Zhang F, Wei C, Jia Y, Shang Z, Sun L, Wu L, Sun Z, Zhou Y, Wang Y, Liu W. Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psychiatry Res 2020; 287:112921. [PMID: 32240896 DOI: 10.1016/j.psychres] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 03/15/2020] [Indexed: 05/23/2023]
Abstract
The outbreak of COVID-19 in China in December 2019 has been identified as a pandemic and a health emergency of global concern. Our objective was to investigate the prevalence and predictors of posttraumatic stress symptoms (PTSS) in China hardest-hit areas during COVID-19 outbreak, especially exploring the gender difference existing in PTSS. One month after the December 2019 COVID-19 outbreak in Wuhan China, we surveyed PTSS and sleep qualities among 285 residents in Wuhan and surrounding cities using the PTSD Checklist for DSM-5 (PCL-5) and 4 items from the Pittsburgh Sleep Quality Index (PSQI). Hierarchical regression analysis and non-parametric test were used to analyze the data. Results indicated that the prevalence of PTSS in China hardest-hit areas a month after the COVID-19 outbreak was 7%. Women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. Participants with better sleep quality or less frequency of early awakenings reported lower PTSS. Professional and effective mental health services should be designed in order to aid the psychological wellbeing of the population in affected areas, especially those living in hardest-hit areas, females and people with poor sleep quality.
Collapse
Affiliation(s)
- Nianqi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Fan Zhang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Cun Wei
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yanpu Jia
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Zhilei Shang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Luna Sun
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Lili Wu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Zhuoer Sun
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yaoguang Zhou
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Yan Wang
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China
| | - Weizhi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai 200433, China.
| |
Collapse
|
45
|
Staugaard SR, Berntsen D. Gender differences in the experienced emotional intensity of experimentally induced memories of negative scenes. PSYCHOLOGICAL RESEARCH 2020; 85:1732-1747. [PMID: 32277252 DOI: 10.1007/s00426-020-01334-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 03/27/2020] [Indexed: 11/25/2022]
Abstract
It is well documented that women have an increased risk of emotional disorders, such as anxiety and depression. Such disorders are typically characterized by intrusive memories and rumination of past events, but findings are mixed as to whether women have enhanced access to memories of emotional events. Some studies have found that women, compared with men, report more frequent and more intense memories of emotionally stressful events, whereas other studies have failed to replicate this effect. These conflicting findings may reflect the use of different memory sampling techniques (e.g., retrospective vs. experimental data) and limited control for factors associated with both gender and emotional memory. The purpose of the present study was to investigate gender differences in memory for emotionally negative events, using three different sampling methods, while at the same time controlling for parameters that might co-vary with gender. Consistent with some previous studies, we found that women and men did not differ in their frequencies of emotionally negative involuntary memories. However, women rated their memories as more intense and arousing than men did, and women also reported higher increases in state anxiety after retrieval. Female gender accounted for unique variance in the emotional intensity and subjective arousal associated with negative memories, when controlling for other theoretically derived variables. The findings provide evidence that female gender is associated with a stronger emotional response to memories of negative events, but not that women remember such events more frequently than men do.
Collapse
Affiliation(s)
- Søren Risløv Staugaard
- Department of Psychology and Behavioral Sciences, Center on Autobiographical Memory Research, Aarhus University, Bartholins Allé 9, 8000, Aarhus C, Denmark.
| | - Dorthe Berntsen
- Department of Psychology and Behavioral Sciences, Center on Autobiographical Memory Research, Aarhus University, Bartholins Allé 9, 8000, Aarhus C, Denmark
| |
Collapse
|
46
|
Seligowski AV, Hurly J, Mellen E, Ressler KJ, Ramikie TS. Translational studies of estradiol and progesterone in fear and PTSD. Eur J Psychotraumatol 2020; 11:1723857. [PMID: 32158516 PMCID: PMC7048196 DOI: 10.1080/20008198.2020.1723857] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/23/2019] [Accepted: 01/08/2020] [Indexed: 12/24/2022] Open
Abstract
Translational models of fear have greatly informed our understanding of PTSD and its underlying fear circuitry. One of the most replicated findings in the field is the two-fold higher PTSD incidence in females compared to males. While sociocultural factors play a role, the most robust biological influencers to date are gonadal hormones, such as estradiol and progesterone, which fluctuate across the menstrual cycle. Among studies that account for these hormones, most do so in isolation or collect both and only report one. Variation in study findings suggests that the ratio between these two hormones (the P/E ratio) may be an important and missing variable to further understand gonadal hormone influences on fear. Here we review cross-species examinations of fear and PTSD, within the contexts of estradiol and progesterone as well as P/E ratios that were calculated based on extant literature. We then provide recommendations for best practices in assay methods and reporting to improve research on the P/E ratio in fear and PTSD. Ultimately, greater understanding of this important variable will advance efforts to characterize gonadal hormone influences on fear learning processes in humans and animals.
Collapse
Affiliation(s)
- Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,McLean Hospital, Belmont, MA, USA
| | - Jordyn Hurly
- McLean Hospital, Belmont, MA, USA.,Northeastern University, Boston, MA, USA
| | | | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,McLean Hospital, Belmont, MA, USA
| | - Teniel S Ramikie
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,McLean Hospital, Belmont, MA, USA
| |
Collapse
|
47
|
Abstract
Previous studies have revealed stress-induced dysregulation of hypothalamic-pituitary-adrenal (HPA) axis in women with premenstrual syndrome (PMS). So far, however, the results about the relationship between HPA axis dysregulation and PMS are mixed. To this end, it is necessary to investigate the basal activity of the HPA axis in women with PMS instead of only assessing a certain stressor. Therefore, this study evaluated the relationship between the cortisol awakening response (CAR) and PMS. Thirty-two women with PMS (mean age 22.47 ± 2.20 years) and 36 healthy controls (mean age 22.28 ± 2.43 years) were included in this study. Saliva samples of our participants were collected successively at 0, 30, 45, and 60 min after awakening to assess CAR during each of two phases of the menstrual cycle (the mid-follicular phase and the late luteal phase). The results showed a significantly attenuated CAR in women with PMS compared with the healthy controls, especially at 45 and 60 min after awakening, regardless of the menstrual cycle phases. Furthermore, there was a significant negative correlation between PMS severity as measured by PMS scale and AUCi (i.e. the Area Under the Curve with respect to increase) in the mid-follicular phase. Our findings suggested that an attenuated CAR activity profile may be an important risk factor for the development of PMS.
Collapse
Affiliation(s)
- Lulu Hou
- Department of Psychology, Nanjing University , Nanjing , China
| | - Yamei Huang
- Mental Health Education and Counseling Center, Beijing Institute of Fashion Technology , Beijing , China
| | - Renlai Zhou
- Department of Psychology, Nanjing University , Nanjing , China
| |
Collapse
|
48
|
An alternative theory for hormone effects on sex differences in PTSD: The role of heightened sex hormones during trauma. Psychoneuroendocrinology 2019; 109:104416. [PMID: 31472433 DOI: 10.1016/j.psyneuen.2019.104416] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/05/2019] [Accepted: 08/22/2019] [Indexed: 02/08/2023]
Abstract
Women are at least twice as susceptible to developing post-traumatic stress disorder (PTSD) compared to men. Although most research seeking to explain this discrepancy has focussed on the role of oestradiol during fear extinction learning, the role of progesterone has been overlooked, despite relatively consistent findings being reported concerning the role of progesterone during consolidation of emotional and intrusive memories. In this review article, we outline literature supporting the role of progesterone on memory formation, with particular emphasis on potential memory-enhancing properties of progesterone when subjects are placed under stress. It is possible that progesterone directly and indirectly exerts memory-enhancing effects at the time of trauma, which is an effect that may not be necessarily captured during non-stressful paradigms. We propose a model whereby progesterone's steroidogenic relationship to cortisol and brain-derived neurotrophic factor in combination with elevated oestradiol may enhance emotional memory consolidation during trauma and therefore present a specific vulnerability to PTSD formation in women, particularly during the mid-luteal phase of the menstrual cycle.
Collapse
|
49
|
Ravi M, Stevens JS, Michopoulos V. Neuroendocrine pathways underlying risk and resilience to PTSD in women. Front Neuroendocrinol 2019; 55:100790. [PMID: 31542288 PMCID: PMC6876844 DOI: 10.1016/j.yfrne.2019.100790] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/26/2019] [Accepted: 09/18/2019] [Indexed: 01/23/2023]
Abstract
Women are twice as likely than men to suffer from posttraumatic stress disorder (PTSD). While women have increased exposure to traumatic events of many types and have greater prevalence of comorbid psychiatric disorders compared to men, these differences do not account for the overall sex difference in the prevalence of PTSD. The current review summarizes significant findings that implicate the role of estradiol, progesterone, and allopregnanolone in female risk for PTSD symptoms and dysregulation of fear psychophysiology that is cardinal to PTSD. We also discuss how these steroid hormones influence the stress axis and neural substrates critical for the regulation of fear responses. Understanding the role of ovarian steroid hormones in risk and resilience for trauma-related adverse mental health outcomes across the lifespan in women has important translational, clinical, and intergenerational implications for mitigating the consequences of trauma exposure.
Collapse
Affiliation(s)
- Meghna Ravi
- Emory University Graduate Program in Neuroscience, Atlanta, GA, United States
| | - Jennifer S Stevens
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, United States
| | - Vasiliki Michopoulos
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, United States; Yerkes National Primate Research Center, Atlanta, GA, United States.
| |
Collapse
|
50
|
Abstract
Women undergo developmental and cyclic changes in hormonal exposures that affect brain function and mental health. Some women are more vulnerable to the effects of these hormonal exposures, for reasons that remain to be determined. Evidence to date indicates that anxiety and mood disorders are the most sensitive to hormonal fluctuations in women but there is also growing evidence for a protective effect of female reproductive hormones on schizophrenia. The hormonal exposures of the menstrual cycle, pregnancy, the postpartum period, lactation, and menopause are quite different and may be associated with at least partially distinct symptom profiles.
Collapse
Affiliation(s)
- Margaret Altemus
- VA Connecticut Health Care System, Women's Clinic, Building 2, Room 7-165, 950 Campbell Avenue, New Haven, CT 06516, USA.
| |
Collapse
|