The impact of comorbid diagnoses on the course of posttraumatic stress disorder symptoms in residents of battered women's shelters

Healthcare resource utilisation and suicidal ideation amongst adolescents in the US with posttraumatic stress disorder, major depressive disorder, and substance use disorders using electronic health records

BACKGROUND

While PTSD is commonly associated with multiple comorbidities, studies have yet to quantify the impact of these comorbidities on key clinical outcomes and HCRU. This study explored risks of emergency room (ER) visits, inpatient admissions (IA), suicidal ideation (SI), and treatment follow-up duration (FU), amongst PTSD patients with comorbid MDD and/or SUD.

METHODS

Using real-world data (RWD) generated by electronic health records accessed from the NeuroBlu database, a cohort of adolescent patients (12-17 yrs) was examined over a one-year study period following PTSD diagnosis.

RESULTS

5794 patients were included in the cohort. Compared to patients with only PTSD (n = 3061), those with comorbid MDD (n = 1820) had greater odds of ER (4.5 times), IA (1.6 times), and FU (4.3 times). Those with comorbid SUD (n = 653) had greater odds of IA (4.5 times), shorter FU (34 days), and lower odds of ER (0.5 times). Both comorbidities (n = 260) had greater odds of ER (3.8 times), IA (2.6 times), SI (3.6 times), and shorter FU (12 days).

LIMITATIONS

These RWD had a high proportion of missingness. Health records of patients who changed service providers could not be accounted for in this study.

CONCLUSIONS

Both MDD and SUD substantially elevated the risk of HCRU and suicidal ideation for PTSD patients.

Mental and Physical Health Changes Following an Abusive Intimate Relationship: A Systematic Review of Longitudinal Studies

Longitudinal studies are critical to understanding health changes following trauma. The present systematic review adopted a longitudinal perspective on intimate partner abuse (IPA) by examining characteristics and findings of studies that followed persons who recently left an abusive relationship or who were at a point where they might leave and reported on health over time. Web of Science, EBSCO, Published International Literature on Traumatic Stress, and PubMed databases were searched using combinations of terms reflecting IPA, longitudinal study design, and health outcomes. Quantitative studies that recruited adults or adolescents, had multiple time points, used a health indicator as an outcome, and where IPA was a predictor, independent variable, or inclusion criterion were included. These methods yielded 36 studies from 20 unique samples. The following domains were coded for each article: citation, demographics, risk of bias, sample setting, design, follow-up, relationship and IPA characteristics, outcomes, and analytic focus. Results showed that all samples were female, and most were help-seeking. Depression, post-traumatic stress, and physical symptoms decreased over time, while quality of life increased in most studies. Changes in anxiety symptoms over time were less consistent. Ongoing IPA and social support were the most consistent predictors of health changes over time, showing relations with indicators of poorer or better health, respectively. There was preliminary evidence that decreases in emotional and physical symptoms plateaued within 9 months of the baseline assessment. Sampling, study design, measurement, and analysis are considered, and recommendations for future research are provided.

"Dreaming Undreamt Dreams" in Psychological Counseling with Italian Women Who Experienced Intimate Partner Violence: A Phenomenological-Interpretative Analysis of the Psychologists' Experience

In psychological consultations with women who survive Intimate Partner Violence, it is essential to work on elaboration of the trauma as a complex trauma within the context of a relationship. We consider dreams to be a symbolic-representative process, which requires the right psychic, relational and contextual conditions to occur, and that is hindered when trauma is present. The objective of the present study is to investigate the meanings that psychologists working at anti-violence centers attribute to the clinical intervention with women victims of IPV, with a focus on the area of sleep and dreaming in a traumatic experience, and in the clinical work on the trauma. Twelve female psychologists were interviewed using the Interpretative Phenomenological Analysis methodology. From the analysis of the interviews, three main themes emerged: (1) Day and night, neither awake nor asleep, (2) Anti Violence Centers: setting as a container of emotion? and (3) dreaming undreamt dreams. The study highlights the importance of dreams as an indicator not only of psychic and mental functioning but also of the psychological relationship within a specific context.

Alteraciones en funciones cognitivas en mujeres maltratadas

El presente estudio ha tenido como objetivo realizar una revisión sistemática y meta-análisis sobre alteraciones en funciones cognitivas en mujeres maltratadas. Se ha contado con una muestra inicial de 643 registros obtenidos de las bases de datos: Medline, ERIC, PsycInfo, CNAIL, Proquest y Scielo. Su análisis llevó a la retención de 12 artículos sobre los que se ha centrado el estudio. Los resultados de la síntesis cualitativa indican que la atención, lenguaje, memoria, habilidades visoespaciales, función ejecutiva, velocidad motora y rendimiento educativo se encuentran alteradas en las mujeres maltratadas, con mayor evidencia de deterioro en las áreas de atención, memoria y funciones ejecutivas. Los resultados del meta-análisis sugieren presencia de daño cerebral en estas mujeres y una especial afectación de la memoria y funciones ejecutivas. Estos resultados avalan la existencia de alteraciones en funciones cognitivas en las mujeres que han sido víctimas de maltrato.