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Ruisch JE, Havermans DCD, Gielkens EMJ, Olff M, Daamen MAMJ, van Alphen SPJ, van Kordenoordt M, Schols JMGA, Schruers KRJ, Sobczak S. Posttraumatic stress disorder in people with dementia: study protocol. Eur J Psychotraumatol 2024; 15:2320040. [PMID: 38488137 PMCID: PMC10946268 DOI: 10.1080/20008066.2024.2320040] [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: 07/26/2023] [Accepted: 01/31/2024] [Indexed: 03/19/2024] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is considered an independent risk factor for dementia. Despite the (clinical) evidence that PTSD is associated with neuropsychiatric symptoms in people with dementia, studies on its prevalence and clinical manifestation are limited, and their quality is affected by the lack of a structured method to diagnose PTSD in this population. The primary aim of the current study is to validate the 'TRAuma and DEmentia' interview as a diagnostic tool for PTSD in people with dementia and to test feasibility of EMDR treatment for people with PTSD and dementia.Methods: This prospective multi-centre study is divided into two parts. In study A, 90 participants with dementia will be included to test the criterion validity, inter-rater reliability and feasibility of the 'TRAuma and DEmentia' interview. In study B, 29 participants with dementia and PTSD will receive eye movement desensitisation and reprocessing therapy by a trained psychologist, and 29 participants with dementia and PTSD will be placed on the waiting list control group.Conclusion: This study aims to improve the diagnostic process of PTSD and to assess the effects of eye movement desensitisation and reprocessing treatment in people with dementia living in Dutch care facilities.Trial registration: NL70479.068.20 / METC 20-063 / OSF registration: https://doi.org/10.17605/OSF.IO/AKW4F.
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Affiliation(s)
- J. E. Ruisch
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht, the Netherlands
- Envida, Care for Older People, Department of Treatment and Support, Maastricht, the Netherlands
- Department of Family Medicine, Maastricht University, Maastricht, the Netherlands
| | - D. C. D. Havermans
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
- TanteLouise, Bergen op Zoom, the Netherlands
| | - E. M. J. Gielkens
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Vrije Universiteit Brussel (VUB), Department of Psychology, Personality and Psychopathology Research Group (PEPS), Brussels, Belgium
| | - M. Olff
- Department of Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health, Amsterdam, the Netherlands
- ARQ National Psychotrauma Centre, Diemen, the Netherlands
| | - M. A. M. J. Daamen
- Department of Family Medicine, Maastricht University, Maastricht, the Netherlands
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Cicero, Department of Treatment and Guidance, Brunssum, the Netherlands
| | - S. P. J. van Alphen
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Vrije Universiteit Brussel (VUB), Department of Psychology, Personality and Psychopathology Research Group (PEPS), Brussels, Belgium
| | - M. van Kordenoordt
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Zuyderland Care, Sittard, the Netherlands
| | - J. M. G. A. Schols
- Envida, Care for Older People, Department of Treatment and Support, Maastricht, the Netherlands
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - K. R. J. Schruers
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht, the Netherlands
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
| | - S. Sobczak
- Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
- Research Center Innovations in Care, Rotterdam University of Applied Science, Rotterdam, the Netherlands
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Cations M, Atee M, Morris T, Whiting D. Neuropsychiatric symptoms of dementia in those with and without a recorded history of psychological trauma: A comparative study from an Australian dementia support service. Int J Geriatr Psychiatry 2024; 39:e6054. [PMID: 38185811 PMCID: PMC10952246 DOI: 10.1002/gps.6054] [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: 09/05/2023] [Accepted: 12/30/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To compare the number and severity of neuropsychiatric symptoms (NPS) and associated caregiver distress between those with and without a noted history of psychological trauma among those referred to a specialised national dementia NPS support service. METHODS This was a 5-year retrospective observational study of records from the Dementia Support Australia NPS support service. NPS were reported by formal or informal caregivers at service entry using the Neuropsychiatric Inventory Nursing Home version or Questionnaire version. A history of psychological trauma was recorded in the person's social or medical history and/or endorsed as a contributor to NPS by a trained dementia consultant after a comprehensive clinical review. Regression was used to examine the impact of a recorded history of psychological trauma on NPS severity and associated caregiver distress, controlling for age and sex. RESULTS Among 41,876 eligible referrals with dementia, 6% (n = 2529) had some reference in their records to a history of psychological trauma. Referrals with a recorded history of psychological trauma were rated with a higher rate of both NPS severity (mean = 12.0) and associated caregiver distress (mean = 16.5) at service entry than those without a recorded history of psychological trauma (means = 10.7 and 14.5, respectively). A recorded history of psychological trauma was associated with higher odds of psychotic symptoms, agitation/aggression, irritability, disinhibition, affective symptoms and night-time behaviours. CONCLUSIONS Traumatic stress symptoms may represent a neglected target for intervention to reduce the impact of NPS in people with dementia.
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Affiliation(s)
- Monica Cations
- College of Education, Psychology and Social WorkFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Mustafa Atee
- The Dementia CentreHammondCareOsborne ParkWestern AustraliaAustralia
- Faculty of Health SciencesCurtin Medical SchoolCurtin UniversityBentleyWestern AustraliaAustralia
- Faculty of Medicine and HealthSydney Pharmacy SchoolThe University of SydneySydneyNew South WalesAustralia
- Centre for Research in Aged CareSchool of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Thomas Morris
- The Dementia CentreHammondCareSt LeonardsNew South WalesAustralia
- Faculty of Medicine and HealthSydney School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Daniel Whiting
- The Dementia CentreHammondCareSt LeonardsNew South WalesAustralia
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Rajkumar RP. Biomarkers of Neurodegeneration in Post-Traumatic Stress Disorder: An Integrative Review. Biomedicines 2023; 11:biomedicines11051465. [PMID: 37239136 DOI: 10.3390/biomedicines11051465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Post-Traumatic Stress Disorder (PTSD) is a chronic psychiatric disorder that occurs following exposure to traumatic events. Recent evidence suggests that PTSD may be a risk factor for the development of subsequent neurodegenerative disorders, including Alzheimer's dementia and Parkinson's disease. Identification of biomarkers known to be associated with neurodegeneration in patients with PTSD would shed light on the pathophysiological mechanisms linking these disorders and would also help in the development of preventive strategies for neurodegenerative disorders in PTSD. With this background, the PubMed and Scopus databases were searched for studies designed to identify biomarkers that could be associated with an increased risk of neurodegenerative disorders in patients with PTSD. Out of a total of 342 citations retrieved, 29 studies were identified for inclusion in the review. The results of these studies suggest that biomarkers such as cerebral cortical thinning, disrupted white matter integrity, specific genetic polymorphisms, immune-inflammatory alterations, vitamin D deficiency, metabolic syndrome, and objectively documented parasomnias are significantly associated with PTSD and may predict an increased risk of subsequent neurodegenerative disorders. The biological mechanisms underlying these changes, and the interactions between them, are also explored. Though requiring replication, these findings highlight a number of biological pathways that plausibly link PTSD with neurodegenerative disorders and suggest potentially valuable avenues for prevention and early intervention.
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Affiliation(s)
- Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India
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Ruisch JE, Nederstigt AHM, van der Vorst A, Boersma SN, Vink MT, Hoeboer CM, Olff M, Sobczak S. Treatment of post-traumatic stress disorder in people with dementia: a structured literature review. Psychogeriatrics 2023; 23:523-534. [PMID: 36932467 DOI: 10.1111/psyg.12951] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 03/19/2023]
Abstract
Post-traumatic stress disorder (PTSD) is associated with cognitive dysfunctions and is an independent risk factor for dementia. A recent study has found the prevalence of PTSD in people with dementia is 4.7%-7.8%. However, little is known about the effectiveness of PTSD treatment for people with dementia. The primary aim of the current study is to review previous studies on the treatment of PTSD in people with dementia. A structured literature review was performed using a 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' analysis in PubMed, Embase, PsycINFO and CINAHL. Two independent researchers screened titles and abstracts. The inclusion criteria were: PTSD symptoms present, diagnosis of dementia, PTSD treatment form described and effects of the treatment mentioned. Articles that matched these criteria were included and content and quality were analyzed. We included nine articles, all case reports, with a total of 11 cases. The discussed treatment options are eye movement desensitisation and reprocessing (EMDR) (n = 3), prolonged exposure (n = 1), cognitive behavioural therapy (n = 1) and pharmacological treatment (n = 4). All articles reported a positive effect of the intervention on several monitored symptoms. Evidence for positive effects and feasibility of EMDR were most reliable, and it was applied in two articles of sufficient quality published in 2018 and 2019. EMDR 'on-the-spot' was described with positive effect in one article in which three cases were discussed. The quality of included papers ranged from insufficient to sufficient. This review shows that people with PTSD and dementia can benefit from PTSD treatment. EMDR, prolonged exposure, acceptance and commitment therapy and pharmacological treatment are applicable in this population. EMDR treatment is most described in this population (n = 5) and shows positive results, and the studies are of sufficient quality (n = 3). Further research in the form of a randomised controlled trial is required to study the effectivity of different treatment interventions in this population.
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Affiliation(s)
- J E Ruisch
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht, The Netherlands.,Department of Treatment and Guidance, Envida, Care for Elderly, Maastricht, The Netherlands
| | - A H M Nederstigt
- Department of Treatment and Guidance, Sevagram, Care for Elderly, Heerlen, The Netherlands.,VOSON, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A van der Vorst
- Department of Treatment and Guidance, Envida, Care for Elderly, Maastricht, The Netherlands
| | - S N Boersma
- VOSON, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M T Vink
- GERION, Department of Medicine for Older People, Amsterdam University Medical Centre/VUmc, Amsterdam, The Netherlands
| | - C M Hoeboer
- Department of Psychiatry, Amsterdam University Medical Centres Location AMC, Amsterdam Public Health, Amsterdam, The Netherlands
| | - M Olff
- Department of Psychiatry, Amsterdam University Medical Centres Location AMC, Amsterdam Public Health, Amsterdam, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - S Sobczak
- Mondriaan Mental Health Centre, Heerlen-Maastricht, The Netherlands.,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Havermans DC, van Alphen SP, Olff M, Van der Velden-Daamen M, Verhey F, Rutten BP, Stuijts P, Cook JM, Sobczak S. The Need for a Diagnostic Instrument to Assess Post-Traumatic Stress Disorder in People with Dementia: Findings from a Delphi Study. J Geriatr Psychiatry Neurol 2023; 36:129-142. [PMID: 35713096 PMCID: PMC9941654 DOI: 10.1177/08919887221103583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cognitive and behavioral aspects may mask posttraumatic stress disorder (PTSD) in people with dementia. PTSD severely lowers quality of life in people with dementia. Proper recognition of PTSD is essential to ensure adequate treatment. However, a valid diagnostic tool for PTSD in dementia is lacking. A Delphi study was conducted among 20 Dutch and 6 international experts in the field of PTSD and dementia care or research. The aim was to reach consensus in 3 rounds on the added value, form, content, and application for developing such an instrument. The first round confirmed the need for a new diagnostic tool for research and clinical practice. Consensus was reached on 23 statements regarding the support base and 19 related to content of the instrument. In the third round, opinions on several conceptual problems were gathered. Based on the experts' opinions, a draft version of an instrument, the TRAuma and DEmentia-interview (TRADE-interview), was developed. Clinical and research implications of this new measure are discussed.
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Affiliation(s)
- Demi C.D. Havermans
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands
- Demi C.D. Havermans, MSc, Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands. Kloosterkensweg 10, 6419PJ Heerlen.
| | - Sebastiaan P.J. van Alphen
- Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands
- Department of Clinical and Life Span Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Medical and Clinical Psychology, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Miranda Olff
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Centers Location AMC, Amsterdam, The Netherlands
| | - Mariëlle Van der Velden-Daamen
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Department of Psychogeriatrics, Cicero-Zorggroep, Brunssum, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Bart P.F. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Joan M Cook
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sjacko Sobczak
- Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Świerad M, Świerad I, Szydło R, Honisz G, Gąsior M, Kalarus Z, Dyrbuś K. Assessment of the Level of Anxiety for COVID-19 Vaccinations. Vaccines (Basel) 2022; 10:vaccines10060915. [PMID: 35746523 PMCID: PMC9227172 DOI: 10.3390/vaccines10060915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/04/2022] [Accepted: 06/07/2022] [Indexed: 01/15/2023] Open
Abstract
Research published especially in the last decade indicates the influence of anxiety on the human decision-making process. This study analyzes the anxiety among individuals who decided to undergo vaccinations for COVID-19. The study assesses that the level of education, especially medical education, age, and gender, had an influence on the level of anxiety in terms of vaccination situations. The STAI self-assessment questionnaire was used. The study was conducted anonymously using the paper-pencil method during two rounds of vaccination; therefore, the respondent sample included mainly medical personnel and elderly people. A total of 898 questionnaires were issued. Age did not affect the trait and state of anxiety, but highly educated people tested during vaccination had a lower anxiety level. Gender had no influence on the trait but did influence the state of anxiety. Overall, women were the group that exhibited a higher level of anxiety than men. Nurses were particularly vulnerable to the negative effects of situational medication in this group.
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Affiliation(s)
- Marcin Świerad
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases in Zabrze, 41-800 Zabrze, Poland; (M.Ś.); (G.H.); (Z.K.)
| | - Ilona Świerad
- Psychological and Pedagogical Counseling Center No. 3 in Katowice, 40-096 Katowice, Poland;
| | - Robert Szydło
- Department of Labor Resource Management, Cracow University of Economics, 31-510 Kraków, Poland
- Correspondence: ; Tel.: +48-660715085
| | - Grzegorz Honisz
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases in Zabrze, 41-800 Zabrze, Poland; (M.Ś.); (G.H.); (Z.K.)
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (M.G.); (K.D.)
| | - Zbigniew Kalarus
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases in Zabrze, 41-800 Zabrze, Poland; (M.Ś.); (G.H.); (Z.K.)
| | - Krzysztof Dyrbuś
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (M.G.); (K.D.)
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