Posttraumatic stress disorder in bosnian war veterans: Analysis of stress events and risk factors

Migraine and Neuroticism: A Scoping Review

Headache is the first cause of consultation in neurology, and one of the most frequent reasons for consultation in general medicine. Migraine is one of the most common, prevalent, and socioeconomically impactful disabling primary headache disorders. Neuroticism can be conceptualized as a disposition to suffer anxiety and emotional disorders in general. Neuroticism has been associated with various mental and physical disorders (e.g., chronic pain, depression), including migraine. With the aim to explore in depth the relationship between migraine and neuroticism, and contribute to the understanding of this relation in order to provide a better treatment for migraine patients based on a personalized and more comprehensive approach, a scoping review was performed using PubMed, Scopus, and Web of Science. Databases were searched independently by the two researchers, reaching a final set of 18 articles to be included. The search terms were: migraine and neuroticism. Neuroticism seems to be highly prevalent in migraine patients. Findings reveal that migraine patients with comorbid depression and anxiety showed higher levels of neuroticism. Depression has been associated with an increased risk of transformation from episodic to chronic migraine whereas neuroticism might be a mediator factor. Neuroticism also might be a mediator factor between childhood maltreatment and migraine. The revision conducted confirms that: (1) Migraine patients usually have a higher level of neuroticism and vulnerability to negative affect, compared to non-migraineurs and tension-type headache patients. (2) Neuroticism is associated with migraine. Nonetheless, more research is needed to clarify potential moderators of this relationship and the role of neuroticism itself in this disease. This knowledge might be useful in order to promote a better management of negative emotions as part of intervention programs in migraine.

Comparison of Prevalence and Risk Factors of PTSS Between Chinese Patients With Depression and Non-depressed Controls During COVID-19 Outbreak

Background: COVID-19 pandemic is a traumatic event all over the world, and may lead to post-traumatic stress symptom (PTSS) in different population who are under the threat of novel corona virus. Therefore, the aim of our study was to compare the prevalence and risk factors of PTSS between Chinese patients with depression and non-depressed controls during the COVID-19 outbreak. Methods: 437 depressed patients and 2,940 non-depressed controls were enrolled in this cross-sectional study between February 14 and May 9, 2020.The Impact of Events Scale-Revised (IES-R), Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the psychological status of all the participants. Results: The prevalence of PTSS (IES-R ≥ 33) in depressed patients (45.08%) was higher than that in non-depressed controls (5.31%). Patients with depression were 16 times more likely to suffer from PTSS than those without depression. Correlation analyses showed that the IES-R total score was positively correlated with SDS, SAS, and PSQI scores in both depressed and non-depressed groups (Bonferroni corrected all p < 0.001). Multiple linear regression analysis showed that SAS score, and PSQI score were independently associated with IES-R total score in both depression and non-depression groups. In depressed patients, education level and duration of media exposure to COVID-19 were positively associated with PTSS, while in the non-depressed group, subjects who were married, in the 31-50 year group or with higher SDS score were more likely to develop PTSS. Conclusions: These results indicate that the prevalence rate of PTSS in patients with depression is very higher than that in subjects without depression. PTSS are associated with a number of socio-demographic and clinical variables.

The negative impact of single prolonged stress (SPS) on bone development in mice

Posttraumatic stress disorder (PTSD) disrupts hypothalamic-pituitary-adrenal (HPA) axis function. Given the established role of HPA axis hormones in regulating bone metabolism, we tested the hypothesis that traumatic stress has a negative impact on bone development. We employed a variant single prolonged stress (SPS) model in which several stressors were applied to three week old C57BL/6J mice. Compared to the controls, the stressed mice showed increased freezing behavior reminiscent of PTSD symptoms. At two weeks, bone mineral content (BMC), bone area (B area) and bone mineral density (BMD) in total body based on dual-energy X-ray absorptiometry (DXA) analysis were reduced by 10.2%, 7.0% and 3.6%, respectively. Micro-CT analysis of the metaphyseal region of the excised tibia revealed that SPS caused a deterioration of trabecular architecture with trabecular number (Tb.N), BV/TV, connectivity density (Conn-Den) decreasing 12.0%, 18.9%, 23.3% and trabecular spacing (Tb.Sp), structure model index (SMI) increasing 13.9%, 21.8%, respectively. Mechanical loading increased the cross-sectional area in the mid-shaft region of the loaded right versus unloaded left tibia by 7.6% in the controls, and 10.0% in the stressed mice. Therefore, SPS applied to pre-pubertal young mice produced strong negative impact on both bone mass acquisition and trabecular architecture. Mechanical loading can be employed to increase bone size, a parameter related to bone strength, in normal as well as stressed conditions.

Lasting consequences of traumatic events on behavioral and skeletal parameters in a mouse model for post-traumatic stress disorder (PTSD)

BACKGROUND

Post-traumatic stress disorder (PTSD) is an anxiety disorder that not only affects mental health, but may also affect bone health. However, there have been no studies to examine the direct relationship between PTSD and bone.

METHODOLOGY/PRINCIPAL FINDINGS

We employed electric shocks in mice to simulate traumatic events that cause PTSD. We also injected the anxiogenic drug FG-7142 prior to electric shocks. Electric shocks created lasting conditioned fear memory in all mice. In young mice, electric shocks elicited not only behavioral response but also skeletal response, and injection of FG-7142 appeared to increase both types of response. For example in behavioral response within the first week, mice shocked alone froze an average of 6.2 sec in 10 sec tests, and mice injected with FG-7142 froze 7.6 sec, both significantly different (P<0.05) from control mice, which only froze 1.3 sec. In skeletal response at week 2, shocks alone reduced 6% bone mineral content (BMC) in total body (P = 0.06), while shocks with FG-7142 injection reduced not only 11% BMC (P<0.05) but also 6% bone mineral density (BMD) (P<0.05). In addition, FG-7142 injection also caused significant reductions of BMC in specific bones such as femur, lumbar vertebra, and tibia at week 3. Strong negative correlations (R(2) = -0.56, P<0.05) and regression (y = 0.2527-0.0037 * x, P<0.01) between freezing behavior and total body BMC in young mice indicated that increased contextual PTSD-like behavior was associated with reduced bone mass acquisition.

CONCLUSIONS/SIGNIFICANCE

This is the first study to document evidence that traumatic events induce lasting consequences on both behavior and skeletal growth, and electric shocks coupled with injection of anxiogenic FG-7142 in young mice can be used as a model to study the effect of PTSD-like symptoms on bone development.