Evaluation of post-traumatic stress disorder (PTSD) and related comorbidities in clinical studies

Relationship between self-psychological adjustment and post-traumatic growth in patients with lung cancer undergoing chemotherapy: a cross-sectional study

OBJECTIVES

This study aimed to determine the potential profiles of self-psychological adjustment in patients with lung cancer undergoing chemotherapy, including sense of coherence (SOC) and positive cognitive emotion regulation (PCER). The relationship between these profiles with post-traumatic growth (PTG) and the relevant factors of self-psychological adjustment in different profiles was analysed.

DESIGN

Cross-sectional study.

SETTING

Patients with lung cancer undergoing chemotherapy in China.

PARTICIPANTS

A total of 330 patients with lung cancer undergoing chemotherapy were recruited out of which 321 completed the questionnaires effectively.

METHODS

Latent profile analysis was used to identify self-psychological adjustment classes based on the two subscales of the Sense of Coherence Scale and Cognitive Emotion Regulation Questionnaire. One-way analysis of variance and multinomial logistic regression were performed to examine the subgroup association with characteristics and PTG.

RESULTS

Three latent profiles of self-psychological adjustment were identified: low level (54.5%), high SOC-low PCER (15.6%) and high PCER (29.9%). The results of univariate analysis showed a significant difference in PTG scores among different self-psychological adjustment subgroups (F=11.55, p<0.001). Patients in the high-PCER group were more likely living in urban areas (OR=2.41, 95% CI 1.17 to 4.97, p=0.02), and time since cancer diagnosis was ≥6 months and <1 year (OR=3.54, 95% CI 1.3 to 9.64, p<0.001).

CONCLUSION

This study revealed that most patients with lung cancer undergoing chemotherapy belonged to the low-level group. Three profiles are associated with PTG. There were differences in characteristics between patients treated with chemotherapy for lung cancer in the high-PCER and low-PCER groups. Thus, these profiles provide useful information for developing targeted individualised interventions based on demographic characteristics that would assist PTG in patients with lung cancer undergoing chemotherapy.

Potential oxidative stress related targets of mitochondria-focused therapy of PTSD

Post-traumatic stress disorder (PTSD) remains a highly prevalent, under-diagnosed, and under-treated psychiatric disorder that often deteriorates over time, and is highly comorbid with major depressive disorder, suicidality, and substance use disorder. Several biomarkers have been proposed but have yet to be implemented into clinical practice. Treatments, including selective serotonin reuptake inhibitors, are efficacious in only a small number of patients, which underscores the need to develop novel, efficient treatments. Mitochondrial dysfunction resulting from chronic oxidative stress has been linked with both altered neurotransmitter signaling and the inflammatory response. Hereinafter, we discuss mechanisms by which mitochondrial dysfunction may contribute to the development of PTSD symptoms, and how these may even increase PTSD susceptibility. We also highlight possible therapeutic targets to reduce oxidative stress to prevent or treat PTSD symptoms.

Steady electrocorticogram characteristics predict specific stress-induced behavioral phenotypes

Introduction

Depending on the individual, exposure to an intense stressor may, or may not, lead to a stress-induced pathology. Predicting the physiopathological evolution in an individual is therefore an important challenge, at least for prevention. In this context, we developed an ethological model of simulated predator exposure in rats: we call this the multisensorial stress model (MSS). We hypothesized that: (i) MSS exposure can induce stress-induced phenotypes, and (ii) an electrocorticogram (ECoG) recorded before stress exposure can predict phenotypes observed after stress.

Methods

Forty-five Sprague Dawley rats were equipped with ECoG telemetry and divided into two groups. The Stress group (n = 23) was exposed to an MSS that combined synthetic fox feces odor deposited on filter paper, synthetic blood odor, and 22 kHz rodent distress calls; the Sham group (n = 22) was not exposed to any sensorial stimulus. Fifteen days after initial exposure, the two groups were re-exposed to a context that included a filter paper soaked with water as a traumatic object (TO) reminder. During this re-exposure, freezing behavior and avoidance of the filter paper were measured.

Results

Three behaviors were observed in the Stress group: 39% developed a fear memory phenotype (freezing, avoidance, and hyperreactivity); 26% developed avoidance and anhedonia; and 35% made a full recovery. We also identified pre-stress ECoG biomarkers that accurately predicted cluster membership. Decreased chronic 24 h frontal Low θ relative power was associated with resilience; increased frontal Low θ relative power was associated with fear memory; and decreased parietal β2 frequency was associated with the avoidant-anhedonic phenotype.

Discussion

These predictive biomarkers open the way to preventive medicine for stress-induced diseases.

Changes in the Serum Concentration Levels of Serotonin, Tryptophan and Cortisol among Stress-Resilient and Stress-Susceptible Individuals after Experiencing Traumatic Stress

BACKGROUND

Stress is a common response to many environmental adversities. However, once dysregulated, this reaction can lead to psychiatric illnesses, such as post-traumatic stress disorder (PTSD). Individuals can develop PTSD after exposure to traumatic events, severely affecting their quality of life. Nevertheless, not all individuals exposed to stress will develop psychiatric disorders, provided they show enhanced stress-resilience mechanisms that enable them to successfully adapt to stressful situations and thus avoid developing a persistent psychopathology.

METHODS

The study involved 93 participants. Of them, 62 comprised a study group and 31 comprised a control group. The aim of the study was to assess serotonin, cortisol and tryptophan concentration levels in subjects with PTSD (stress-susceptible; PTSD-SS) and in healthy individuals (stress-resilient; PTSD-SR), who had experienced a traumatic event but fully recovered after the trauma. The subjects were between 18 and 50 years of age (mean 35.56 ± 8.26 years). The serum concentration levels of serotonin, cortisol and tryptophan were measured with an ELISA kit.

RESULTS

It was found that the serotonin, tryptophan and cortisol concentration levels were consistent with the features of both PTSD-SR and PTSD-SS patients. It was reported that the mean cortisol concentration levels increased more significantly in the PTSD-SS group than in the PTSD-SR group, versus those in the control group. Similarly, the PTSD-SS group was found to show a larger decrease in the mean serotonin concentration levels than the PTSD-SR group, versus those in the control group. No significant changes were found in the tryptophan concentration levels between the study groups, versus those in the control group.

CONCLUSIONS

These findings can be useful when attempting to improve resilience in individuals using neuropharmacological methods. However, it is necessary to conduct more cross-sectional studies that would address different types of negative stress to find out whether they share common pathways.