No Discrepancy in Combined Genotype Distribution Data Between Two Related Studies of 5-HTTLPR and Posttraumatic Stress Disorder Risk.

Recent work suggests that the 9-repeat (9R) allele located in the 3′UTR VNTR of the SLC6A3 gene increases risk of posttraumatic stress disorder (PTSD). However, no study reporting this association to date has been based on population-based samples. Furthermore, no study of which we are aware has assessed the joint action of genetic and DNA methylation variation at SLC6A3 on risk of PTSD. In this study, we assessed whether molecular variation at SLC6A3 locus influences risk of PTSD. Participants (n = 320; 62 cases/258 controls) were drawn from an urban, community-based sample of predominantly African American Detroit adult residents, and included those who had completed a baseline telephone survey, had provided blood specimens, and had a homozygous genotype for either the 9R or 10R allele or a heterozygous 9R/10R genotype. The influence of DNA methylation variation in the SLC6A3 promoter locus was also assessed in a subset of participants with available methylation data (n = 83; 16 cases/67 controls). In the full analytic sample, 9R allele carriers had almost double the risk of lifetime PTSD compared to 10R/10R genotype carriers (OR = 1.98, 95% CI = 1.02–3.86), controlling for age, sex, race, socioeconomic status, number of traumas, smoking, and lifetime depression. In the subsample of participants with available methylation data, a significant (p = 0.008) interaction was observed whereby 9R allele carriers showed an increased risk of lifetime PTSD only in conjunction with high methylation in the SLC6A3 promoter locus, controlling for the same covariates. Our results confirm previous reports supporting a role for the 9R allele in increasing susceptibility to PTSD. They further extend these findings by providing preliminary evidence that a “double hit” model, including both a putatively reduced-function allele and high methylation in the promoter region, may more accurately capture molecular risk of PTSD at the SLC6A3 locus.

Objectives: This study aimed to determine the risk of depression and post-traumatic stress disorder among Filipino adults with respiratory allergies in an allergy unit during the COVID-19 pandemic. Also, we sought to identify if certain demographic variables are associated with these mental health conditions. Methodology: Respondents from an allergy unit completed the online survey from January to May 2022. Data obtained included sociodemographic factors and the presence of respiratory allergies. Patient Health Questionnaire - 9 (PHQ-9) and Impact of Event Scale-Revised (IES-R) ratings were used to measure depression and risk of post-traumatic stress disorder (PTSD), respectively. The relative risk or risk ratio (RR) of depression and post-traumatic stress disorder (PTSD) among subjects and the influence of demographic characteristics, type, and severity on the risk of depression and post-traumatic stress disorder (PTSD) among the subjects were estimated using log-binomial regression. Results: A total of 173 respondents were included in the study: 92 with respiratory allergies and 80 without respiratory allergies. Compared to those without allergies, those with allergies had a much higher proportion of post-graduate degree and higher monthly income. Of the individuals, 40.12% suffered from allergic rhinitis, 3.49% from asthma, and 9.88% from both allergies. The mean PHQ-9 score for all respondents was 7.80 (SD = 6.23), with a mean score of 7.89 (SD = 6.34) and 7.72 (SD = 6.29) for those without and with respiratory allergies, respectively. Among those without respiratory allergies, 41.25% had mild depression, 12.50% had moderate depression, 11.25% had moderately severe depression, and 6.25% had severe depression. Among those with allergies, 33.70% had mild depression, and 19.57% had moderate depression. The mean score for the intrusion, avoidance, and hyperarousal subscales of the IES-R were 10.32 (SD = 6.34), 11.17 (SD = 7.21), and 6.99 (SD = 5.38), respectively, and the overall mean IES-R score for the respondents was 10.32 (SD = 7.34). Among those without respiratory allergies, 31.50% had high scores for PTSD, 2.50% had probable PTSD, 20% had PTSD as a clinical concern, and 46.25% did not have PTSD. For those with allergic rhinitis, the prevalence of high scores for PTSD was 40.58%, while it was 50.00% for those with asthma. Depression was highly correlated with age and marital status. For PTSD, those who were married (OR = 0.31, p = 0.012) were 3.23 times less likely to develop the condition than their single counterparts. The type of respiratory allergies, the severity of allergic rhinitis, and the level of asthma control were not significantly associated with the severity of depression and PTSD of any degree. Conclusion: Patients with respiratory allergies did not have an increased risk of depression and post-traumatic stress disorder in this particular population. The PHQ-9 AND IES-R scores among those with respiratory allergies and those without were shown to have no significant difference. Demographic factors found to be associated with depression were age and marital status, while for PTSD, it was only marital status. The type of respiratory allergy, control, and severity were not associated with depression and PTSD of any degree.

IntroductionChildbirth, traditionally viewed as a natural and positive process, can become a traumatic experience when obstetric violence or disrespectful treatment occurs. This type of experience can cause symptoms consistent with Post-Traumatic Stress Disorder negatively affecting maternal mental health, bonding with the newborn, and the development of the newborn.ObjectivesTo analyze the relationship between perceptions of inadequate treatment during childbirth and the risk of postpartum Post-Traumatic Stress Disorder at 6 months in a sample of women assessed 3 months after birth.MethodsAn observational study with six-month follow-up was conducted in 341 women in Spain, initially recruited 3 months postpartum. Validated questionnaires were used: Childbirth Abuse and Respect Evaluation-Maternal Questionnaire (perceived abuse or disrespect), Perinatal Post Traumatic Stress Disorder, Family Apgar, and MOS social support survey Bivariate and multivariate analyses were performed using logistic regression.ResultsThree hundred forty-one women participated, with a mean age of 33.38 years (SD = 4.23). 10.9% of the participants were at risk of Post-Traumatic Stress Disorder. Childbirth Abuse and Respect Evaluation-Maternal Questionnaire dimensions correlated positively with the Perinatal Post Traumatic Stress Disorder, with “inappropriate treatment by professionals” being the most significant (r = 0.60; 95% CI: 0.53–0.67). A greater perception of obstetric violence (Abuse and Respect Evaluation-Maternal Questionnaire ≥ P95) significantly increased the likelihood of developing Perinatal Post Traumatic Stress Disorder (aOR: 48.38; 95%CI: 10.07–232.44). Associations with risk of developing Post-Traumatic Stress Disorder were also observed for instrumental birth (aOR: 5.29; 95% CI: 1.53–18.28) and previous cesarean section (aOR: 7.54; 95% CI: 1.10–51.79). More social support was associated with a lower risk of Post-Traumatic Stress Disorder (aOR: 0.96; 95%CI: 0.94–0.99).Discussion and conclusionA higher perception of obstetric violence is associated with an increased risk of developing postpartum Post-Traumatic Stress Disorder. Furthermore, invasive interventions such as instrumental births or previous cesarean sections increase psychological vulnerability. In contrast, social support acts as a protective factor. It is recommended to implement screening tools such as Abuse and Respect Evaluation-Maternal Questionnaire, reinforce training in respectful treatment, and promote humane care models to ensure the physical and emotional safety of women.

Childhood gender nonconformity has been associated with poorer relationships with parents, but it is unknown if childhood gender nonconformity is associated with childhood abuse or risk of posttraumatic stress disorder (PTSD) in youth. We examined whether gender nonconformity before age 11 years was associated with childhood sexual, physical, and psychological abuse and lifetime risk of probable PTSD by using self-report questionnaire data from the 2007 wave of the Growing Up Today Study (n = 9864, mean age = 22.7 years), a longitudinal cohort of US youth. We further examined whether higher exposure to childhood abuse mediated possible elevated prevalence of PTSD in nonconforming children. Finally, we examined whether association of childhood gender nonconformity with PTSD was independent of sexual orientation. Exposure to childhood physical, psychological, and sexual abuse, and probable PTSD were elevated in youth in the top decile of childhood gender nonconformity compared with youth below median nonconformity. Abuse victimization disparities partly mediated PTSD disparities by gender nonconformity. Gender nonconformity predicted increased risk of lifetime probable PTSD in youth after adjustment for sexual orientation. We identify gender nonconformity as an indicator of children at increased risk of abuse and probable PTSD. Pediatricians and school health providers should consider abuse screening for this vulnerable population. Further research to understand how gender nonconformity might increase risk of abuse and to develop family interventions to reduce abuse risk is needed.

Disasters are associated with increased risk of posttraumatic stress disorder (PTSD) and major depression, but no study, to the authors' knowledge, has determined whether genotype interacts with disaster exposure and social support to moderate risk of these phenotypes. The authors tested the hypothesis that a polymorphism in the serotonin transporter gene (locus, SLC6A4; variant, serotonin 5-HTTLPR) moderates risk of posthurricane PTSD and major depression given high hurricane exposure and low social support. The authors interviewed a household probability sample of adults 6-9 months after the 2004 hurricanes about hurricane exposure, social support, and posthurricane PTSD and major depression. DNA was collected from a subset of participants. Participants were 589 adults ages 18 and older from 38 Florida counties who provided valid DNA samples. Outcome measures were DSM-IV diagnoses of posthurricane PTSD and major depression derived from structured interviews. The low-expression variant of the 5-HTTLPR polymorphism increased risk of posthurricane PTSD and major depression but only under the conditions of high hurricane exposure and low social support after adjustment for sex, ancestry (as determined by Bayesian clustering of genotypes), and age. Similar effects were found for major depression. High-risk individuals (high hurricane exposure, the low-expression 5-HTTLPR variant, low social support) were at 4.5 times the risk of developing PTSD and major depression of low-risk individuals. The low-expression variant of the 5-HTTLPR polymorphism modifies risk of postdisaster PTSD and major depression under conditions of high hurricane exposure and low social support, confirming and extending previous research.

Neighborhood characteristics, trauma, and the risk of post-traumatic stress disorder in New York City

Gender, Position of Authority, and the Risk of Depression and Posttraumatic Stress Disorder among a National Sample of U.S. Reserve Component Personnel

Background:Traumatic craniofacial injuries result in negative psychological sequelae. This study aimed to analyze Injured Trauma Survivor Screen (ITSS) results to assess posttraumatic stress disorder (PTSD) risk in traumatic craniofacial injuries and identify corresponding factors that may contribute to increased risk.Methods:In a retrospective cohort analysis, all patients with craniofacial fractures, identified via International Classification of Diseases, 10th Revision codes, who were screened with the ITSS survey at a single level 1 trauma center from June 2022 to January 2024 were included.Results:Two hundred forty-eight patients met the inclusion criteria (median age 54 y; interquartile range: 33.0–72.5 y; 66.1% men); 22.9% of patients screened positive for PTSD risk. With every 1-day increase in length of stay, the odds of a positive PTSD risk score were 1.08 times that of a negative PTSD risk score (odds ratio [OR] 1.08; 95% confidence interval [CI]: 1.03–1.13; P = 0.0022). Hispanic patients had higher odds of a positive PTSD risk score compared with White patients (OR 5.24; 95% CI: 2.03–13.54; P = 0.0086). Injury via assault had greater odds of a positive PTSD risk score compared with ground-level fall (OR 6.65; 95% CI: 1.80–24.54; P = 0.0162).Conclusions:Craniofacial trauma carries a similar risk of PTSD to the general trauma population. Increased length of stay, Hispanic race, and injury via assault are patient characteristics that can raise suspicion for PTSD risk in this trauma population, especially at centers that do not make use of the ITSS.

BackgroundPrevious research has shown that the use of renin-angiotensin system (RAS) blockers is linked to a lower prevalence of posttraumatic stress disorder (PTSD), but longitudinal studies are scarce. We aimed to estimate the association between the use of RAS blockers and the risk of PTSD among individuals taking antihypertensive medications.MethodsThis longitudinal study included participants aged 40–69 from the UK Biobank. Exposure data were obtained from the initial assessment (2006–10), while outcome data were obtained from the online mental health questionnaire administered 6–11 years later (2016–17). We included participants who were under antihypertensive treatment and did not have a prior diagnosis of PTSD before the initial assessment. Use of RAS blockers was defined as self-reported regular use, at the initial assessment, of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB). Among participants who experienced adverse life experiences, cases of probable PTSD were defined with the six-item PTSD Checklist-Civilian version score ≥ 14. Logistic regression with inverse probability of treatment weighting was used to estimate the odds ratios (ORs) and 95% confidence interval (CI) for the association between RAS blocker use and the risk of probable PTSD.ResultsOf the 15,954 participants (mean age = 59.9 years; 42.6% women) under antihypertensive treatment with no prior history of PTSD at the initial assessment, 64.5% were taking RAS blockers. After a mean follow-up of 7.5 years, 1,249 (7.8%) were newly identified with probable PTSD. RAS blocker users had a lower risk of probable PTSD than RAS blocker non-users (OR = 0.84 [95% CI: 0.75–0.94]), whereas the use of other antihypertensive medications showed no such association (users vs. non-users; calcium channel blockers, OR = 0.99 [95% CI: 0.88–1.11]; beta-blockers, 1.20 [1.08–1.34]; and thiazide-related diuretics, 1.15 [1.03–1.29]). The association between probable PTSD risk and the use of ACEi vs. ARB showed no significant difference (p = 0.96).ConclusionsAmong individuals under antihypertensive treatment, the use of RAS blockers was associated with a decreased risk of probable PTSD. This added benefit of RAS blockers should be considered in the selection of antihypertensive medications.

Background: The COVID-19 pandemic is a health emergency resulting in multiple stressors that may be related to posttraumatic stress disorder (PTSD). Objective: This study examined relationships between risk and protective factors, pandemic-related stressors, and PTSD during the COVID-19 pandemic. Methods: Data from the European Society of Traumatic Stress Studies (ESTSS) ADJUST Study were used. N = 4,607 trauma-exposed participants aged 18 years and above were recruited from the general populations of eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. We assessed sociodemographic (e.g. gender), pandemic-related (e.g. news consumption), and health-related (e.g. general health condition) risk and protective factors, pandemic-related stressors (e.g. fear of infection), and probable PTSD (PC-PTSD-5). The relationships between these variables were examined using logistic regression on multiple imputed data sets. Results: The prevalence of probable PTSD was 17.7%. Factors associated with an increased risk for PTSD were younger age, female gender, more than 3 h of daily pandemic-related news consumption (vs. no consumption), a satisfactory, poor, or very poor health condition (vs. a very good condition), a current or previous diagnosis of a mental disorder, and trauma exposure during the COVID-19 pandemic. Factors associated with a reduced risk for PTSD included a medium and high income (vs. very low income), face-to-face contact less than once a week or 3–7 times a week (vs. no contact), and digital social contact less than once a week or 1–7 days a week (vs. no contact). Pandemic-related stressors associated with an increased risk for PTSD included governmental crisis management and communication, restricted resources, restricted social contact, and difficult housing conditions. Conclusion: We identified risk and protective factors as well as stressors that may help identify trauma-exposed individuals at risk for PTSD, enabling more efficient and rapid access to care. HIGHLIGHTS N = 4,607 trauma-exposed adult participants were recruited from the general population during the first year of the COVID-19 pandemic. The prevalence for probable posttraumatic stress disorder was 17.7%. We identified risk factors (e.g. poor health condition) and protective factors (e.g. social contact) associated with posttraumatic stress disorder.

The unexpected death of a loved one and risk for onset of PTSD and depression in the Nepal Chitwan Valley Family Study.

Introduction: Post-traumatic stress disorder usually occurs after a traumatic event and this COVID-19 pandemic has affected mental health to a great extent. While there is extensive research being conducted about this aspect among the general population, the most neglected are the Industrial workers during the first lockdown period. The aim of the study was to assess the risk of post-traumatic stress disorder symptoms using the impact of event scale-revised (IES-R), their main stressors and coping measurements among the industrial workers of Hyderabad. Methods: A telephonic interview schedule was adopted to fill the online questionnaire among Industrial workers of age group 20-55 years during the lockdown period. Hundred and seventy-four participants were included in our study and data was collected using standardized tools IES-R and brief resilient coping scale. Various stressors and also their coping strategies were elucidated. Results: At the risk of post-traumatic stress disorder symptoms were found among 20.6% and at risk of suppressed immune system functioning which is presumed to have its effect for the next 10 years was 13.8%. The main stressors of COVID-19 with increased IES-R score were not staying with family members, influence of social media, Any acquaintance with COVID-19 infected person effect on daily life and white-collar group. Coping measurements with a brief resilient coping scale found 17.4% as low resilient copers. Conclusion: This identification of high-risk post-traumatic stress disorder symptoms needs to be addressed earlier to bring up preventive strategies such as counseling services in the occupational health care centers of our industries.

Though still in infancy, the field of psychiatric genetics holds great potential to contribute to the development of new diagnostic and therapeutic options to treat these disorders. Among a large number of existing neurotransmitter systems, the serotonin system dysfunction has been implicated in many psychiatric disorders and therapeutic efficacy of many drugs is also thought to be based on modulation of serotonin. Serotonin transporter gene polymorphism is one of the most extensively studied polymorphisms in psychiatric behavioral genetics. In this article, we review the status of evidence for association between the serotonin gene polymorphism and some common mental disorders like affective disorders, post-traumatic stress disorder, obsessive-compulsive disorder, suicide, autism, and other anxiety and personality disorders. Going beyond traditional association studies, gene-environment interaction, currently gaining momentum, is also discussed in the review. While the existing information of psychiatric genetics is inadequate for putting into practice genetic testing in the diagnostic work-up of the psychiatric patient, if consistent in future research attempts, such results can be of great help to improve the clinical care of a vast majority of patients suffering from such disorders.

The aim of the study is to estimate in a sample of US fire investigators the (1) prevalence of generalized anxiety disorder (GAD), depression, posttraumatic stress disorder (PTSD) risk, and mental health services use and (2) association between organizational stigma and mental health disorders. This is a cross-sectional study design used to administer between November 2023 and January 2024, a 35-item behavioral/mental health survey. Approximately 18.0% of fire investigators had GAD, 22.8% depression, and 18.2% PTSD risk. Organizational stigma about mental health disorders was reported by 53.3% of fire investigators. The most frequently used behavioral/mental health services were cognitive behavioral therapy (40.1%) and medication management (36.1%). Organizational stigma around reporting mental health disorders was significantly associated with PTSD risk (adjusted odds ratio = 5.25 [2.41-11.43]). Mental health disorders are present in the fire investigator workforce, and organizational stigma is associated with limited report of PTSD risk.

Urban fire?ghters are at risk of posttraumatic stress disorder (PTSD) because of their occupational exposure to trauma event. PTSD has been recognized as public health problem because it links to many health consequences including cardiovascular disease. This study was conducted in 2 phases. The first phase; a cross-sectional study, was aimed to determine a prevalence of risk of PTSD among all Bangkok firefighters and to access its associated factors. The second phase; a longitudinal study, aimed to access an association between risk of PTSD and changes of cardiovascular biomarker (Brain Natriuretic Peptide (BNP), Troponin T (TnT), and high-sensitive C-reactive protein (hs-CRP)) after 6-months follow-up. In the first phase of the study, all Bangkok firefighters were recruited for self-reported questionnaire. 302 of 1215 firefighters (24.90%) were met the suggested PCL cut-point criteria for civilian (PCL Scores ? 30). Health problems, smoking status, alcohol consumption, physical activity, sleep quality, duration of work, and past exposure to major fire in Thailand were associated with risk of PTSD (p-value<0.05). In phase 2, all firefighters from 2 purposively selected firefighter stations were recruited to participate. Blood check-up was performed in August, 2017 and February, 2018. 19 risk of PTSD and 35 non-risk of PTSD firefighters were participated. Brain-derived neurotrophic factor (BDNF), which is a member of the neurotrophin family of growth factors reflected for long-term memory, was investigated as a biomarker of PTSD. At baseline of study, the results showed a significant different BDNF concentration between risk of PTSD and non-risk of PTSD firefighters. Two cardiovascular biomarkers (hs-CRP and BNP) were�associated with PTSD. After 6 month follow-up, 27.8% of firefighters were loss to follow-up and 14 of them were excluded because of blood samples. 12 risk of PTSD and 13 non-risk of PTSD firefighters were completed follow-up. General characteristic of remained firefighters was not different from baseline (p-value>0.05). The results showed that only BNP was associated with risk of PTSD (adjusted OR=31.22). In conclusion, firefighter at risk of PTSD was increased risk of cardiovascular biomarker change. Further intervention and policy related to coping mental health among firefighter should be introduced for reducing the risk of cardiovascular disease.�