Post-Traumatic Stress Disorder in Patients with Rheumatic Diseases During the COVID-19 Outbreak​

ObjectiveThe COVID-19 pandemic is not only a traumatic event, but a collective stressor unfolding over time, causing devastating implications for the mental health. This study aimed to shed light on...

Meta-analysis of post-traumatic stress disorder and COVID-19 in patients discharged

PTSD and Combat-Related Injuries: Functional Neuroanatomy

With the accelerated pace of population aging in China, the number of patients suffering from myocardial infarction (MI) is increasing annually. During disease progression, patients are at significantly higher risk of developing severe negative emotions, and emerging evidence suggests that post-traumatic stress disorder (PTSD) is significantly associated with cardiovascular disease, which seriously affects patients’ quality of life. Objective: The aim of this study was to comprehensively assess the prevalence and influencing factors of PTSD in MI patients through systematic review and Meta-analysis. Methods:A computerized search of PubMed, the Cochrane Library, Embase, Web of Science, PsycINFO, China Knowledge Network (CNKI), WanFang Data, VIP, and China Biomedical Literature Database (CBM) was conducted to collect longitudinal studies, case-control studies, and cross-sectional studies related to PTSD prevalence rates and influencing factors in MI patients published up to August 1,2024.Literature screening, data extraction and quality assessment were done independently by two researchers and Meta-analysis was done using Stata 16.0 software. This study has been registered on the PROSPERO platform, registration number: CRD42024577243. Results: A total of 16 papers were included, with a total sample size of 3,768 cases involving 8 influencing factors.The results of the Meta-analysis showed that the prevalence of PTSD in patients with MI was 20.4% (95% CI = 15.0–26.5%). Female (OR = 3.12, 95% CI = 1.97–4.97, P < 0.001), high neuroticism score (OR = 2.21, 95% CI = 1.20–4.07, P = 0.011), and high intrusive rumination score (OR = 2.95, 95% CI = 1.50–5.83, P = 0.002) were the risk factors for PTSD in MI patients. While age (OR = 1.01, 95% CI = 0.98–1.04, P = 0.440), education level (OR = 0.55, 95% CI = 0.07–4.48, P = 0.574), social support rating scale (OR = 0.81, 95% CI = 0.52–1.26, P = 0.346), Killip cardiac function classification (OR = 2.29, 95% CI = 0.91–5.80, P = 0.080) and creatine kinase isoenzyme (OR = 1.03, 95% CI = 0.99–1.05, P = 0.124) were not associated with the development of PTSD in MI patients. Conclusion: The prevalence of PTSD was higher in patients with MI. The prevalence varied by evaluation tool and study area. Risk factors were multifactorial, including general factors (female) and overall assessment (high neuroticism score, high invasive rumination score). Therefore, early intervention and proper de-escalation of PTSD symptoms in patients with MI by medical staff are needed in clinical practice to reduce the risk of PTSD.

Lifetime prevalence of posttraumatic stress disorder (PTSD) in the general population is reported to be 6.8%. Individuals with alcohol dependence and substance abuse have high prevalence of PTSD. However, the prevalence of PTSD in heavy drinkers with alcoholic hepatitis (AH) is not known.The study's aim was to determine the prevalence of PTSD in heavy drinkers with and without AH. We screened for PTSD using the Primary Care-PTSD questionnaire among heavy drinkers with (n=115) and without (n=64) AH participating in a multicenter observational study in which participants were followed up to 12months following their enrollment. The prevalence of PTSD in heavy drinkers with AH was 34% and was not different from heavy drinking controls without liver disease (34%). In the entire group screened for PTSD, the presence of PTSD was associated with higher alcohol consumption as reported by average drinks per last 30days and average grams of alcohol consumed per day (p=0.047 for both tests), but not associated with relapse of heavy drinking or mortality. Similarly, patients with AH and PTSD did not have higher relapse rate or higher mortality compared to patients with AH but no PTSD. Compared to previously reported prevalence in general population, heavy drinking individuals with or without AH have significantly higher prevalence of PTSD. However, PTSD was not associated with higher relapse rate or higher mortality in this population.

Safety of SARS-CoV-2 mRNA vaccines and effects of immunosuppressive drugs on adverse reactions in patients with rheumatic diseases

The aim of this study was to identify the risk factors for posttraumatic stress disorder in patients with myocardial infarction. Cohort, case-control, and cross-sectional studies on posttraumatic stress disorder (PTSD) in patients with myocardial infarction were searched from PubMed, Embase, Cochrane Library, Web of Science, China Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and Technology Journal database. The Newcastle-Ottawa Quality Assessment Scale was used to score the quality of the included literature in the cohort and case-control studies, and the cross-sectional studies were scored using the American Agency for Health Care Quality and Research cross-sectional study quality evaluation criteria. The literature was screened independently by 2 researchers, and if there was no consensus, the inclusion was decided by a third party. The extraction content included first author, publication year, sample size, PTSD assessment tool, PTSD assessment time, PTSD incidence, influencing factors, and study type. Meta-analysis of data was performed using Stata17.0 software. Ten studies were included, including 2 cohort studies, 7 cross-sectional studies, and 1 case-control study, with a total sample size of 2371 patients, including 26 influencing factors. The results of meta-analysis showed that the prevalence of PTSD in patients with myocardial infarction was 21.2%. Statistically significant influencing factors were gender (odd ratio [OR] = 3.124), neuroticism score (OR = 2.069), and age (OR = 0.913). The prevalence of PTSD in patients with myocardial infarction in China is higher than that in other countries. Female and neurotic personality are risk factors for developing PTSD in patients with myocardial infarction, and old age is protective factor for developing PTSD in patients with myocardial infarction. Targeted measures should be taken to prevent and reduce the occurrence and development of PTSD in patients with myocardial infarction in the future.

Background: The purpose of this study is to investigate the prevalence of post-traumatic stress disorder (PTSD) in patients who have recovered from COVID-19. Methods: In this descriptive cross-sectional study, 97 individuals who had recovered from COVID-19 and had a history of hospitalization were selected using a cluster sampling method. Data was collected through demographic questionnaires created by the researcher. The studied variables were first analyzed using descriptive statistical methods, followed by appropriate statistical tests to examine the relationships between variables. A significance level of less than 0.05 was considered for all tests. Data analysis was conducted using SPSS 21 statistical software. Results: The average PTSD score was severe in 48% of the recovered patients. Regression results indicated that variables such as age, education, marital status, occupation, and illness positively affected the development of PTSD. The relationship between PTSD and age was direct, with men having higher average PTSD scores than women. Additionally, individuals with lower levels of education were more likely to exhibit PTSD. Married individuals showed higher rates of PTSD than others. Retired individuals had higher PTSD scores compared to those in other occupations. However, no statistically significant relationship was found between PTSD and physical or mental illness (P > 0.05). Conclusions: Based on the results, at least half of the individuals who faced COVID-19 are at risk of psychological effects and post-traumatic stress symptoms. Timely counseling and treatment services may prevent potential long-term consequences.

ABSTRACTThe object of this study was to reveal the occurrence, risk factors and prognosis of posttraumatic stress disorder (PTSD) in patients with trigeminal neuralgia (TN). Adult patients who were diagnosed with TN were prospectively collected from our neuroscience center. Among the 103 patients recruited, thirty (29.1%) participants were identified as probable PTSD cases measured with PTSD Checklist for DSM-5 (PCL-5). Compared with patients without PTSD, patients with probable PTSD were more likely to be female, have severe pain intensity, be with severely interfered general activities, be with more intense depression and anxiety, and be more habitually using maladaptive coping strategies. Logistic regression analysis showed female sex, severe pain intensity, anxiety and depression predicted probable PTSD. In the 28 patients who were initially identified as probable PTSD and had 6-month follow-up data, 21 reported complete pain relief and 4 reported partial pain relief. Fifteen of the patients who experienced complete pain relief recovered from probable PTSD. Our work indicated that PTSD can develop among patients with TN. Complete pain relief through surgical treatments can help most patients with probable PTSD recover, however, psychological support is advised for those who are still obsessed by mental disorders even after pain relief.

Internally displaced children are at risk of not receiving the general health services they require, since they have health needs that are unique to those of adults. Therefore, the first step in designing intervention programs for them is to determine their mental health status. This study determined the relationship of sociodemographic factors with the prevalence of depression and PTSD among internally displaced children in Nigeria. A descriptive correlational research design was adopted for the study using adapted versions of the Child PTSD Symptom Scale (CPSS) and the child version of the Revised Child Anxiety and Depression Scale - RCADS (Depression Subscale). Frequency, percentage, binary logistic regression and chi-square were used for data analysis. Findings showed that the participants (n=474) comprised 55.3% male and 44.7% female children, with 85.9% having a low household income. The prevalence rate of PTSD and depression among displaced children was 79.7% and 84.8%, respectively. More than a third (47.5%) of the children were severely depressed, with more male (28.2%) than female children (21.2%) having moderately severe depression. A greater proportion of male (39.3%) than female (30.7%) children had severe PTSD. Functional impairment due to PTSD was found in 90.7% of the children. At a 95% confidence interval, age and gender did not significantly predict the prevalence of depression and PTSD among internally displaced children in Nigeria (OR < 1 and P > 0.05). At p<0.05, demographic characteristics of the children, such as parents' education, household size and housing size, correlated significantly with the prevalence of PTSD and depression among them. Findings of this study suggest a high prevalence of depression and PTSD among displaced children in Nigeria and therefore call for the government to make available counselling and rehabilitation services to all IDPs, especially the children, to improve their mental health.

The study's aim was to examine the prevalence and severity of posttraumatic stress disorder (PTSD) longitudinally among high school students with different genotypes of the leptin gene (LEP) rs7799039 after the 2008 Wenchuan earthquake in China. The symptoms of PTSD were measured by the PTSD Checklist-Civilian Version (PCL-C) based on DSM-IV-TR criteria in 462 students at 6, 12, and 18 months after the earthquake. The genotypes of LEP rs7799039 were identified by polymerase chain reaction-restriction fragment length polymorphism analyses in 2018 using genomic DNA prepared in 2008 and stored at -80°C and verified by DNA sequencing. The association of LEP genotypes with PTSD was then analyzed by various statistical methods. The AA homozygotes had higher prevalence of PTSD than the G allele carriers at 12 months (22.30% vs 10.53%, P = .013) and higher median (interquartile range [IQR]) PCL-C scores at 12 (27.00 [24.00-35.75] vs 26.00 [22.00-31.25], P = .010) and 18 months (27.00 [21.00-32.00] vs 24.00 [19.00-29.00], P = .003) post-earthquake among female subjects. Female students had higher PCL-C scores than male subjects at 6 and 12 months regardless of the genotypes but only among the AA homozygotes at 18 months (27.00 [21.00-32.00] vs 22.00 [18.00-26.00], P = .000). The potential risk factors for and predictors of PTSD severity differed at different time points during follow-up. LEP rs7799039 was a potential factor for PTSD at 12 months and a predictor of PTSD severity at 18 months post-earthquake. An association of LEP rs7799039 with the prevalence and severity of PTSD in Chinese adolescents was observed. These results indicate that females with the LEP rs7799039 AA genotype had more severe PTSD characteristics compared to female G allele carriers, suggesting that psychosocial or pharmacologic managements may particularly be needed by these female subjects.

Objective. The aim of this study was to investigate the prevalence of post-traumatic stress disorder (PTSD) in patients with burn injuries undergoing physical therapy, and to evaluate their quality of life. Methods. A total of 21 patients who underwent physical therapy for burn injuries between October 2012 and December 2012, in the Physical Therapy and Rehabilitation outpatient clinic of a Training and Research Hospital, were included in the study. The sociodemographic form for data collection, the Clinician- Administered PTSD Scale (CAPS) for the diagnosis of PTSD, and the Short Form 36 (SF-36) Health Survey for the assessment of the quality of life, were used. Results. Eight patients (38.1%) had PTSD. These patients had poor physical functioning, and indicated a lower rate of role functioning-physical, vitality, and role functioning-social, compared to those without PTSD. However, it did not reach statistical significance. The physical functioning related to the quality of life was statistically significantly lower in the patients with contracture. Conclusions. PTSD seems to be an important health issue in patients with burn injuries. Clinicians who attempt to tailor treatment interventions should keep in mind that these patients require psychosocial rehabilitation, as well as physical therapy.

We aimed to assess the prevalence of posttraumatic stress disorder (PTSD) in patients treated in hospital because of COVID-19. Further on, we investigated risk factors for the development of posttraumatic stress disorder in patients. 120 patients who were diagnosed with COVID-19 and treated at the hospital were included in the study. They were reevaluated in the first and third months after discharge. At third month, 108 patients completed the study. While 27.5% of patients hospitalized due to COVID-19 met the criteria for acute stress disorder (ASD) during hospitalization and, 1.7% of patients met the criteria for PTSD in the first month after discharge. In the third month, there were no patients who met the criteria for PTSD. It was observed that knowledge the mode of transmission, stigmatization, and economic anxiety due to the pandemic were associated with higher PCL-5 scores. PCL-5 scores were found to decrease more slowly in female patients (p = 0.001). Baseline logarithmic PCL-5 scores were an important predictor of PCL-5 scores in the first (B = 0.26 [95% CI: 0.27–0.55], p < 0.001), and third months (B = 0.31 [95% CI: 0.19–0.41], p < 0.001). The scales of insomnia severity (B = 0.35 [95% CI:0.17–0.53], p < 0.001), hopelessness (B = 0.24 [95% CI: 0.06–0.42], p < 0.001), depression (B = 0.26 [95% CI: 0.06–0.46], p < 0.001), and anxiety (B = 0.18 [95% CI: 0–0.31], p < 0.001) predicted log-PCL-5 scores. Posttraumatic stress symptoms are associated with many psychological, and socio-demographic factors. Therefore, a holistic approach is required to reduce the effects of the COVID-19 pandemic. Early psychiatric evaluation, adequate and accurate information can minimize the effects of trauma caused by COVID-19.

Post Traumatic Stress Disorder and Depression in Survivors of Thrombotic Thrombocytopenic Purpura

Backgrounds: The COVID-19 epidemic has affected people's mental health around the world. According to previous epidemics, an increase in post-traumatic stress disorder (PTSD) has been seen until one year later. Objectives: Due to the importance of psychological issues secondary to COVID-19, in this study, the frequency of PTSD symptoms in the follow-up of patients with COVID-19 who were hospitalized in Sari was evaluated. Methods: In this cross-sectional study, 199 patients diagnosed with COVID-19 who were hospitalized in Sari were identified, and patients’ records were recorded. PTSD criteria were assessed based on the PTSD Checklist for DSM 5 (PCL-5). Data were analyzed using SPSS 16. Results: In the present study, the overall prevalence of PTSD was 19.1% (38 patients). The frequency of PTSD was higher in women, married people, people with children, and those aged 20-44 years. The prevalence of PTSD was higher in 29 patients (38.2%) with higher education. Conclusions: This study showed that PTSD has a high prevalence in people with a history of COVID-19, and it is necessary for these patients to undergo psychiatric evaluations.