Acute Stress Disorder Research Articles

Prevalence of mental health problems in mothers of preterm infants admitted to NICU: A cross-sectional study.

To study the prevalence of mental health problems among mothers of preterm infants admitted to the neonatal intensive care unit (NICU). In this cross-sectional two-arm study, 130 mothers in each group, with either term infants not in NICU or preterm infants admitted to NICU, underwent mental health assessment using the Generalized Anxiety Disorder Scale, Centre for Epidemiologic Studies-Depression Scale, Stanford Acute Stress Reaction Questionnaire and Modified Parental Stress Scale-NICU. Their coping styles and quality of life were also assessed. Data were analyzed using SPSS IBM 25.0. Anxiety (66.2% versus 46.9%) and depression (45.4% versus 23.1%) were more common among NICU mothers. Regarding subdomains of acute stress reaction, a higher number of NICU mothers showed symptoms of anxiety, re-experience and functional impairment. For mothers with infants in NICU, sight, sound, and parental role alterations were stressful. They had reduced quality of life scores in domains of physical health, psychological health, and social relationships. Also, a higher number of these mothers exhibited problem-solving and emotion-focused coping. Preterm birth with NICU admission of the infant is more stressful for a mother than the term birth of a healthy neonate. It affects her mental health and quality of life. Both the obstetrician and the pediatrician should be mindful of this.

Association Between Adverse Childhood Experiences and Posttraumatic Stress Disorder Symptoms in Adults With Injury

This case-control study examines the risk factors associated with acute stress disorder in patients with severe injury.

The evolving personal, professional and physical impact on healthcare professionals during three COVID-19 waves: A cross-sectional study.

BackgroundThe COVID-19 pandemic has led to huge pressure on not only healthcare systems, but also on healthcare professionals.ObjectiveAs the pandemic continues, the aim of this study is to evaluate how 10 reactions of healthcare professionals evolved during the first 18 months of COVID-19.MethodsA repeated cross-sectional study was performed with eight measurement points between April 2020 and September 2021 in Belgium. Participants were asked how frequently (on a scale of 0–10) they experienced positive and negative reactions during normal circumstances and during past week, referred to as before and during COVID-19, respectively. These reactions were stress, fatigue, difficulty sleeping, muscle strain, hypervigilance, leaving profession, headache, doubting knowledge and skills, flashbacks and fear.ResultsIn total, 13 308 respondents were included in our study. During both the first (March 2020) and second COVID-19 peak (November 2020), the measured personal, professional and physical reactions were significantly higher compared to before COVID-19. The third wave in April 2021 was shorter and less severe with regard to hospital admissions and deaths, yet an important impact on healthcare professionals could still be observed. ‘Fatigue,’ ‘stress,’ ‘difficulty sleeping’ and ‘muscle strain’ are the most worrying reactions in September 2021, which are increasing compared to the previous measurements.ConclusionOur results showed that acute stress reactions decreased over time but that chronic stress reactions and professional reactions, such as ‘intent to leave,’ increased. Healthcare organizations and policy makers should realize that 18 months after the start of COVID-19 almost all of the measured reactions continue to be more prevalent than before COVID-19. Moreover, the continuous increase over the last three measurement periods of the number of healthcare professionals who want to leave their profession is alarming. Continuous follow-up of the personal, professional and physical reactions is more than necessary.

Associations of childhood maltreatment with hypertension in South African women: a cross-sectional study

ObjectivesTo examine the associations of childhood maltreatment (CM) with hypertension, and the mediating effects of hypertension risk factors on the associations in South African women, using baseline data of the...

CE: Pain and Mental Health Symptoms After Traumatic Orthopedic Injury

This article highlights the need to screen survivors of traumatic orthopedic injuries for postinjury symptoms associated with stressor-related disorders such as acute stress disorder and posttraumatic stress disorder, including pain, sleep disturbances, anxiety, and depression. The authors discuss the presentation of these postinjury symptoms, the instruments used to screen for each, the various pharmacological and nonpharmacological treatments, and the nursing implications for managing postinjury symptoms in traumatic orthopedic injury survivors.

Trauma Informed Care in the Obstetric Setting and Role of the Perinatal Psychiatrist: A Comprehensive Review of the Literature.

Trauma is highly prevalent, and women are twice as likely as men to develop posttraumatic stress disorder following a traumatic exposure. Consequently, many women entering the perinatal period have trauma histories. In the perinatal period, a trauma history can negatively impact treatment engagement and adversely affect the experience of pregnancy, postpartum, and parenting. A trauma-informed care approach can mitigate these effects. This review aims to summarize literature that can aid psychiatrists in (1) identifying signs and symptoms of trauma in perinatal women, (2) integrating elements of trauma-informed care into perinatal mental health care, and (3) offering interventions that can minimize adverse outcomes for perinatal women and their children. A PubMed search was conducted with keywords including trauma, pregnancy, perinatal, posttraumatic stress disorder, postpartum posttraumatic stress disorder, and trauma informed care. Perinatal care, given its somewhat invasive nature, has the potential to traumatize or cause retraumatization. Trauma-related disorders are common and can present or worsen in the perinatal period. Trauma can manifest in multiple forms in this population, including exacerbation of preexisting posttraumatic stress disorder, new onset acute stress disorder in the perinatal period, or postpartum posttraumatic stress disorder secondary to traumatic childbirth. Unaddressed trauma can adversely affect the experience of pregnancy, postpartum, and parenting. Psychiatrists caring for women in the perinatal period are in an ideal position to screen for trauma and offer appropriate intervention. A trauma-informed approach to obstetric care can help clinical teams respond to the unique trauma-related challenges that can arise during obstetric care. Trauma-informed care, with its emphasis on establishing a culture of safety, transparency, trustworthiness, collaboration, and mutuality, can empower health care providers and systems with powerful tools to respond to trauma and its myriad effects in a strengths-based manner. By applying a trauma-informed lens, psychiatrists can help their obstetric colleagues provide patient-centered compassionate care and treatment. Applying a trauma-informed approach to evaluation and treatment of perinatal populations could decrease the toll trauma has on affected women and their children.

Critical Appraisal of Clinical Practice Guidelines (CPG) Training for Graduate Student Nurses: Exemplar of a CPG for the Management of Post-Traumatic Stress Disorder (PTSD)

Background: Clinical practice guidelines serve as a framework for clinical decisions supporting best practices to optimize patient care. Critical appraisal of a clinical practice guideline is an important clinical skill for advanced practice nurses and other advanced healthcare professionals. Hence, advanced practice nursing students should receive appraisal training of clinical practice guidelines to develop their critical skills in determining their quality and potential incorporation into evidence-based clinical practice. Objective: This paper describes the incorporation of a critical appraisal of a clinical practice guideline in a graduate nursing program for advanced nursing practice. As an exemplar of the appraisal process, the clinical practice guideline from the United States (US) Department of Veterans Affairs and the Department of Defense (VA/DoD) on the management of post-traumatic stress disorder and acute stress disorder was critically appraised. Methodology: Students enrolled in a graduate nursing course were formed into groups of 3-4, and selected a clinical practice guideline according to their specialty. A group of four students enrolled in the Psychiatric and Mental Health Nurse Practitioner program critically appraised the VA/DoD clinical practice related to the management of posttraumatic stress disorder and acute stress disorder using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Students’ performance and feedback were evaluated. Results: The students viewed the course activity positively and appreciated learning the CPG appraisal process and its use in practice. The VA/DoD clinical practice guideline was deemed of high quality and user-friendly for practitioners’ use in clinical decision-making despite minor limitations. Conclusion and recommendations: Incorporation of clinical practice guideline assessment using the AGREE II Instrument in the advanced practice nursing curriculum should be considered. Participating graduate students considered the skill needed for their future advanced practice. Regular updates of clinical practice guidelines and their appraisals are also recommended.

Cross-sectional survey following a longitudinal study on mental health and insomnia of people with sporadic COVID-19.

BACKGROUNDIn the post-pandemic era, the emergence of sporadic cases of coronavirus disease 2019 (COVID-19) and the scale of the pandemic are unpredictable. Therefore, the impact of sporadic cases of COVID-19 and isolation measures on mental health and sleep in different groups of people need to be analyzed. AIMTo clarify the severity of psychological problems and insomnia of staff and community residents around a hospital with sporadic cases of COVID-19, and their relationship with quarantine location and long-term changes.METHODSA cross-sectional survey was conducted on community residents and medical staff. Many of these medical staff had been subjected to different places of quarantine. Community residents did not experience quarantine. Hospital anxiety and depression scale (HADS), acute stress disorder scale (ASDS) and insomnia severity index (ISI) were used to evaluate anxiety and depression, acute stress disorder symptoms, and the severity of insomnia. Additionally, we conducted a 1-year follow-up study on medical staff, with related scales measurement immediately after and one year after the 2-wk quarantine period.RESULTSWe included 406 medical staff and 226 community residents. The total scores of ISI and subscale in HADS of community residents were significantly higher than that of medical staff. Further analysis of medical staff who experienced quarantine showed that 134 were quarantined in hotels, 70 in hospitals and 48 at home. Among all subjects, the proportions of HADS, ASDS and ISI scores above normal cutoff value were 51.94%, 19.17% and 31.11%, respectively. Multivariable logistic regression analysis found that subjects with higher total ASDS scores had a greater risk to develop anxiety and depression. The total ISI score for medical staff in hotel quarantine was significantly higher than those in home quarantine. Total 199 doctors and nurses who completed the 1-year follow-up study. Compared with baseline, HADS and ASDS scores decreased significantly one year after the end of quarantine, while ISI scores did not change significantly. CONCLUSIONSporadic COVID-19 cases had a greater psychological impact on residents in surrounding communities, mainly manifested as insomnia and depressive symptoms. Hotel quarantine aggravated the severity of insomnia in medical staff, whose symptoms lasted ≥ 1 year.

The effect of courage on stress: The mediating mechanism of behavioral inhibition and behavioral activation in high-risk occupations.

Employees in high-risk occupations are exposed to tremendous work acute stress or prolonged stress disorders that are likely to undermine the health and organizational effectiveness. Based on positive psychology, courage which refers to behavioral approach despite the experience of fear could buffer the negative effects on stress. However, there is little known about the mechanisms by which courage decreases the risk of stress. Motivational systems may play an underlying role in this process, as behavioral inhibition system (BIS) is inhibited and behavioral activation system (BAS) is evoked by risk or threat. The current study aimed to examine the mediating effects of behavioral inhibition and activation on the relationship between courage and stress in the high-risk occupations. This study recruited 1,761 high-risk employees aged from 18 to 27 (M = 19.32; SD = 4.14) with a cluster sampling method who completed Courage Measure (CM), the BIS/BAS Scales and the Psychological Stress Evaluation Test (PSET). The correlation and mediation analyses examined the inter-variable correlations as well as the underlying mechanism between courage and stress. The results support the hypothesis and reveal that the behavioral inhibition mediates the association between courage and stress (B indirect = -0.02, p < 0. 01, 95%CI = -0.03 to -0.003). The behavioral activation of fun seeking mediates the association between courage and stress as well (B indirect = -0.04, p < 0. 01, 95%CI = -0.058 to -0.029). These findings suggest that behavioral inhibition and activation of fun seeking play imperative mechanism underpinning the buffering effect of courage on stress. Other theoretical and applied implications for desensitizing stress in the high-risk occupations are discussed.

Early Identification of Post-Traumatic Stress Disorder in Trauma Patients: Development of a Multivariable Risk Prediction Model.

The purpose of this study was to build a risk prediction model to identify trauma patients at the time of injury who are at high risk for post-traumatic stress disorder (PTSD) 1year later. Patients 18+ with operative orthopedic trauma injuries were enrolled in prospective social determinants of health cohort. Data were collected through initial surveys, medical records at time of injury, and 1-year follow-up phone screenings. Univariate analysis examined associations between factors and PTSD at 1 year. The best fit multivariable logistic regression model led to a novel PTSD risk prediction tool based on weights assigned similar to the Charlson index methods. Of 329 enrolled patients, 87 (26%) completed follow-up surveys; 58% screened positive for chronic PTSD. The best fit model predicting PTSD included age, insurance, violent mechanism, and 2 acute stress screening questions (AUC .89). Using these parameters, the maximum possible TIPPS index was 19. Those with PTSD at 1year had a mean TIPPS index of 12.9 ± 4.0, compared to 5.9 ± 4.2 for those who did not (P < .001). Traumatic injury often leads to PTSD, which can be predicted by a novel risk score incorporating age, insurance status, violent injury mechanism, and acute stress reaction symptoms. Stability in life and relationships with primary care physicians may be protective of PTSD. Diagnostic level II.

Personalized approach to the correction of stress-related disorders in soldiers under a full-scale invasion

War is the most powerful psychosocial stressor. Combat stress exerts a powerful traumatic effect on every military, which is the main reason for the development of post-traumatic stress disorders, acute stress disorders and combat mental injuries. Based on the data obtained during our study, it was developed and tested a personalized program for the correction of stress-related disorders and the rehabilitation of persons affected by combat stress with the differentiated use of psychopharmacotherapy, psychotherapy and psychoeducation methods. Against the background of carrying out the develo ped system of therapy and rehabilitation, the quali ty of life index in the main group by all scales in- creased by an ave rage of 42.1 ± 1.4 %, in the control group by an average of 31.4 ± 1.3 %. Thus, as a result of the implementa- tion of the indicated personalized program for the correction of stress-related disorders, an improvement in the quality of medical care for military personnel in modern conditions is expected.

Stress-related disorders and subsequent cancer risk and mortality: a population-based and sibling-controlled cohort study in Sweden

Prior research has suggested a potential role of psychological stress on cancer development while the role of familial factors on this association is underexplored. We conducted a nationwide cohort study including 167,836 individuals with a first-onset stress-related disorder (including post-traumatic stress disorder, acute stress reaction, adjustment disorder and other stress reactions) diagnosed between 1981 and 2016 in Sweden (i.e., exposed patients), 1,631,801 birth year- and sex-matched unexposed individuals, and 179,209 unaffected full siblings of the exposed patients. Cox models were used to estimate the hazard ratios (HRs) of newly diagnosed cancer and cancer-related death, beyond 1 year after diagnosis of stress-related disorders. We further examined the potential mediation roles of behavior-related morbidities in the associations of stress-related disorders with smoking or alcohol-related cancer incidence and mortality. We found modestly elevated risks of cancer incidence and mortality among exposed patients compared with matched unexposed individuals (incidence: HR = 1.03, 95% CI 1.01–1.06; mortality: HR = 1.13, 95% CI 1.07–1.18), while not when comparing with full siblings (incidence: HR = 1.03, 95% CI 0.99–1.08; mortality: HR = 1.09, 95% CI 1.00-1.19). Similarly, the suggested elevations in incidence and mortality of individual cancer sites (or groups) in the population-based comparison attenuated towards null in the between-sibling comparison. The risk elevations for smoking or alcohol-related cancers in the population-based comparison (incidence: HR = 1.18, 95% CI 1.11–1.24; mortality: HR = 1.20, 95% CI 1.12–1.29) were partially mediated by alcohol-related morbidities during follow-up. Collectively, our findings suggest that the association between stress-related disorders and cancer risk and mortality is largely explained by familial factors, including shared behavioral hazards.

Evaluation of COVID-19 pandemic on components of social and mental health using machine learning, analysing United States data in 2020.

BackgroundCOVID-19 was named a global pandemic by the World Health Organization in March 2020. Governments across the world issued various restrictions such as staying at home. These restrictions significantly influenced mental health worldwide. This study aims to document the prevalence of mental health problems and their relationship with the quality and quantity of social relationships affected by the pandemic during the United States national lockdown.MethodsSample data was employed from the COVID-19 Impact Survey on April 20–26, 2020, May 4–10, 2020, and May 30–June 8, 2020 from United States Dataset. A total number of 8790, 8975, and 7506 adults participated in this study for April, May and June, respectively. Participants’ mental health evaluations were compared clinically by looking at the quantity and quality of their social ties before and during the pandemic using machine learning techniques. To predict relationships between COVID-19 mental health and demographic and social factors, we employed random forest, support vector machine, Naive Bayes, and logistic regression.ResultsThe result for each contributing feature has been analyzed separately in detail. On the other hand, the influence of each feature was studied to evaluate the impact of COVID-19 on mental health. The overall result of our research indicates that people who had previously been diagnosed with any type of mental illness were most affected by the new constraints during the pandemic. These people were among the most vulnerable due to the imposed changes in lifestyle.ConclusionThis study estimates the occurrence of mental illness among adults with and without a history of mental disease during the COVID-19 preventative limitations. With the persistence of quarantine limitations, the prevalence of psychiatric issues grew. In the third survey, which was done under quarantine or house restrictions, mental health problems and acute stress reactions were substantially greater than in the prior two surveys. The findings of the study reveal that more focused messaging and support are needed for those with a history of mental illness throughout the implementation of restrictions.

Psychopathological states among Congolese health workers during the first wave of COVID-19 pandemic: links with emotion regulation and social support

ABSTRACT Background: The COVID-19 pandemic is an unprecedented stressor for frontline healthcare workers, notably increasing acute stress disorder and depression rates. Emotion regulation and social support could be major protective factors against such psychopathological states, but their role has not been explored outside Western contexts. Objective: To assess the association between emotion regulation, social support, acute stress disorder, and depression among healthcare workers directly confronted with the first wave of COVID-19 pandemic in the eastern Democratic Republic of the Congo. Method: A cross-sectional study assessed acute stress disorder, depression, adaptive (i.e. acceptance, positive refocusing, …) and maladaptive (i.e. self-blame, rumination, catastrophizing, …) emotion regulation strategies, social support (instrumental, emotional, and informational levels), as well as self-reported situations and feelings related to COVID-19, in a population of 252 frontline healthcare workers (121 women; 131 men; mean age: 39 ± 11 years old) at the Referral General Hospital of Bukavu. We also explored the relations between these variables through bivariate and multivariate logistic regression. Results: Forty percent of participants presented symptoms of depression, and 16% presented acute stress disorder. In bivariate logistic regression, these psychiatric outcomes were associated with the availability of a COVID-19 protection kit [OR = 0.24 (0.12–0.98)], hostility toward health workers [OR = 3.21 (1.23–4.21)], putting into perspective [OR = 0.91 (0.43–0.98)], self-blame [OR = 1.44 (1.11–2.39)], catastrophizing [OR = 1.85 (1.01–4.28)], blaming others [OR = 1.77 (1.04–3.32)], emotional support [OR = 0.83 (0.49–0.98)], instrumental support [OR = 0.74 (0.28–0.94)], and informational support [OR = 0.73 (0.43–0.98)]. In multivariate logistic regression, hostility [OR = 2.21 (1.54–3.78)], self-blame [OR = 1.57 (1.02-2.11)], rumination [OR = 1.49 (1.11-3.13)] and emotional support [OR = 0.94 (0.65-0.98)] remained significantly associated with psychiatric outcomes. Conclusion: Depression and acute stress disorder were highly prevalent among Congolese healthcare workers during the first wave of the COVID-19 health pandemic. Hostility, self-blame, rumination, and social support were associated with depression and/or acute stress disorder and should be targeted by interventions aiming to support health workers’ wellbeing. HIGHLIGHTS Frontline health workers presented high prevalence of acute stress disorder (16%) and depression (40%) during the first wave of COVID-19 pandemic in the Eastern Democratic Republic of the Congo, as they were working in hostile environment without enough protection kits. Acute stress disorder and depression were negatively associated with adaptive emotion regulation and social support; and positively with maladaptive emotion regulation. Intervention aiming to support health workers in pandemics should target emotion regulation and social support.

Examining the incidence of acute stress in pediatric trauma patients

ObjectivePediatric patients can be significantly impacted emotionally by exposure to acute trauma which may negatively impact long-term functioning and lead to an increase in overall distress. This study reports on...

Work-related stress in medical personnel: A new instrument for screening and evidence-based recommendations for therapeutic management

Medical personnel is constantly exposed to a variety of stressful events, starting from work overloading, to threats to one’s own health or personal integrity, disruptions in personal relationships due to high stress in the professional environment, continuous need to keep in touch with the advances of medical science and therapeutic guidelines etc. Structured evaluation of work-related stress disorders (WRSD) is important both for screening purposes in a vulnerable population like the medical personnel, and for the monitoring of the overall status evolution during individual or organizational interventions. Beside burnout syndrome, major depressive episodes, anxiety disorders, acute stress reactions, posttraumatic stress reactions, substance use disorders, adjustment disorders are also included in the category of WRSD. A specific instrument has been designed for the purpose of screening for WRSD in this specific population, i.e. the Work-related Stress Inventory for Medical Personnel, structured as a 20 items, self-administered instrument (WRSIMP-20). This inventory evaluates three main dimensions- (1) mood symptoms and somatic equivalents, (2) work and professional environment-related discomfort, and (3) interpersonal relationship-associated distress. The results of online administration of WRSIMP-20 in 81 health care workers and 52 individuals not related in any way to health care professions (control group) were consistent with the premises, as this inventory has been proven valid for the targeted population. Larger trials and test-retest evaluation are needed in order to complete the psychometric properties of WRSIMP-20, but this instrument seems promising in the detection of individuals vulnerable to WRSD

Racial/ethnic differences in acute and longer-term posttraumatic symptoms following traumatic injury or illness.

Racial/ethnic differences in mental health outcomes after a traumatic event have been reported. Less is known about factors that explain these differences. We examined whether pre-, peri-, and post-trauma risk factors explained racial/ethnic differences in acute and longer-term posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in patients hospitalized following traumatic injury or illness. PTSD, depression, and anxiety symptoms were assessed during hospitalization and 2 and 6 months later among 1310 adult patients (6.95% Asian, 14.96% Latinx, 23.66% Black, 4.58% multiracial, and 49.85% White). Individual growth curve models examined racial/ethnic differences in PTSD, depression, and anxiety symptoms at each time point and in their rate of change over time, and whether pre-, peri-, and post-trauma risk factors explained these differences. Latinx, Black, and multiracial patients had higher acute PTSD symptoms than White patients, which remained higher 2 and 6 months post-hospitalization for Black and multiracial patients. PTSD symptoms were also found to improve faster among Latinx than White patients. Risk factors accounted for most racial/ethnic differences, although Latinx patients showed lower 6-month PTSD symptoms and Black patients lower acute and 2-month depression and anxiety symptoms after accounting for risk factors. Everyday discrimination, financial stress, past mental health problems, and social constraints were related to these differences. Racial/ethnic differences in risk factors explained most differences in acute and longer-term PTSD, depression, and anxiety symptoms. Understanding how these risk factors relate to posttraumatic symptoms could help reduce disparities by facilitating early identification of patients at risk for mental health problems.

Factors preceding occupational distress in emergency nurses: An integrative review.

This integrative review aimed to synthesise current evidence on the factors that precede and contribute to the occupational distress of emergency nurses. Emergency nurses practice within an environment challenged by demand exceeding capacity, an inability of staffing to meet this demand in addition to limited resources which contribute to form a unique risk to clinician and patient safety. The risk of occupational distress, while demonstrated across specialties, is noted to be highest in emergency nurses with subsequent impacts for clinicians, organisations and patients being explored. While previous studies have examined singular outcomes or elements, a comprehensive review that considers the factors and components of the overarching occupational distress is not evident in the current published literature. Whittemore and Knafl's integrative review methodology enabled a structured format for synthesis and analysis of literature. A review of CINAHL, MEDLINE, Psych INFO, Embase, Australian Digital Thesis Network, University Microfilm International and Google Scholar between 2014 and 2021 was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Search terms explored the contributions of compassion fatigue, burnout, acute and post-traumatic stress disorder, and secondary traumatic stress/vicarious trauma to occupational distress. This search resulted in sixteen publications included for synthesis. Literature for inclusion was identified as quantitative (seven), qualitative (six) and mixed-methods (three) studies. Factors identified as contributing to the development of occupational distress arise from the characteristics and situations of individual nurses, local organisational governance and the inherent nature of the emergency nurse role. Consequentially, there are negative impacts on patients, clinicians and healthcare organisations. Emergency nurses experience exposure to several unique factors contributing to occupational distress which may originate from individual, organisational, occupational sources or a combination of these. Future research and strategies to address these factors could strengthen clinicians and organisations in the delivery of safe, holistic, high-quality nursing care. Emergency nurses practice in unique and challenging environments which place them at higher risk of occupational distress with subsequent negative impacts for the clinician, healthcare organisation and patients. Through the investigation and development of strategies such as the facilitation of knowledge of patient disposition, emergency nurses may experience an increase in their well-being, retention, job satisfaction and resiliency.

Acute stress disorder in trauma patients discharged in 72 h or less

IntroductionAcute Stress Disorder (ASD) is a psychiatric condition affecting individuals exposed to trauma and requires the presence of symptoms 72 h following trauma. Patients evaluated for trauma related injury are often discharged prior to 72 h, but the risk of ASD remains. The aim of this study was to quantify the rate of acute stress disorder in trauma patients admitted for fewer than 72 h. Materials and MethodsWe performed a prospective, observational study of trauma patients discharged prior to 72 h at our ACS Level I Trauma Center between June 2020 and December 2020. Participants were administered an institutional screening tool following hospital discharge. Positive screens were then administered the diagnostic Acute Stress Disorder Scale (ASDS) tool. The rate of ASD was calculated and bivariate comparisons between participants who met diagnostic criteria and those who did not were performed to identify risk factors for the development of acute stress disorder. Results116 patients participated (median age 54, 66% male, median injury severity score (ISS) 9). Forty patients (34%) screened positive via the institutional screening tool, with 14 (12%) ultimately demonstrating ASD by ASDS. Participants who developed ASD were more likely to be female (71 vs. 30%, p = 0.005), African American (43 vs. 12% White, p = 0.016), spend less time in the hospital overall (1–2 vs. 2–3 days. p = 0.045), and have a lower ISS (6 vs. 9, p = 0.041). ConclusionsOur study found 12% of trauma patients discharged prior to 72 h developed ASD. These data point to possible benefit in reassessment of injured patients following hospital discharge and the importance of developing pathways for trauma patients to access mental health resources.

Neuropsychiatric Consequences of COVID-19 Pandemic: A Synthetic Review from a Global Perspective.

Some research suggests that distress, secondary to isolation and fear following COVID-19 infection, can negatively affect the long-term more than the COVID-19 infection itself. This narrative review aims to provide a global view on the neuropsychiatric consequences of COVID-19 that can be ascribed to several factors, ranging from the direct effect of infection, to the body's responses against the infection, or to the psychological sequelae of social isolation, unemployment, and fear for one's health and livelihood. Current findings show that the more severe the respiratory infection, the more likely are central nervous system (CNS) complications regarding the infection itself. The immune reactions to the infection may result in symptoms similar to chronic fatigue as well as neurocognitive deficits, which last long after the infection is gone. An increase in symptoms of depression, anxiety, and trauma-related stress may also follow upon economic fears and isolation from friends and family. The consequences of the pandemic are not limited to adults; children learning remotely and away from classmates and routine activities may develop adjustment disorders, acute stress disorder, and a variety of manifestations of grief. A summary of case reports suggests that COVID-19-related stress, economic recession, and political unrest increase the risk of suicidal behaviors and acts of violence. However, it is unknown whether manifestations of mental disorders result from social causes or whether CNS complications may be responsible.