Comorbid Posttraumatic Stress Disorder Research Articles

A Three-Generation Study of the Prevalence and Comorbidity of Posttraumatic Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder Among Afghan Refugees

Afghan refugees are at the forefront of international attention amidst the unfolding global refugee crisis. Having borne witnesses to the horrors of war, fled their homeland, and endured the tragic loss of loved ones, they suffered a psychological trauma that reshaped their cognitive and emotional frameworks. This cross-sectional survey explores the prevalence and comorbidity of posttraumatic stress disorder and posttraumatic obsessive-compulsive disorder among Afghan refugees living in Haripur, Pakistan, and the intergenerational transmission of PTSD across their three generations. Researchers collected data from 48 male participants representing three generations of 16 Afghan refugee families using the Obsessive-Compulsive Inventory-Revised and the Posttraumatic Diagnostic Scale for DSM-5-TR. The findings revealed a significant positive correlation between posttraumatic obsessive-compulsive disorder and posttraumatic stress disorder, indicating a substantial co-occurrence of posttraumatic obsessive-compulsive disorder and posttraumatic stress disorder. About 79.20% of total participants were diagnosed with posttraumatic obsessive-compulsive disorder, and it was more prevalent among the first generation (87.5%) than in the second and third generations (75.0%) each—additionally, significant variability across generations in the prevalence of PTSD. The first-generation refugees experienced severe and very severe symptoms (12.5%), the second-generation experienced moderate symptoms, and the third-generation experienced mild symptoms (16.6%). These results emphasize the importance of addressing the comorbidity of both disorders in refugee communities to underscore their intergenerational adverse mental health outcomes.

Residual symptoms following trauma-focused treatment for comorbid posttraumatic stress disorder and major depressive disorder.

Despite effective psychotherapy options for posttraumatic stress disorder (PTSD), some patients do not fully respond, and even among those reporting substantial improvement, residual symptoms following treatment are common. Psychiatric conditions frequently co-occur with PTSD, yet research on residual symptoms among comorbid samples is lacking. This study examined residual symptoms of PTSD and depression among 71 active duty service members with PTSD and comorbid major depressive disorder (MDD). As part of a clinical trial, participants were randomized to cognitive processing therapy (CPT) or a novel treatment designed to address PTSD and comorbid MDD, behavioral activation-enhanced CPT (BA+CPT). Analyses compared individual residual symptoms between treatments and groups based on PTSD and MDD diagnostic status at posttreatment. For both PTSD and MDD, the conditional probabilities for each residual symptom did not differ between CPT and BA+CPT, suggesting treatment type did not influence which symptoms persisted. For the 36 service members who lost their PTSD diagnosis at posttreatment, conditional probabilities of residual PTSD symptoms were highest for sleep problems, concentration difficulties, and hypervigilance; for MDD symptoms, conditional probabilities were highest for sleep problems, concentration difficulties, and low energy. These most common residual symptoms were identical for the 31 service members who lost their MDD diagnosis at posttreatment. Residual symptoms observed among service members with PTSD and comorbid MDD mirrored those commonly identified among single disorder PTSD or MDD samples. Identifying and addressing residual symptoms most meaningful to patients will maximize benefit from PTSD treatment.

Clinical Insights into PTSD and OCD Comorbidity

This paper examines the complex relationship between post-traumatic stress disorder (PTSD) and obsessive- compulsive disorder (OCD), highlighting how trauma can not only exacerbate, but also trigger the onset of obsessive-compulsive symptoms, contributing to treatment resistance. Both disorders share overlapping features such as intrusive thoughts, avoidance behaviors, and abnormalities in brain regions responsible for emotional regulation, including hyperactivity in the amygdala and hypoactivity in the prefrontal cortex. Trauma-induced OCD, which often emerges after trauma, tends to be more resistant to standard treatments like exposure and response prevention (ERP) due to the heightened emotional distress linked to trauma memories. This paper also discusses the neurobiological underpinnings of these comorbid conditions, presenting evidence of disrupted cortico-striatal- thalamo-cortical (CSTC) circuits, which affect fear processing and cognitive control. By incorporating trauma- focused interventions, such as trauma-sensitive ERP, prolonged exposure therapy (PE), and mindfulness-based cognitive therapy (MBCT), clinicians can more effectively address the emotional dysregulation that drives and exacerbates OCD symptoms. A case study of a treatment-resistant OCD patient with comorbid PTSD underscores the need for tailored, multidimensional approaches to improve clinical outcomes. The findings stress the importance of early trauma identification and integrating cognitive-behavioral strategies with trauma-informed care to promote lasting recovery in patients with these dual diagnoses.

Role of Momentary Alcohol Cognitions in Event-Level Relations Between PTSD Symptoms and Alcohol Outcomes: Le rôle des cognitions momentanées liées à l'alcool au niveau de l'événement entre les symptômes du TSPT et la consommation d'alcool.

Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur. Momentary alcohol cognitions may represent in-the-moment, modifiable risk factors to target in interventions for comorbid PTSD and AUD. However, the role of such cognitions in risk for problematic drinking as it emerges in response to individuals' fluctuating PTSD symptoms across their daily lives remains unknown. The present study aimed to test whether state-level PTSD-alcohol expectancies and/or drinking motives modulate in-the-moment associations between PTSD symptoms and alcohol outcomes. Frequent drinking adults with current PTSD (n = 54) reported on their posttraumatic symptoms and alcohol cognitions, craving, and consumption during four momentary surveys each day for 14 days (3,024 observations) in an ecological momentary assessment design. Multilevel moderation analyses tested whether in-the-moment PTSD-alcohol expectancies and/or drinking motives moderated relations of PTSD symptoms with alcohol craving and consumption. Findings demonstrated a significant interaction between PTSD symptoms and coping drinking motives on in-the-moment alcohol craving. Specifically, greater experience of PTSD symptoms related more strongly to craving for alcohol during events in which drinkers endorsed higher levels of coping drinking motives. There were no additional interaction effects for drinking motives or PTSD-alcohol expectancies on either alcohol craving or consumption. Coping drinking motives appear to convey strong in-the-moment risk for PTSD-related alcohol craving yet not subsequent alcohol consumption. Future research should delineate concurrent alcohol risk and possible protective processes active in the presence of PTSD symptoms to help identify targets for interventions tailored to the unique risk processes maintaining comorbid PTSD and AUD.

Integrating Drug Target Information in Deep Learning Models to Predict the Risk of Adverse Events in Patients with Comorbid Post-Traumatic Stress Disorder and Alcohol Use Disorder.

Background/Objectives: Comorbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) patients are at a significantly higher risk of adverse outcomes, including opioid use disorder, depression, suicidal behaviors, and death, yet limited treatment options exist for this population. This study aimed to build on previous research by incorporating drug target information into a novel deep learning model, T-DeepBiomarker, to predict adverse outcomes and identify potential therapeutic medications. Methods: We utilized electronic medical record (EMR) data from the University of Pittsburgh Medical Center (UPMC), analyzing 5565 PTSD + AUD patients. T-DeepBiomarker was developed by integrating multimodal data, including lab results, drug target information, comorbidities, neighborhood-level social determinants of health (SDoH), and individual-level SDoH (e.g., psychotherapy and veteran status). The model was trained to predict adverse events, including opioid use disorder, suicidal behaviors, depression, and death, within three months following any clinical encounter. Candidate medications targeting significant proteins were identified through literature reviews. Results: T-DeepBiomarker achieved high predictive performance with an AUROC of 0.94 for adverse outcomes in PTSD + AUD patients. Several medications, including OnabotulinumtoxinA, Dronabinol, Acamprosate, Celecoxib, Exenatide, Melatonin, and Semaglutide, were identified as potentially reducing the risk of adverse events by targeting significant proteins. Conclusions: T-DeepBiomarker demonstrates high accuracy in predicting adverse outcomes in PTSD + AUD patients and highlights candidate drugs with potential therapeutic effects. These findings advance pharmacotherapy for this high-risk population and identify medications that warrant further investigation.

Posttraumatic stress disorder and metabolic syndrome: the role of some biofactors in treatment

Post-traumatic stress disorder (PTSD) and metabolic syndrome (MetS) are often comorbidities and share neurobiological and clinical features. In particular, the results of meta-analyses indicate a higher prevalence of MetS in patients with PTSD compared to the general population. At the same time, PTSD is also a known risk factor for MetS. The involvement of common pathogenetic mechanisms characteristic of both conditions partially explains this coincidence. Insufficient intake and deficiency of certain biofactors, especially micronutrients (vitamins and essential minerals), are associated with an increased risk of MetS, type 2 diabetes mellitus, and cardiovascular diseases, and maintaining their physiological content in the body reduces this risk. Taking nutritional supplements with certain biofactors may help as an adjunct to conventional therapy to prevent and treat PTSD and, more often than not, MetS at the same time. This is because both conditions are linked to deficiencies in a number of biofactors. This review aims to discuss the role of several biofactors, including α-lipoic acid, vitamin B1/benfotiamine, L-carnitine and acetyl-L-carnitine, ω-3 polyunsaturated fatty acids, quercetin, magnesium, vitamins D and E, polyphenols, in the prevention and treatment of PTSD and MetS comorbidity, as well as to analyze new trends and future research directions. We conducted the search in databases such as Scopus, Science Direct (from Elsevier), PubMed, and MEDLINE. The keywords used were “post-traumatic stress disorder”, “metabolic syndrome”, and “biofactors”. We manually searched the bibliography of publications to identify research results that were not found during the online search.

Coexisting patterns of posttraumatic stress disorder and depression symptoms in college students who experienced childhood maltreatment: Different types of maltreatment exposure

BackgroundChildhood maltreatment is often associated with comorbid posttraumatic stress disorder (PTSD) and depression, but the impact of different types of maltreatment on this comorbidity is not well understood. MethodsUsing network analysis, we examined differences in comorbidity patterns of PTSD and depression symptoms among college students who experienced different forms of childhood maltreatment. We selected a subsample of 2968 students (Mage = 19.38, SD = ±1.45) who reported exposure to childhood maltreatment from a larger sample of 5231 students. ResultsThis study showed that symptoms of negative emotions and cognitive change, intrusive symptoms, and increased alertness might play a significant role in the diagnosis and prognosis of comorbid PTSD and depression. The most central nodes in the network of physical maltreatment were flashbacks, and irritability, whereas the most central nodes in the network of emotional and compound trauma, were low mood and sadness. Moreover, network structure and strength differed significantly between maltreatment types, and differences in specific symptom associations were also observed. ConclusionNetwork analysis provides insights into which symptoms contribute to the development of comorbidities in individuals with different childhood maltreatment types, as well as how specific symptoms are interconnected in the network. This information can aid in developing targeted and effective interventions for different maltreatment forms.

The Effect of Bilateral, Two-Level Cervical Sympathetic Chain Blocks on Specific Symptom Clusters for Traumatic Brain Injury, Independent of Concomitant PTSD Symptoms.

Background/Objectives: The aim of this study was to determine if performing ultrasound-guided, bilateral, two-level cervical sympathetic chain blocks (2LCSBs) (performed on subsequent days) improves symptoms associated with traumatic brain injury (TBI) that do not overlap with posttraumatic stress disorder (PTSD). Methods: A retrospective chart review was conducted between August 2022 and February 2023. We identified twenty patients who received bilateral 2LCSBs for PTSD and anxiety symptoms and who also had a history of TBI. Neurobehavioral Symptom Inventory (NSI) scores were collected at baseline, one week, and one month post treatment in 13 males and 7 females. A sub-analysis of the first ten questions of the NSI, which we identified as not overlapping with PTSD or anxiety symptoms, generated an NSI sub-score. Results: Out of 20 patients, all showed improvement in their NSI scores and NSI sub-scores. The NSI sub-scores had a baseline average of 15.45 (on a 40-point scale); the average score at one week post treatment was 8.30; and that at one month post treatment was 7.80. This represents a 49.51% improvement in TBI symptoms which did not overlap with PTSD or anxiety symptoms between baseline and one month. Conclusions: The use of bilateral 2LCSBs may be helpful in treating patients with TBI, regardless of the presence of comorbid PTSD symptoms.

Prevalence of Post-Traumatic Stress Disorder among COVID-19 Survivors: A 6-Month Follow-up Study in a Few Referral Hospitals of Tehran, Iran

Background: COVID-19 has significantly impacted individuals globally, leading to heightened levels of stress and psychological distress. COVID-19 hospitalized patients experience social exclusion, physical pain, and survival anxiety. This study aims to screen recovered COVID-19 patients for Post-Traumatic Stress Disorder (PTSD) and assess its correlation with psychosocial factors for six months. Methods: In this descriptive-analytical cohort study, 401 patients aged 18-80 years were hospitalized in hospitals related to Tehran University of Medical Sciences due to COVID-19 from March 1 to May 31, 2021, and were followed for six months. Recovered patients completed electronic PCL-5 and demographic questionnaires to be screened for PTSD and other psychiatric comorbidities. The data were analyzed utilizing multivariate logistic regression models. Results: Based on the PCL-5, PTSD was diagnosed in 6.4% of the samples. 10.2% of the samples received a subthreshold PTSD diagnosis. 46.2% of the samples with a PTSD diagnosis had a positive past psychiatric history. Results demonstrated that a previous positive psychiatric diagnosis has a statistically significant relationship with PTSD (p<0.05). This research did not reveal any significant association between PTSD symptoms and demographic features. Conclusion: PTSD and subthreshold PTSD rates in COVID-19 patients after hospital discharge are significant. A positive past psychiatric history was recognized as a contributing factor contributing to the onset of PTSD. COVID-19 survivors should be screened for PTSD during follow-up examinations.

Healthcare costs and resource utilization of patients with chronic post-traumatic stress disorder: a retrospective US claims analysis of commercially insured patients.

Aim: Exploring the healthcare costs and resource use among privately insured US patients with post-traumatic stress disorder (PTSD). Methods: This study used Merative MarketScan data. The index date was defined as the first PTSD claim. Study period included a 1-year pre-index and 2-year post-index follow-up. Cases with only acute PTSD, cancer, or insurance gap during the study period were excluded. The PTSD with (PwC) and PTSD without comorbidities (PwoC) cohorts were defined by the presence/absence of comorbid mental health conditions (schizophrenia, bipolar and major depressive disorder). Baseline PTSD (BP) cohort included PwoC cases with only index PTSD event and without FDA-approved PTSD medications or psychotherapy. Sub-analysis is conducted among patients with PTSD and substance/alcohol use disorder. Study cohorts were matched in a 1:1:1 ratio. Results: The matched sample included 5076 patients (1681 PwC, 1681 PwoC, 1714 BP). PwC patients had higher 2-year PTSD-related costs than PwoC and BP patients ($3762 vs $1750 and $841; all p<0.001). The same trend was noted among all-cause and anxiety-related costs. PwC patients had higher 2-year PTSD-related inpatient and emergency department (ED) rates than PwoC (10.2% vs 1.7% and 6.8% vs 2.6%, all p<0.001) and inpatient and outpatient rates than BP (10.2% vs 2.1% and 98.0% vs 93.1%; all p≤0.004). The sub-analysis had 3776 patients (3154 PwC, 537 PwoC, 85 BP). PwC had higher 2-year PTSD-related costs than PwoC and BP ($7668 vs $2919 and $1,483; all p<0.001). The same trend was noted in all-cause and anxiety-related costs. PwC also had higher 2-year PTSD-related inpatient and ED rates than PwoC (25.6% vs 10.4% and 12.7% vs 5.2%; all p<0.001) and inpatient and outpatient rates than BP (25.6% vs 8.2% and 95.5% vs 84.7%; all p<0.001). Conclusion: PTSD is associated with high healthcare costs and resource use. The highest economic burden was observed in patients with PTSD and mental health comorbidities.

The effect of mindfulness-based cognitive therapy on PTSD and depression symptoms in trauma-exposed black adults: Pilot randomized controlled trial results

Low-income, urban-dwelling Black adults are disproportionately affected by traumatic experiences, posttraumatic stress disorder (PTSD), and depression and encounter inequities in treatment access. In addition to the benefits Mindfulness-Based Cognitive Therapy (MBCT) for depression, there is preliminary evidence of successful symptom reduction in PTSD via MBCT across two prior pilot studies in veterans. Studies examining the effects of MBCT among trauma-exposed Black adults remains limited, and examination of effects across specific PTSD clusters is almost nonexistent. We examined the preliminary efficacy of adapted MBCT versus waitlist control (WLC) on PTSD and depression symptoms in a pilot randomized controlled trial (RCT). Black adults (N = 80; 86.10 % women) with repeated trauma exposure, who screened positive for PTSD and depression, were recruited from an urban public hospital and randomized to 8-week adapted MBCT or WLC. Symptoms were measured pretreatment and posttreatment with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the Beck Depression Inventory-II (BDI-II). Mixed model analyses were conducted with an intent-to-treat approach, examining change in PTSD and depression scores between MBCT and WLC over time. There was no significant difference in total PTSD and depression symptom change between MBCT and WLC. CAPS-5 avoidance symptoms showed a nominally significant decrease in the MBCT group (F[1, 68.10] = 5.98, p = .017; t[71.60] = 3.61, p < .001). Findings suggest MBCT might be helpful for addressing avoidance symptoms among Black adults with comorbid PTSD and depression. Although lacking power to draw final conclusions about treatment efficacy, this study provides preliminary data suggesting the importance of future fully powered trials.

Common and divergent neuroimaging features in major depression, posttraumatic stress disorder, and their comorbidity.

Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are common stress-related psychiatric disorders. Genetic and neurobiology research has supported the viewpoint that PTSD and MDD may possess common and disorder-specific underlying mechanisms. In this systematic review, we summarize evidence for the similarities and differences in brain functional and structural features of MDD, PTSD, and their comorbidity, as well as the effects of extensively used therapies in patients with comorbid PTSD and MDD (PTSD+MDD). These functional magnetic resonance imaging (MRI) studies highlight the (i) shared hypoactivation in the prefrontal cortex during cognitive and emotional processing in MDD and PTSD; (ii) higher activation in fear processing regions including amygdala, hippocampus, and insula in PTSD compared to MDD; and (iii) distinct functional deficits in brain regions involved in fear and reward processing in patients with PTSD+MDD relative to those with PTSD alone. These structural MRI studies suggested that PTSD and MDD share features of reduced volume in focal frontal areas. The treatment effects in patients with PTSD+MDD may correlate with the normalization trend of structural alterations. Neuroimaging predictors of repetitive transcranial magnetic stimulation response in patients with PTSD+MDD may differ from the mono-diagnostic groups. In summary, neuroimaging studies to date have provided limited information about the shared and disorder-specific features in MDD and PTSD. Further research is essential to pave the way for developing improved diagnostic markers and eventually targeted treatment approaches for the shared and distinct brain alterations presented in patients with MDD and PTSD.

Insomnia and Chronic Pain Mediate the Relationship Between Traumatic Brain Injury and Reduced Positive Airway Pressure Adherence Among Veterans.

To examine whether co-morbid insomnia, post-traumatic stress disorder (PTSD), depression, and chronic pain mediate the relationship between traumatic brain injury (TBI) and positive airway pressure (PAP) treatment adherence. One Veterans Health Administration (VHA) sleep medicine site. Veterans (n =8836) who were prescribed a modem-enabled PAP device. Secondary analysis of clinical data. We used path analysis to examine: (1) whether Veterans with a history of TBI were more likely to experience insomnia, PTSD, depression, and chronic pain; (2) in turn, whether Veterans with these co-morbid conditions exhibited lesser PAP adherence; and (3) whether Veterans with a history of TBI will exhibit lesser PAP adherence, even while accounting for such co-morbid conditions. Model estimates were adjusted for sociodemographic (eg, race/ethnicity) and clinical characteristics (eg, mask leakage). Health conditions were abstracted from the VHA medical record. PAP adherence was measured using average nightly use (hours). Among 8836 Veterans, 12% had a history of TBI. TBI history was not associated with PAP adherence when accounting for the presence of insomnia, PTSD, depression, and chronic pain. Indirect effect estimates indicated that a history of mild, moderate-severe, or unclassified TBI was associated with lesser PAP adherence, as mediated by the presence of co-morbid insomnia and chronic pain. Generally, TBI was associated with an increased likelihood of co-morbid insomnia, PTSD, depression, and chronic pain. In turn, insomnia and chronic pain, but not PTSD or depression, were associated with lesser PAP adherence. Our study offers empirical support for insomnia and chronic pain as potential explanatory mechanisms underlying the relationship between TBI history and suboptimal PAP adherence. While additional research is needed to confirm causality, findings offer preliminary evidence that can inform the development of tailored PAP adherence interventions for Veterans with TBI and obstructive sleep apnea.

THE COMORBIDITY OF DEPRESSION AND PTSD IN SEXUALLY ABUSED CHILDREN: A SYSTEMATIC REVIEW

&lt;p&gt;&lt;strong&gt;Background and Purpose: &lt;/strong&gt;In recent years, the incidence of child sexual abuse (CSA) has significantly increased, particularly among younger children. Such traumatic experiences can have profound and long-lasting effects on a child's mental health, often leading to an increased risk of developing disorders such as depression and post-traumatic stress disorder (PTSD). This study aims to investigate the comorbidity of depression and PTSD in children who have experienced sexual abuse. The primary objective is to examine whether these two disorders frequently coexist in children subjected to CSA.&lt;strong&gt; Method: &lt;/strong&gt;This study follows the PRISMA 2020 guidelines and employs a systematic review methodology. No statistical analysis methods were utilized. The research sample also included adolescents, providing a broader understanding of the effects of CSA across different age groups.&lt;strong&gt; Results: &lt;/strong&gt;The findings revealed a strong correlation between child sexual abuse and the comorbidity of depression and PTSD, indicating that children who have been sexually abused are at a heightened risk of developing both disorders simultaneously.&lt;strong&gt; Conclusion: &lt;/strong&gt;Children who have experienced sexual abuse are highly likely to develop both depression and PTSD. However, further research is necessary to deepen our understanding of this comorbidity and to explore effective interventions.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0791/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Borderline personality disorder and post-traumatic stress disorder in adolescents: protocol for a comparative study of borderline personality disorder with and without comorbid post-traumatic stress disorder (BORDERSTRESS-ADO)

BackgroundBorderline Personality Disorder (BPD) is a prevalent and debilitating psychiatric condition often accompanied by Post-Traumatic Stress Disorder (PTSD), with a substantial prevalence of trauma history among affected individuals. The clinical, cognitive, and cerebral parallels shared with PTSD suggest a trauma-related etiology for BPD. Studies consistently demonstrate a reduction in hippocampal volume in individuals with BPD, echoing findings in PTSD. However, the interpretation of this shared neurobiological profile remains contentious, with ongoing debates regarding the independence of these pathologies or the potential exacerbation of diminished hippocampal volume in BPD due to concurrent PTSD. Differential impacts on hippocampal subfields across both disorders may further complicate interpretation, suggesting the volume of hippocampal subfields as a potential discriminant biomarker. This study aims to characterize the multidimensional specific and shared profiles of BPD and PTSD-related alterations, with a particular emphasis on hippocampal subfields during adolescence, a crucial period in BPD development.MethodsThis study focuses on female adolescents, who are more prevalent in the BPD population. Participants are categorized into three groups: BPD, BPD with comorbid PTSD, and a control group of matched healthy individuals. Data collection encompasses clinical, cognitive, and neuroimaging domains commonly affected in both disorders, utilizing various imaging markers (including gray matter macrostructure, white matter microstructural integrity, and regional functional connectivity).DiscussionThis study examines adolescent BPD with and without comorbid PTSD on clinical, neuroimaging, and cognitive levels. It is the first to use a comprehensive multi-modal approach within the same sample. Additionally, it uniquely explores hippocampal subfield volume differences in adolescents. Analysis of the relationship between the investigated domains and the effects of PTSD comorbidity will elucidate specific and shared alteration profiles in both disorders.Trial registrationIDRCB number 2019-A00366-51 / clinicaltrials.gov ID: NCT0485274. Registered on 21/04/2021.

Traumatic brain injury rehabilitation for warfighters with post-traumatic stress.

While there is extensive empirical support and clinical guidance for the treatment of mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) individually, less is known about treating the comorbid presentation of both conditions. The purpose of this review article is to provide information on the mental health treatment needs of service members (SMs) engaged in traumatic brain injury (TBI) rehabilitation. It also aims to offer a framework for an integrated treatment approach to address the cognitive and psychological health needs of warfighters. We review the prevalence and outcomes associated with comorbid TBI and PTSD and present relevant access to care considerations. Additionally, we identify an integrated approach to TBI treatment which takes psychological trauma into consideration. We introduce a trauma-informed care (TIC) model with specified diagnostic and treatment considerations for the service member and veteran (SM/V) communities. TIC is a strengths-based framework that raises the system-wide awareness of treatment facilities to the impact of psychological trauma on behavioral health. A comprehensive diagnostic approach is recommended with considerations for symptom etiology. Clinical considerations derived from available guidelines are identified to meet critical treatment needs for SM/Vs presenting for TBI treatment with a remote history of mTBI and psychological trauma or known PTSD. Clinical practice guidelines are used to inform an integrated TBI treatment model and maximize rehabilitation efforts for warfighters. Given the prevalence of comorbid TBI and PTSD among SM/Vs and its impact on outcomes, this review presents the integration of appropriate diagnostics and treatment practices, including the incorporation of clinical practice guidelines (CPGs) into TBI rehabilitation.

The Effects of Bioactive Compounds on PTSD Treatment.

Post-traumatic Stress Disorder (PTSD) is a psychiatric disease that arises in individuals who have experienced a traumatic event such as combat exposure, childhood physical abuse, sexual violence, physical assault, an accident, etc. Being difficult to diagnose and treat, PTSD is actively studied in areas of medicine, psychiatry, biochemistry, and rehabilitation. PTSD is characterized by significant comorbidity and is accompanied by depression and anxiety. Current treatment strategies for PTSD symptoms include psychotherapy and medications. Naturally derived compounds can offer therapeutic benefits for mood disorders without unpleasant side effects. Bioactive compounds found in food exhibit beneficial effects such as antioxidant, anti-inflammatory, and neuroprotective activities. Here, we describe the promising therapeutic benefits of a number of bioactive substances that have been evaluated in a variety of animal models and human experimental studies. Anxiolytic, antidepressant, and antidementia activities of bioactive compounds emphasize their potential for treating PTSD comorbidities. Hypothetical mechanisms of actions are also discussed, providing insights into their potential for human mental health.

Impact and Needs in Caregiving for Individuals With Dementia and Comorbid Posttraumatic Stress Disorder Living in Nursing Homes.

Impact and Needs in Caregiving for Individuals With Dementia and Comorbid Posttraumatic Stress Disorder Living in Nursing Homes.

Feasibility of a Virtual Adaptation of a Yoga Intervention for Veterans with Chronic Pain and Posttraumatic Stress Disorder.

Purpose/Objective: This study assessed the feasibility and acceptability of a yoga intervention for veterans with comorbid posttraumatic stress disorder (PTSD) and chronic pain (CP) that was adapted for virtual implementation. Research Method/Design: This pilot feasibility study at a large, mid-Atlantic Veteran's Affairs (VA) Medical Center with veterans with both PTSD and CP examined the adaptation of an eight-session virtual yoga group intervention. Participants (n = 18, 11 completers) were primarily male (82.4%), African American (76.5%), with no prior yoga experience (70.6%). A measure of client satisfaction was administered at completion and attendance rates were examined. Self-reported symptom measures were also assessed. Results: There were no instances of injuries or other adverse effects related to the study. This study yielded a 39% attrition rate, consistent with in-person yoga interventions. Mean number of sessions attended was 5.53 (SD = 1.73). Participants rated overall satisfaction as high (M = 28.09; SD = 3.96; potential range 8-32). Conclusions/Implications: This study provides initial data on the acceptability of a virtual yoga intervention for veterans with comorbid PTSD and CP, with attrition and satisfaction rates in line with prior in-person iterations. Implications of virtual adaption and considerations for future efforts will be discussed. This study was not preregistered but has been registered subsequently on ClinicalTrials.gov [CTR #: NCT06123065].

The bridge relationships of PTSD and depression symptoms among snakebite victims: a cross-sectional community-based survey

BackgroundThe incidence of comorbid depression and post-traumatic stress disorder (PTSD) symptoms is higher in snakebite victims. However, the present state and contributing factors of depression and PTSD among Chinese snakebite victims remain unclear.MethodsA representative sample of 6837 snakebite victims were assessed with the Post-traumatic Stress Disorder Checklist (Civilian Version) and The Center for Epidemiologic Studies Depression Scale. Multivariate analyses, including network analysis, evaluated the contributing factors of PTSD and depression symptoms caused by snake bites, as well as the bridge symptoms of comorbidity networks.ResultsAmong 6,837 snakebite victims, 79.5% reported PTSD symptoms and 81.4% reported depression symptoms. Comorbidity of PTSD and depression symptoms was found in 75.1%. Key factors included the presence sequelae after snakebite (ORPTSD = 2.31, ORDepression = 1.89), time to medical facilities (6–8 h: ORPTSD = 3.17, ORDepression = 2.46), and marital status (divorced/widowed: ORPTSD = 1.78, ORDepression = 1.76). Symptoms I1 ("Repeated disturbing memories") and D1 ("Bothered by things that don't usually bother me") bridged PTSD and depression networks.ConclusionThe primary psychological challenges for snakebite victims in China are PTSD and depression symptoms, which is concerning. Standardized diagnosis and treatments, timely medical care, and stable marital relationships can reduce risks. Additional psychological support and management of negative memories, especially for those with severe bridge symptoms, can be beneficial. Further research should concentrate on understanding victims' psychological states and developing effective interventions.