High Incidence Of Posttraumatic Stress Disorder Research Articles

Long-Term Follow up of Renal and Other Acute Organ Failure in Survivors of Critical Illness Due to Covid-19.

BackgroundLittle is known about the long-term health sequelae and outcomes of various organ failures in ICU survivors of Covid-19. The aim of our research was to study the characteristics of 120-day ICU survivors of the initial pandemic surge and report their long term (>6 months) outcomes.MethodsWe conducted a telephone questionnaire-based follow up study of 120- day survivors of Covid-19 admitted to ICUs at Montefiore Medical Center, Bronx, NY from 3/10/2020 to 4/11/2020. The study period was 2 months (11/1/2020-12/31/2020).Results126 out of 300 (42%) survived to 120-days post-hospital discharge. The median age of survivors was 54 (47-61) years. Seventy-eight (62%) patients developed acute kidney injury (AKI); thirty-five (44.9%) of them required renal replacement therapy (RRT). One hundred-five (83.3%) required invasive mechanical ventilation; ten of them required tracheotomy. 103 (81.7%) completed the telephone questionnaire-based study, at a median (IQR) of 216.5 (200-234.5) days after hospital discharge. 29 (28.2%) patients reported persistent shortness of breath, 24, (23.3%) complained of persistent cough, and persistent anosmia in 9 (8.8%). AKI resolved completely in 58 (74.4%) patients. Of 35 AKI patients who required initiation of RRT during hospitalization, 27 (77%) were liberated from RRT and 20 (57%) had resolution of AKI. Of 20 patients without AKI resolution, 12 developed chronic kidney disease, whereas 8 still require RRT. Thirty-three (32.4%) patients developed post-traumatic stress disorder (PTSD) and 10 (11.8%) reported major depression. Many of the patients (68%) regained baseline functional status. Readmissions occurred in 22.3% patients within first 6 months after discharge.ConclusionPersistent symptoms of long Covid have been reported in ICU survivors of Covid-19 for extended durations. Outcomes of Covid-19 associated acute kidney injury are excellent. There is a high incidence of PTSD and depression in COVID-19 ICU survivors. Functional outcomes are good, but these patients remain at increased risk of hospital readmission.

Incidence of post-traumatic stress disorder in survivors of traumatic fracture: a systematic review and meta-analysis

ABSTRACT Post-traumatic stress disorder (PTSD) is prevalent in traumatic events. It is a great hazard of physical and mental health due to their severity and frequency. Traumatic fractures are one of the major causes of PTSD. The incidence of traumatic fractures has been high in recent years, which will directly or indirectly result in PTSD. Our target is to estimate the pooled incidence of PTSD in fracture patients after traumatic events and to explore possible influencing factors by a meta-analysis. The systematic searches in the electronic bibliographic databases of Web of Science, ScienceDirect, Ovid MEDLINE, PubMed, CNKI (China National Knowledge Infrastructure), Wangfang , and Veipu Databases. Not only were heterogeneity and 95% confidence interval (CI) used for comprehensive assessing each pooled, but also was the P value. Subgroup analyses for some sample characteristics were calculated the pooled incidence of PTSD among patients suffered from fractures. In total, 2619 patients suffered from fracture, and were assessed PTSD in the 12 eligible studies. The heterogeneity was not low (I2 = 97.6%, P < 0.001) in the 12 eligible studies. The pooled incidence of PTSD in fracture patients was 29% (95% CI, 20% to 39%) using random-effects model. Subgroup analyses revealed that the pooled incidence of PTSD among patients after traumatic fracture was statistically significant differences according to the study design, the study location, tools to assess the symptoms of PTSD, the mean age and injury mechanism (all P < 0.001). Fracture sites, injury mechanism and pain were the main influencing factors of PTSD in fracture patients. Our results highlight the phenomenon that high incidence of PTSD in patients after fracture and they should be followed up regularly and be provided effective interventions. Future efforts to improve and control the main influencing factors of PTSD for this population still needed.

Post-traumatic stress disorder and resilience among flood affected farmers of Kerala, India

Background: In mid-August 2018, Kerala witnessed the worst floods since 1924 due to abnormally high rainfall and simultaneous release of water from its dams, resulting in extreme flooding in 13 of the 14 districts in the State. The large-scale flooding impacted millions of people and caused nearly 400 deaths as well as immense damage to property. This was followed by flooding yet again in August 2019, thereby triggering further damage. Farmers whose crops got completely wiped out were one group that were severely affected. This study investigated the presence of post-traumatic stress disorder (PTSD) in farmers and also checked the relationship between PTSD and resilience. Methods: The sample consisted of 100 farmers from the Alappuzha and Pattanamtitta districts of Kerala which were severely affected by the flood. Data was collected through the PTSD-8, Brief Resilience Scale (BRS) along with sociodemographic data and flood related information.Results: 74% of the farmers scored high on the test indicating the presence of PTSD. The farmers of interior Pathanamthitta had significantly higher incidence (84%) of PTSD than coastal Alappuzha farmers (66%). The level of damage due to the flood did not have significant correlation with PTSD. There was significant negative correlation between PTSD and resilience (r=-0.64).Conclusions: There was high incidence of PTSD among the farmers of central Kerala post the 2018 and 2019 floods and it was higher in interior Pathanamthitta than in coastal Alappuzha which is more used to the vagaries of the waters. Resilience helps to combat PTSD.

Resilience and Post-Traumatic Stress Disorder among Flood Affected Farmers of Kerala, India

Background: In mid-August 2018, Kerala witnessed the worst floods since 1924 due to abnormally high rainfall and simultaneous release of water from its dams, resulting in extreme flooding in 13 of 14 districts in the State. The large-scale flooding impacted millions of people and caused nearly 400 deaths as well as immense damage to property. This was followed by flooding yet again in August 2019, thereby triggering further damage. Farmers whose crops got completely wiped out were one group that were severely affected. This study investigated the presence of Post-Traumatic Stress Disorder (PTSD) in farmers and also checked the relationship between PTSD and resilience. A purposive sample of 100 farmers from the Alappuzha and Pathanamthitta district of Kerala which were severely affected were taken. Data was collected through the PTSD-8, Brief Resilience Scale (BRS) along with sociodemographic data and flood related information. Data was analyzed to find that there was a high incidence of PTSD among the farmers (74%). Prevalence of PTSD was higher in interior Pathanamthitta than in coastal Alappuzha which was used to flooding due to its proximity to the sea and river mouth. The flood related variables such as level of damage did not have significant correlation with PTSD. However there was significant negative correlation between PTSD and resilience (r=- 0.64).

Posttraumatic stress disorder among patients with oral and maxillofacial trauma in a South Indian population.

To determine the incidence and severity of Post-Traumatic Stress Disorder (PTSD) in maxillofacial trauma patients and to assess the predisposing factors. Post-Traumatic Stress Disorder (PTSD) was assessed as per the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. The PTSD checklist for DSM-5 (PCL-5), was used initially to screen patients for PTSD for a provisional diagnosis. These provisionally diagnosed patients were then subjected to a structured interview by a Clinician Administered PTSD Scale for DSM-5 (CAPS-5). The PTSD status outcome of PCL-5 and CAPS-5 were correlated. PTSD was compared among patients with different types of facial fractures/injuries and also compared based on their anatomic location. The reliability of PCL-5 scale in relation to the structured CAPS-5 was assessed and the specificity was found to be 71.4%. Patients with both aesthetic and functional deformity exhibited greater severity of injury and showed higher incidence of PTSD with higher conversion rate from the 1st month to 3rd month. The frequency of PTSD in deformities with higher severity like zygomaticomaxillary complex injuries was found to be statistically significant. A high incidence of PTSD is associated with maxillofacial trauma and early detection is essential.

PO-284 Aerobic Exercise Preconditioning Prevents Behavioral Deficits in an Ovariectomized Rat Model of Post-traumatic Stress Disorder

Objective Post-traumatic Stress Disorder (PTSD) occurs in people who suffers reparative shocking, scary, or dangerous event. Evidences demonstrate that PTSD is associated with cognitive decline and depression. In the general population, women tend to show higher incidence of PTSD compared with men. Using the the ovariectomized rat model, the present work was designed to investigate the potential beneficial effect of aerobic exercise on the prevention of PTSD.&#x0D; Methods Adult Sprague-Dawley male rats were randomly divided into the following four groups (n = 8-10 in each group): 1) naïve control group; 2) ovariectomized group (OVX), 3) OVX with PTSD group (OVX + PTSD), 4) OVX + exercise group (OVX + Exe), and 5) OVX + PTSD + exercise (OVX + PTSD + Exe). For exercise pretreatment groups, the rats were subjected to 30 min of treadmill exercise (30 min/day, 5 days / week) for continuous 4 weeks. Open field test and elevated plus maze were used to measure behavioral changes from day 59 to day 66. Hippocampal levels of 17β-estradiol (E2) and brain-derived neurotrophic factor (BDNF) level were measured.&#x0D; Results 1. Results of open field and elevated plus maze test revealed that OVX animals exposed to PTSD showed obvious anxiety-like behavior compared to OVX animals without exercise. Intriguingly, anxiety-like behavior in OVX + PTSD group was significantly improved by aerobic exercise pretreatment in ovariectomized animals after PTSD. 2. Hippocampal levels of E2 and BDNF levels in the OVX + Exe group were significantly increased after aerobic exercise compared to these from OVX without exercise group.&#x0D; Conclusions These findings demonstrated that aerobic exercise preconditioning can efficiently prevent anxiety-like behavior in the ovariectomized rats subjected to PTSD, a mechanism could be associate with the increased levels of E2 and BDNF induced by exercise treatment.

Distinguishing schizophrenia from posttraumatic stress disorder with psychosis.

Co-occurrence of psychotic symptoms with symptoms typically thought of as posttraumatic stress disorder (PTSD) is well known, and there has been considerable debate whether this represents a psychotic subtype or a comorbid psychotic disorder. Psychotic symptoms typical of schizophrenia occur with a higher than expected frequency in PTSD. A large genome-wide association study (GWAS) has identified a collection of genes associated with PTSD, and these genes overlap with those identified as increasing the risk of developing schizophrenia. Up to 70% of returning veterans experience symptoms of PTSD. These individuals also fall within the peak age range for the onset of schizophrenia. PTSD with psychosis may occur for several reasons: trauma increases one's risk for schizophrenia and PTSD; patients with schizophrenia have a higher incidence of PTSD and may present with characteristic psychotic symptoms overlapping with psychosis in schizophrenia. Secondary to symptom overlap, there may be substantial misdiagnosis of psychotic disorders as PTSD, or nonidentification of a comorbid psychotic disorder. This overlap calls into question traditional diagnostic boundaries with implications for initial and long-term treatment of PTSD and psychosis. This review will discuss the recent literature relating to the association of PTSD with schizophrenia.

Loss of social resources predicts incident posttraumatic stress disorder during ongoing political violence within the Palestinian Authority.

Exposure to ongoing political violence and stressful conditions increases the risk of posttraumatic stress disorder (PTSD) in low-resource contexts. However, much of our understanding of the determinants of PTSD in these contexts comes from cross-sectional data. Longitudinal studies that examine factors associated with incident PTSD may be useful to the development of effective prevention interventions and the identification of those who may be most at-risk for the disorder. A 3-stage cluster random stratified sampling methodology was used to obtain a representative sample of 1,196 Palestinian adults living in Gaza, the West Bank and East Jerusalem. Face-to-face interviews were conducted at two time points 6-months apart. Logistic regression analyses were conducted on a restricted sample of 643 people who did not have PTSD at baseline and who completed both interviews. The incidence of PTSD was 15.0 % over a 6-month period. Results of adjusted logistic regression models demonstrated that talking to friends and family about political circumstances (aOR = 0.78, p = 0.01) was protective, and female sex (aOR = 1.76, p = 0.025), threat perception of future violence (aOR = 1.50, p = 0.002), poor general health (aOR = 1.39, p = 0.005), exposure to media (aOR = 1.37, p = 0.002), and loss of social resources (aOR = 1.71, p = 0.006) were predictive of incident cases of PTSD. A high incidence of PTSD was documented during a 6-month follow-up period among Palestinian residents of Gaza, the West Bank, and East Jerusalem. Interventions that promote health and increase and forestall loss to social resources could potentially reduce the onset of PTSD in communities affected by violence.

Psychological Injuries: Forensic Assessment, Treatment, and Law

Back to table of contents Previous article Next article Book ReviewFull AccessPsychological Injuries: Forensic Assessment, Treatment, and LawMargery Gans Ed.D.Margery Gans Ed.D.Search for more papers by this authorPublished Online:1 Nov 2006https://doi.org/10.1176/ps.2006.57.11.1663aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The Canadian authors of this volume—a psychiatrist, psychologist, and two researchers—seek to illuminate issues related to the forensic assessment of psychological injuries. They review the history of injury law in Britain and America and the evolution of claims from those made solely for physical injury to those made for psychological damage, which is less easy to determine and measure. The book is well written and should be accessible to lawyers, psychologists, and other professionals with a basic knowledge of clinical and forensic practice.The increase in claims for psychological damage has depended heavily on the diagnosis of posttraumatic stress disorder (PTSD). The authors explore this diagnosis, a post-World War II concept that has become increasingly sophisticated and complex. They review screening methods designed to diagnose and assess PTSD, their strengths and limitations, and their applicability to different populations. They address malingering and review research on the course, prevalence, treatment, and prevention of PTSD, and then present cases that link clinical and forensic concerns.Two of the book's strengths are the focus on the experience of minorities and the emphasis on clinical issues. The authors stress that research outcomes for groups need to be applied carefully to individual clients or unstudied communities. Research may not ask the questions that are salient to particular subgroups. For example, the higher incidence of PTSD among women may be related to oversimple definitions of trauma in specific measures. Also, women may experience assault differently from men because of the implicit sexual threat that may accompany physical assault, the greater likelihood of physical injury, and their greater vulnerability to adult and childhood sexual assault. Their experience has not necessarily been captured in research.Regarding minorities, the authors point out that dichotomizing the population into white and nonwhite provides almost no information about the complex subcultures in the United States today. Each of these cultures may have its own individual understanding and experience of what is traumatic and how posttraumatic stress is expressed. Being a minority and facing racism may in itself be a potentially traumatic experience, and the adversarial court system may exacerbate posttraumatic symptoms, especially for anyone not in the mainstream.The authors also address evaluator bias and assumptions—heuristics—that can skew an evaluation and the general lack of familiarity most clinicians have with recent research on PTSD. Practice lags behind empirical findings, and clinicians are urged to use a structured assessment with empirically tested tools. Finally, the book anticipates future trends in injury assessment and how psychology and the law may interact and identifies areas for research.In sum, this book is thoughtful and thorough. The authors review the field, balancing their faith in empirically grounded research with healthy skepticism. They remind us that our biases, heuristics, and the client's subjective experiences must always remain in awareness as we become educated in the most up-to-date techniques.Dr. Gans is a licensed psychologist at Forensic Services, Arlington, Massachusetts. FiguresReferencesCited byDetailsCited ByNone Volume 57Issue 11 November, 2006Pages 1663-1664PSYCHIATRIC SERVICES November 2006 Volume 57 Number 11 Metrics PDF download History Published online 1 November 2006 Published in print 1 November 2006

Psychological Injuries: Forensic Assessment, Treatment, and Lawby William J. Koch, Ph.D., Kevin S. Douglas, Ph.D., Tonia L. Nicholls, Ph.D., and Melanie L. O'Neill; New York, Oxford University Press, 2006, 336 pages, $39.95

Back to table of contents Previous article Next article Book ReviewFull AccessPsychological Injuries: Forensic Assessment, Treatment, and LawMargery Gans Ed.D.Margery Gans Ed.D.Search for more papers by this authorPublished Online:1 Nov 2006https://doi.org/10.1176/ps.2006.57.11.1663aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The Canadian authors of this volume—a psychiatrist, psychologist, and two researchers—seek to illuminate issues related to the forensic assessment of psychological injuries. They review the history of injury law in Britain and America and the evolution of claims from those made solely for physical injury to those made for psychological damage, which is less easy to determine and measure. The book is well written and should be accessible to lawyers, psychologists, and other professionals with a basic knowledge of clinical and forensic practice.The increase in claims for psychological damage has depended heavily on the diagnosis of posttraumatic stress disorder (PTSD). The authors explore this diagnosis, a post-World War II concept that has become increasingly sophisticated and complex. They review screening methods designed to diagnose and assess PTSD, their strengths and limitations, and their applicability to different populations. They address malingering and review research on the course, prevalence, treatment, and prevention of PTSD, and then present cases that link clinical and forensic concerns.Two of the book's strengths are the focus on the experience of minorities and the emphasis on clinical issues. The authors stress that research outcomes for groups need to be applied carefully to individual clients or unstudied communities. Research may not ask the questions that are salient to particular subgroups. For example, the higher incidence of PTSD among women may be related to oversimple definitions of trauma in specific measures. Also, women may experience assault differently from men because of the implicit sexual threat that may accompany physical assault, the greater likelihood of physical injury, and their greater vulnerability to adult and childhood sexual assault. Their experience has not necessarily been captured in research.Regarding minorities, the authors point out that dichotomizing the population into white and nonwhite provides almost no information about the complex subcultures in the United States today. Each of these cultures may have its own individual understanding and experience of what is traumatic and how posttraumatic stress is expressed. Being a minority and facing racism may in itself be a potentially traumatic experience, and the adversarial court system may exacerbate posttraumatic symptoms, especially for anyone not in the mainstream.The authors also address evaluator bias and assumptions—heuristics—that can skew an evaluation and the general lack of familiarity most clinicians have with recent research on PTSD. Practice lags behind empirical findings, and clinicians are urged to use a structured assessment with empirically tested tools. Finally, the book anticipates future trends in injury assessment and how psychology and the law may interact and identifies areas for research.In sum, this book is thoughtful and thorough. The authors review the field, balancing their faith in empirically grounded research with healthy skepticism. They remind us that our biases, heuristics, and the client's subjective experiences must always remain in awareness as we become educated in the most up-to-date techniques.Dr. Gans is a licensed psychologist at Forensic Services, Arlington, Massachusetts. FiguresReferencesCited byDetailsCited ByNone Volume 57Issue 11 November, 2006Pages 1663-1664PSYCHIATRIC SERVICES November 2006 Volume 57 Number 11 Metrics PDF download History Published online 1 November 2006 Published in print 1 November 2006

Secondary prevention for police officers involved in job-related psychologically stressful or traumatic situations

Police officers are at high risk of being exposed to psychologically straining situations and potentially psychotraumatic experiences. In this article, such situations are exemplified and categorized, and the role and significance of secondary prevention following traumatic experiences is discussed. From 1994 to 2003, 649 police officers received secondary prevention after being involved in a total of 250 potentially traumatic or psychologically stressful incidents. Psychological support was provided by teams of specially trained professionals in the acute phase after the incident following careful psychological evaluation. In a retrospective evaluation, the diagnoses obtained were analyzed with regard to sex and age and correlated with the severity of the incident. Three clusters of potentially traumatic situations were formed: (1) Employment of fire-arms with danger for the officer, (2) Standard situations including violence towards a third party, (3) Suicide or attempted suicide of a police officer. Police officers who experienced events assigned to cluster (1), comprising situations with considerable traumatic potential, had the highest incidence of posttraumatic stress disorder (PTSD) or other mental illness. Compared to male officers, females were more often diagnosed with other mental illness, whereas males had a higher incidence of PTSD. Cluster (2), which comprised situations of an officer's daily professional life, was not associated with an increased risk of mental illness. Officers were apparently capable of coping with situations considered psychologically straining for the general public without detectable evidence of a traumatic reaction. In cluster (3), which reflects the most dramatic interference with team relations, other forms of mental illness were diagnosed at a higher incidence.