Long-term Psychiatric Consequences Research Articles

Blood glutamate scavenging as a novel glutamate-based therapeutic approach for post-traumatic brain injury anxiety and social impairment

Traumatic brain injury (TBI) is a serious condition that is associated with an increased risk of severe, long-term psychiatric consequences. Drugs that target the glutamatergic system have proven successful in treating both TBI and many of its psychiatric sequelae. Blood glutamate scavengers (BGS) cause a decrease in blood glutamate levels, leading to a reduction in glutamate’s concentration gradient from the brain to the blood and decreased levels of brain glutamate. This study evaluated the BGS pyruvate as a treatment for TBI-related neuropsychiatric conditions in a rat model. 213 rats were divided into four groups in a 2 × 2 design: Sham or TBI rats treated with pyruvate or control treatment. Magnetic resonance imaging, neurological status, brain glutamate and blood glutamate levels were assessed following the injury. Four weeks after the start of treatment, all rats underwent behavioral tests to assess anxious behavior and social impairment (aggressive and hierarchical behavior). Rats responded positively to pyruvate in several tasks, lowering brain glutamate levels and reducing anxiety and depression, as well as modulating TBI-related changes in social behavior. Glutamate scavenging with pyruvate may be an effective therapeutic option for post-TBI behavioral changes by reducing associated elevations in brain glutamate levels.

Male partners' expected response, coping mechanisms, social and health institutions expectations after early pregnancy loss: A systematic review

Introduction: Parents with early pregnancy loss uses various coping models, men cope with the loss differently, with immediate and long-term psychiatric consequences. As men’s emotional coping mechanisms are heavily affected by societal dilemmas, they hide their emotions. This study aims to determine how different types of early pregnancy loss affect male partners responses, coping strategies and expectations.Method: The study used the PICO approach and searched for relevant articles from June 15th, 2020, to December 15th, 2020. Forty-eight (48) articles were selected based on pre-determined inclusion and exclusion criteria from Ovid MEDLINE® without Revisions and Embase database.Summary of evidence: Male partners are equally psychologically involved as women but are often overlooked. There is a lack of a strong support system from society and professional caregivers to help these men. They are generally seen as the family’s source of strength. Men feel uncomfortable when emotionally affected by the event as they cannot channel their emotions out due to societal pressures and expectations. Men need to be supported by providing the necessary grief management.Conclusion: Male partners responses, their coping strategies and what they expect from society and healthcare providers require an in-depth investigation to determine the support they need.

Postnatal Antioxidant and Anti-inflammatory Treatments Prevent Early Ketamine-Induced Cortical Dysfunctions in Adult Mice.

Early brain insult, interfering with its maturation, may result in psychotic-like disturbances in adult life. Redox dysfunctions and neuroinflammation contribute to long-term psychiatric consequences due to neurodevelopmental abnormalities. Here, we investigated the effects of early pharmacological modulation of the redox and inflammatory states, through celastrol, and indomethacin administration, on reactive oxygen species (ROS) amount, levels of malondialdehyde (MDA) and antioxidant enzymes (superoxide dismutase 1, SOD1, glutathione, GSH, and catalase, CAT), as well as of pro-inflammatory cytokines (tumor necrosis factor-alpha, TNF-α, interleukin-6, IL-6, and interleukin-1 beta, IL-1β), in the prefrontal cortex of adult mice exposed to a neurotoxic insult, i.e. ketamine administration, in postnatal life. Early celastrol or indomethacin prevented ketamine-induced elevations in cortical ROS production. MDA levels in ketamine-treated mice, also administered with celastrol, were comparable with the control ones. Indomethacin also prevented the increase in lipid peroxidation following early ketamine administration. Whereas no significant differences were detected in SOD1, GSH, and CAT levels between ketamine and saline-administered mice, celastrol elevated the cortical amount of these antioxidant enzymes and the same effect was induced by indomethacin per se. Both celastrol and indomethacin prevented ketamine-induced enhancement in TNF-α and IL-1β levels, however, they had no effects on increased IL-6 amount resulting from ketamine exposure in postnatal life. In conclusion, our data suggest that an early increase in cortical ROS scavenging and reduction of lipid peroxidation, via the enhancement of antioxidant defense, together with inhibition of neuroinflammation, may represent a therapeutic opportunity against psychotic-like disturbances resulting, later in life, from the effects of a neurotoxic insult on the developing brain.

Sepsis-Associated Brain Dysfunction: A Review of Current Literature.

Sepsis-associated brain dysfunction (SABD) may be the most common type of encephalopathy in critically ill patients. SABD develops in up to 70% of septic patients and represents the most frequent organ insufficiency associated with sepsis. It presents with a plethora of acute neurological features and may have several serious long-term psychiatric consequences. SABD might cause various pathological changes in the brain through numerous mechanisms. Clinical neurological examination is the basic screening method for SABD, although it may be challenging in subjects receiving with opioids and sedative agents. As electrographic seizures and periodic discharges might be present in 20% of septic patients, screening with electroencephalography (EEG) might be useful. Several imaging techniques have been suggested for non-invasive assessment of structure and function of the brain in SABD patients; however, their usefulness is rather limited. Although several experimental therapies have been postulated, at the moment, no specific treatment exists. Clinicians should focus on preventive measures and optimal management of sepsis. This review discusses epidemiology, clinical presentation, pathology, pathophysiology, diagnosis, management, and prevention of SABD.

Perceived Needs for Mental Health Care Among Emerging Adults With Cancer

The challenges of living with cancer can compound the normative stresses of navigating emerging adulthood and have long-term psychiatric consequences. However, there is a lack of information on the mental health services required by this potentially vulnerable group of young people. This study estimated the prevalence of mental disorder among emerging adults (EAs) with cancer and examined their perceived needs for mental health care. Data from 5,590 individuals (15–29 years) who participated in the Canadian Community Health Survey—Mental Health were used in the analyses. The prevalence of mood or substance use disorder among those with cancer ( n = 42) was 42.9% compared to 32.2% among controls. EAs with cancer had higher odds of reporting unmet perceived needs for mental health care, OR = 7.72, 95% CI [1.85, 28.57]. This suggests an opportunity to improve future health services aimed at addressing the mental health care needs for EAs with cancer and potentially, other long-term chronic conditions.

The long-term psychiatric sequelae of severe injury: a 6-year follow-up study.

The impact of mental health on disease burden associated with injury represents a major public health issue, yet almost no information is available on the associated long-term mental health outcomes. The primary aim of this study was to assess the psychiatric outcomes 6 years after a severe injury and their subsequent impact on long-term disability. The secondary aim was to investigate the relationship between a mild traumatic brain injury (mTBI) and long-term psychiatric disorder and its impact on disability. From April 2004 to February 2006, randomly selected injury patients admitted to 4 hospitals across Australia were assessed during hospitalization and at 72 months after trauma (N = 592). Injury characteristics, the presence of an mTBI (ICD-9 criteria), and previous psychiatric history were assessed during hospitalization. Structured clinical interviews for psychiatric disorders (DSM-IV and DSM-5) and a self-report measure of disability (WHODAS II) were administered at 72 months. At 72 months after a severe injury, 28% of patients met criteria for at least 1 psychiatric disorder, with 45% of those presenting with comorbid diagnoses. The most prevalent psychiatric disorder was a major depressive episode (11%) followed by substance use disorder (9%), agoraphobia (9%), posttraumatic stress disorder (6%), and generalized anxiety disorder (6%). The presence of any psychiatric disorder was found to increase the risk for disability (P < .001, odds ratio = 6.04). An mTBI was found to increase the risk for having some anxiety disorders but not to increase disability by itself. The long-term psychiatric consequences of severe injury are substantial and represent a significant contributor to long-term disability. This study points to an important intersection between injury and psychiatric disorder as a leading contributor to disease burden and suggests this growing burden will impose new challenges on health systems.

Long-term psychiatric consequences of exposure to trauma in Cambodia: A regional household survey

The long-term psychiatric consequences of exposure to war and/or mass conflict continue to be of great concern and particularly in Cambodia. The current cross-sectional study examined the relationship between history of trauma and current psychiatric and functional morbidity in 3200 randomly selected adults aged 18–60 in Cambodia. Structured interviews were conducted from November 2011 until May 2012 in two predominantly rural regions purposively selected for differing duration of exposure to the Khmer Rouge occupation. Information was also collected regarding ongoing daily stressors and intimate partner violence. Despite high prevalence rates of conflict/war-related trauma, current rates of psychiatric disorders (depression, post-traumatic stress disorder) were relatively low, suggesting that the effects of trauma and extreme hardship in civilian populations may be modified by contextual factors and/or the passage of time. Poor to fair physical health was, however, reported by nearly 60% of the sample. Daily stressors were more important for current morbidity levels than history of trauma, especially in the region with shorter Khmer Rouge occupation. The results suggest that a focus exclusively on past trauma may overlook the contribution of adverse daily life circumstances towards current levels of well-being in civilian populations affected by war and/or mass conflict.

Long-term psychiatric consequences from carbon monoxide exposure: Progression of endogenous cause or toxicant effect?*

Long-term psychiatric consequences from carbon monoxide exposure: Progression of endogenous cause or toxicant effect?*

The Mental Health Consequences of Disaster-Related Loss: Findings from Primary Care One Year After the 9/11 Terrorist Attacks

This study examines the long-term psychiatric consequences, pain interference in daily activities, work loss, and functional impairment associated with 9/11-related loss among low-income, minority primary care patients in New York City. A systematic sample of 929 adult patients completed a survey that included a sociodemographic questionnaire, the PTSD Checklist, the PRIME-MD Patient Health Questionnaire, and the Medical Outcomes Study Short Form-12 (SF-12).Approximately one-quarter of the sample reported knowing someone who was killed in the attacks of 9/11, and these patients were sociodemographically similar to the rest of the sample. Compared to patients who had not experienced 9/11-related loss, patients who experienced loss were roughly twice as likely (OR = 1.97, 95%; CI = 1.40, 2.77) to screen positive for at least one mental disorder, including major depressive disorder (MDD; 29.2%), generalized anxiety disorder (GAD; 19.4%), and posttraumatic stress disorder (PTSD; 17.1%). After controlling for pre-9/11 trauma, 9/11-related loss was significantly related to extreme pain interference, work loss, and functional impairment. The results suggest that disaster-related mental health care in this clinical population should emphasize evidence-based treatments for mood and anxiety disorders.

Long-term Psychiatric Consequences of Hurricane Katrina

&lt;p&gt;The psychological effects of the stressors and trauma associated with Hurricane Katrina are far from resolved. In this issue of &lt;cite&gt;Psychiatric Annals&lt;/cite&gt;, the reader will learn about the effects of the hurricane on evacuees, first responders, physicians, and other survivors.&lt;/P&gt;

Erfüllen kriegstraumatisierte, gerontopsychiatrische Patienten PTSD-Kriterien?

Long-term psychiatric consequences of World War II are currently a main medical and political topic in Germany. This retrospective study examined 33 psychogeriatric cases. PTSD-criteria following ICD-10 were fulfilled in every case. All patients had a delayed subtype of PTSD with a latency of 14-60 years between trauma and onset of disorder. No case of chronic PTSD was found. In 26 cases a depression was diagnosed. Long latencies for PTSD are a typical feature in psychogeriatrics, possibly due to the situation in post-war-Germany probably even more in the Soviet occupied zone, the later German Democratic Republic (GDR). In the GDR it was not at all a public topic to speak about Russian violence (political taboo). The depressive and psychotic comorbidity of psychogeriatric PTSD-patients should be examined more specifically in future studies.

Psychologic Aspects of Early Pregnancy Loss

Early pregnancy loss is a complicated psychologic event that occurs in 12% to 24% of recognized pregnancies. Women who have experienced miscarriage often have common bereavement reactions and while the intensity and experience of these reactions diminishes over time for most women, a substantial minority will develop long-term psychiatric consequences. Depression, symptoms of anxiety, obsessive-compulsive disorder, and posttraumatic stress disorder are the most commonly reported psychologic reactions to miscarriage. The course and impact of these disorders on a grieving mother and her partner are discussed and treatment recommendations are made. The psychologic effects of therapeutic abortion are also be briefly discussed.

The long-term psychiatric consequences of accidental injury. A longitudinal study of 107 adults.

One hundred and seven accidentally injured adults were studied while in hospital and assessed prospectively twice more in a mean period of 28 months. The patients were studied by means of taped clinical interviews, including the Comprehensive Psychopathological Rating Scale (which includes the Montgomery-Asberg Depression Rating Scale), and several self-report measures of distress (Schedule of Recent Life Events, General Health Questionnaire, Impact of Event Scale and State Anxiety Inventory) at the three assessments. The total incidence of psychiatric disorders considered to be caused by the accident during the follow-up period was 22.4%. The incidence of non-organic psychiatric disorders caused by the accident was 16.8% at the first follow-up and 9.3% at the final follow-up. Depressive disorders of different severity were most often seen. Only one patient suffered from a post-traumatic stress disorder during the follow-up, and none at the final follow-up (DSM-III). Organic mental disorders were diagnosed in 9.3% of the patients. In 5.6% of the patients this was the only disorder.