Posttraumatic Depression Research Articles

Subjective symptoms and their association with psychiatric symptoms 3 months after ICU discharge: sub-analysis of a single-center prospective observational study.

Despite a growing volume of literature on post-intensive care syndrome, we know little about how subjective symptoms affect intensive care unit survivors in the long term. This study aimed to elucidate the prevalence of subjective symptoms and to determine the clinical importance of post-intensive care syndrome by evaluating the association between these symptoms and psychiatric symptoms. We evaluated new-onset or worsening subjective symptoms and psychiatric symptoms in 81 patients at 3 months after discharge from an intensive care unit. More than half of patients had at least one subjective symptom, such as weakness (n=31), fatigue (n=23), malaise (n=14), body pain (n=14), or insomnia (n=9). The presence of subjective symptoms is associated with worse psychiatric symptoms (post-traumatic stress disorder, anxiety, and depression) at 3 months after ICU discharge. We found insomnia was particularly strongly associated with psychiatric symptoms in our study group. UMIN Clinical Trial Registry no. UMIN000023743, September 1, 2016.

A Full Systematic Review on the Effects of Cognitive Behavioural Therapy for Mental Health Symptoms in Child Refugees

Global conflict in 2019 created record numbers of displaced children. These children have experienced multiple traumas and subsequently suffer high levels of mental health symptoms. Cognitive-behavioural therapy (CBT) is commonly used for post-traumatic stress disorder (PTSD), depression and anxiety, however the current evidence-base of CBT in child refugees is sparse, with mixed results. This study aimed to assess the effects of CBT on symptoms of PTSD, depression and anxiety in child refugees/AS. Ethics were reviewed and granted by the University of Manchester ethics committee. Medline, Embase, Cochrane, PsycINFO and CINAHL were systematically searched. Studies were included if CBT was delivered to refugee/AS children with pre and post-intervention measures of symptoms. Sixteen studies fulfilled criteria. In all studies, mental health symptom scores post-intervention had reduced, suggesting an improvement in mental health following CBT. This reduction was statistically significant in twelve studies (p < 0.001–0.5), clinically significant in eight studies and maintained at follow-up periods. No adverse effects of CBT were identified. This is the first systematic review to focus solely on CBT in child refugee populations, with unanimously positive results. Its use is cautiously recommended, however the need for more methodologically rigorous studies in this population is highlighted.

The Relationship Between Women’s Resources and Health-Related Quality of Life in a Sample of Female Victims of Intimate Partner Violence

While it is known that resource inadequacy increases the risk of exposure to intimate partner violence (IPV) and that women’s health is significantly impacted by IPV, scant research has documented diminished resources as a primary determinant of women’s health. Fifty female victims of moderate to severe IPV completed assessments of their physical, sexual and psychological experiences of IPV, resource profile, symptoms of posttraumatic stress disorder (PTSD) and depression and mental and physical health-related quality of life (HRQoL). Women’s resources, controlling for age, income, psychological abuse and sexual coercion, were unique predictors of symptoms of PTSD, symptoms of depression; and mental HRQoL. The public health implications of the adequacy of women’s resources are discussed in the context of IPV prevention and intervention. Future studies should evaluate the efficacy of economic empowerment programs regarding the impact on IPV survivors’ mental and physical health and safety.

Unique Pain Management Needs for Pregnant Women with Pre-existing PTSD and Other Mental Health Disorders

This review describes how the presence of maternal mental health disorders influences peripartum pain. It provides practical guidance for tailored anesthetic plans that address the unique needs of pregnant women with such disorders. The role of maternal mental health conditions in the peripartum experience and postpartum course for the mother-baby dyad is an evolving area of interest in the current psychiatric and obstetric literature. It is only recently, however, that providers are beginning to understand how pre-existing maternal posttraumatic stress disorder (PTSD), anxiety, or depression influences how these patients perceive pain during labor or cesarean section. There is, unfortunately, a lack of understanding and consistency in the approach to pain management for these patients. Emphasis on recognition of these unique patient needs and tailoring of peripartum pain management strategies is crucial in helping to achieve a positive birth experience and minimize increased postpartum mental health symptom severity and/or chronic pain for these patients. Peripartum pain during labor and/or surgical delivery can be influenced by a pre-existing history of mental health conditions. Specialized pain assessment and management strategies should accommodate the unique needs of these patients.

The influence of sociodemographic variables in the triggering of emotional symptoms after an air disaster

Abstract The study aimed to identify the predictive relationship of sociodemographic variables and emotional symptoms related to post-traumatic stress disorder, depression, anxiety, and stress. A sample of 194 people who experienced an air disaster, average age of 32 years, participated in the survey. The instruments used were: Sociodemographic Data Questionnaire, Post-Traumatic Stress Disorder Checklist – Civilian Version, and Depression Anxiety and Stress Scale. A multiple regression analysis indicated that women participants were associated with post-traumatic stress disorder symptoms and those directly exposed to the disaster had higher odds ratios to develop post-traumatic stress disorder, depression, and stress symptoms. It is expected, with this information, to identify early the people who may be most vulnerable and contribute to the elaboration of intervention protocols.

Supplemental Material for Prediction of Posttraumatic Stress and Depression One-Month Post-Injury: A Comparison of Two Screening Instruments

Supplemental Material for Prediction of Posttraumatic Stress and Depression One-Month Post-Injury: A Comparison of Two Screening Instruments

An Exploratory Study of the Acceptability and Feasibility of Yoga Among Women in Substance Use Disorder Recovery

Objectives: This qualitative study explored the acceptability and feasibility of yoga among women in substance use disorder (SUD) recovery. Design: Seventeen women in SUD recovery for 2 weeks or longer were recruited from nine sites in the mid-South, including a Medication-Assisted Treatment clinic in a hospital setting, prison re-entry housing, community-based peer support organizations (e.g., Alcoholics Anonymous [AA], Narcotics Anonymous [NA]), a residential SUD treatment facility, a yoga teachers' online group, and through referrals. The median age of participants was 41.5, with ages ranging from 25 to 65. We used an interpretive description approach to explore both the perceptions of women without yoga experience and the experiences of women with yoga experience to collect formative data for intervention development and implementation. The interviews were recorded and transcribed verbatim. A hybrid analysis (i.e., inductive and deductive coding) was applied to the data. Results: Women's narratives included a high prevalence of trauma exposure. Overall, women in this sample were interested in either beginning or continuing yoga. Barriers to participation included perceived lack of self-efficacy of yoga, weight, and physical injuries. Additional environmental barriers included balancing care of self with caring for others, including partners, children, and NA/AA sponsees; as well as prioritizing finances, housing, employment, and transportation. Conclusion: High prevalence of trauma exposure among women in SUD recovery necessitates careful consideration of co-occurring psychiatric disorders such as post-traumatic stress disorder, anxiety and depression and the necessary professional psychological support, as well as serious physical injuries that require modification in yoga āsana classes. As transportation and balancing care needs were salient in these data, rural SUD populations could be served with telehealth interventions that provide SUD recovery support with integrative health practices such as adjunctive yoga interventions.

Depression following traumatic brain injury: a comprehensive overview.

Traumatic brain injury (TBI) represents a major health concern affecting the neuropsychological health; TBI is accompanied by drastic long-term adverse complications that can influence many aspects of the life of affected individuals. A substantial number of studies have shown that mood disorders, particularly depression, are the most frequent complications encountered in individuals with TBI. Post-traumatic depression (P-TD) is present in approximately 30% of individuals with TBI, with the majority of individuals experiencing symptoms of depression during the first year following head injury. To date, the mechanisms of P-TD are far from being fully understood, and effective treatments that completely halt this condition are still lacking. The aim of this review is to outline the current state of knowledge on the prevalence and risk factors of P-TD, to discuss the accompanying brain changes at the anatomical, molecular and functional levels, and to discuss current approaches used for the treatment of P-TD.

Broken Heartstrings-Post-Traumatic Stress Disorder and Psychological Burden after Acute Mitral Regurgitation Due to Chordae Tendineae Rupture.

Chordae tendineae rupture (CTR) is a potentially life-threatening cardiac event often resulting in Acute mitral regurgitation (AMR). We assessed Post-traumatic stress disorder (PTSD), depression, and anxiety symptoms in CTR patients with AMR (age 82.3 ± 4.2 years; 66.7% men) and compared them to CTR patients with Chronic mitral regurgitation (CMR) and Myocardial infraction (MI) patients. Regression analyses revealed that PTSD scores were significantly higher in CTR patients with AMR than in CTR patients with CMR or MI patients. CTR patients with CMR had the lowest levels of PTSD-symptoms. Depression and anxiety scores were elevated across all three groups. Our results suggest that psychosocial factors need to be considered in CTR patients’ care.

Cumulative Risk of Psychological Distress in College Students Effected by Hurricane Harvey

&lt;p style="text-align:justify"&gt;This study examines the relationship between prior trauma and post disaster psychological distress in a sample of college students exposed to Hurricane Harvey in Houston, Texas in 2017. College students (n = 324) receive treatment for psychological problems at very low rates, so screening for the most vulnerable students after a disaster is important. While the relationship between prior trauma and post-disaster psychological distress is well established, the evidence for prior disaster exposure as a risk factor outside of other trauma is mixed. Prior trauma was divided into two cumulative risk style indicators: prior traumatic experiences (excluding disasters) and prior disaster exposure. In multiple linear regression models, prior traumatic experiences were significant predictors of post-disaster symptoms of both post-traumatic stress disorder and depression following the hurricane. Prior disaster exposures were not significant in either case. Implications for future screening and analysis of risk factors are discussed.&lt;/p&gt;

Effects of a group experiential therapy program on the psychological health of military veterans: a preliminary investigation

ABSTRACT This study examined the clinical effects of a brief group experiential therapy treatment centered on psychodrama in a sample of military veterans. The sample (N = 72) comprised male (n = 54) and female (n = 18) United States military veterans (M age = 44.19, SD age = 12.51) who completed the six-day treatment. Self-reported military-related posttraumatic stress (M-PTSD), anxiety, depression, and quality of life were assessed at baseline (T0), end of treatment (T1), three-month follow-up (T2), and six-month follow-up (T3). Prior combat exposure was also measured at T0, and acceptability and user satisfaction ratings were reported at T1. Within-subjects changes on all outcomes from T0 to T1, T2, and T3 were medium to large in effect size. After controlling for relevant demographic characteristics, prior combat exposure, and baseline multimorbidity, the results revealed significant improvements in clinical symptoms and quality of life from T0 to T1, T2, and T3. A majority of the participants who met criteria for M-PTSD, anxiety, or depression caseness at T0 attained recovery status at T1, T2, and T3. Acceptability and satisfaction ratings were high. The findings offer preliminary evidence supporting the efficacy of the group experiential treatment in sustaining reduced psychological symptoms and improving the quality of life of military veterans.

Estimation of the Development of Depression and PTSD in Children Exposed to Sexual Abuse and Development of Decision Support Systems by Using Artificial Intelligence

ABSTRACT The most common diagnoses after childhood sexual abuse are Post-Traumatic Stress Disorder and depression. The aim of this study is to design a decision support system to help psychiatry physicians in the treatment of childhood sexual abuse. Computer aided decision support system (CADSS) based on ANN, which predicts the development of PTSD and Major Depressive Disorder, using different parameters of the act of abuse and patients was designed. The data of 149 girls and 21 boys who were victims of sexual abuse were included in the study. In the designed CADDS, the gender of the victim, the type of sexual abuse, the age of exposure, the duration until reporting, the time of abuse, the proximity of the abuser to the victim, number of sexual abuse, whether the child is exposed to threats and violence during the abuse, the person who reported the event, and the intelligence level of the victim are used as input parameters. The average accuracy values for all three designed systems were calculated as 99.2%. It has been shown that the system designed by using these data can be used safely in the psychiatric assessment process, in order to differentiate psychiatric diagnoses in the early post-abuse period.

Abstract 314: Cardiac Arrest Related Cognitive Activity

Background: Few studies have examined the psychological outcomes of cardiac arrest (CA) survivors. While some negative outcomes including post-traumatic disorder, anxiety and depression have been reported in ~50%, interestingly, ~10-20% of CA survivors have reported lucid, well-structured thought processes during CA associated with positive psychological outcomes and transformation post CA. We aimed to characterize the themes describing the cognitive experiences recalled by survivors. Method: In a qualitative study 118 self-reported cases were extracted from a CA survivor registry, coded the data using thematic analysis to identify emerging themes followed by descriptive statistics to identify frequencies of identified themes. Results: Analysis of 69 in-hospital and 45 out-of-hospital CA events led to identification of 10 major and 64 sub-themes describing the breadth of CA survivors’ cognitive experiences. Most predominate features included having no sense of pain during on-going CPR (18%), perception of being separate from the body (46%), observing the body from a point outside (40%), travelling through a tunnel towards a destination (16%) and having a life review (19%). Interestingly, in the life-review category 87% perceived the life-review to be an educational experience focused on their actions and intentions towards others, 38% described reliving of certain actions with a sense of shame, and 18% perceived to examine life events from others’ perspective. In addition, another category of cognitive experiences were also described that appeared to relate to events during recovery of consciousness around the time of return of spontaneous circulation (ROSC) where 14% of survivors sensed the pressure of CPR and 18% woke up with pain. Conclusion: CA survivor’s memories appear to reflect two categories: 1) a life review and perception of observing themselves during CPR without pain, which is felt to be educational, positive and peaceful and 2) memories related to the recovery phase around the time of ROSC. These include sensing CPR related events such as pain, chest pressure and distress. While the former category may explain the long-term positive transformation, the latter may explain the long-term occurrence of PTSD and anxiety in CA survivors.

Family Bereavement Adaptation After Death of a Loved One in an Intensive Care Unit: Impact of Race/Ethnicity.

Limited longitudinal studies have hindered the understanding of family adaptation after loss of a loved one in an intensive care unit (ICU). Based on the Double ABCX Model, this study examined changes in adaptation to bereavement for family members in the first year after the ICU death, with special attention to the effects of race/ethnicity. A repeated-measures design was used to conduct the investigation using 3 time points (1-3, 6, and 12 months) after the ICU death. Data were analyzed using linear mixed modeling. Family members (n = 30) consisted of 60% non-Hispanic Whites and 40% African Americans (AAs). During the first 1 to 3 months, moderate to severe symptoms of posttraumatic stress disorder, depression, anxiety, and stress were found (60%, 40%, 30%, and 26.7%, respectively). Initially, non-Hispanic Whites had higher depression scores than African Americans. The change in depression and posttraumatic stress disorder symptoms over 1 year differed by race/ethnicity. Many family members tended to be at risk of psychological sequelae in the early months after a patient's death in an ICU. Racial/ethnic differences in bereavement process need further exploration to understand the broader context within family members grieve and effectively offer support over the course of the first year.

The mental health burden of COVID-19 on cardiac healthcare workers and their patients

The COVID-19 pandemic is taking a toll on the healthcare workforce across the world and, with many health professionals experiencing high levels of exposure to the coronavirus, the rate of infection among healthcare workers is high. Documented mental health effects on these workers are also concerning, with higher-than-usual levels of acute stress, post-traumatic stress symptoms, anxiety, depression and sleep disorders, particularly insomnia. Cardiac patients are particularly vulnerable, and health professionals caring for this group face additional stresses. This article provides an overview of the mental health impacts of the pandemic on healthcare workers, with an emphasis on those working in hospital settings and in cardiac care, as well as on the patients for whom they care. The specific impacts of COVID-19 are also discussed, as well as associated social restrictions on cardiac patients, both during hospitalisation and early recovery, and in terms of long-term risks. Strategies are proposed that healthcare workers can adopt to help preserve and improve their coping and enhance their resilience as they work through this unprecedented and unpredictable pandemic.

Coming to terms with Fukushima disaster-related trauma and earlier trauma by constructing a new identity. About a case

The incidence of post-traumatic stress disorder, depression, and anxiety generally increases after disasters, and the 2011 Great East Japan Earthquake and nuclear power plant accident were no exception. Psychological first aid providers who deliver interventions to address mental health issues do not emphasize psychiatric expertise, but instead go into the field to help residents rebuild and stabilize their daily lives and provide a link between them and supporters. When psychiatric problems do not improve with such interventions and persist for more than a few years, specialized psychiatric interventions are considered. Past studies have examined the experience of prolonged exposure therapy (a specialized cognitive behavioral therapy for post-traumatic stress disorder) among survivors of the Fukushima nuclear power plant accident. The participant in this study was a survivor who was evacuated from the nuclear power plant accident but had experienced multiple traumas and had been a victim of domestic violence before the disaster. Recovery in this case did not involve a simple psychiatric treatment for trauma, but rather a process of overcoming the values that caused indulgence in victimization to form a new identity.

Mental Health Scenario of Climate Migrant Women among Slum Dwellers in Dhaka City

Climate change is a global challenge which is likely to affect the mankind in substantial ways. Not only climate change is expected to affect physical health, it is also likely to affect mental health. Increased frequency of disasters with climate change can lead to posttraumatic stress disorder, adjustment disorder, and depression. Changes in climate may require population to migrate, which can lead to acculturation stress. It can also lead to increased rates of physical illnesses, which secondarily would be associated with psychological distress. Using a qualitative approach, this research explores the mental health status of migrant women in two urban slum areas in Dhaka city. The purpose of this study is to perform a review of existing secondary data and present mental health scenario of climate migrant women among slum dwellers and amplified gaps in knowledge regarding psychological health care system in Bangladesh. It is found that there is a lack of mental health preparedness and response in majority parts in the country specially the city slum, where aid cannot be reached to the sufferers. The paper concludes with a discussion of what can and should be done to tackle the expected mental health issues consequent to climate change and migration.

Perceived Executive Functioning among Female Survivors of Intimate Partner Violence

ABSTRACT Current literature demonstrates that female survivors of intimate partner violence (IPV) suffer cognitive impairment. Nonetheless, less is known about how women perceive their cognitive functioning and related factors. The main objective was to assess to what degree abuse severity and mental health are related to perceived cognitive functioning in women who have been exposed to IPV. A group of female IPV survivors (n = 82) were assessed with the Quality of Life Outcomes in Neurological Disorders (Neuro-QOL-EF), Composite Abuse Scale Revised (CASR-SF), the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale (GAD-7). Findings revealed self-reported impairment in concentration, information processing, and attention. Associations were found between self-reported executive function (EF) and posttraumatic stress, abuse severity, and depression. Further, a model including abuse severity and posttraumatic stress explained up to 20.8% of the variance in perceived EF. Findings indicate that female survivors report a high prevalence of difficulties in the domain of EF. Self-reported impairment in EF may be indicative of higher levels of posttraumatic stress (PTSD) and depression, meriting further assessment and possibly treatment. This study opens the way for the potential use of perceived cognitive functioning screening tools with female survivors.

The prevalence, posttraumatic depression and risk factors of domestic child maltreatment in rural China: A gender analysis

ObjectiveCurrently, gender disparities in domestic child maltreatment (DCM) have become an important and highly controversial issue worldwide. This study aims to provide panoramic evidence from China on this issue. MethodData were derived from a survey of 4,308 children (Mage = 12.13, 48.7% were boys) conducted in seven provinces in rural China from June to December 2019. This study used multistage cluster sampling to select respondents, and modified versions of the JVQ Scale and the DSM-5 Scale (11–17 years old) were adopted. ResultsThis study reached three significant conclusions. First, the gender disparities in DCM vary among different maltreatment subtypes. Compared with girls, boys are more likely to experience physical abuse. A higher prevalence of neglect is observed among girls than among boys. Second, although DCM significantly increased the likelihood of posttraumatic depression for all children, its negative effect was more severe for girls than for boys. Third, gender heterogeneity is less evident than gender homogeneity in the risk factors for DCM. In rural China, children’s problematic behaviours, family structure, parents’ experiences of childhood violence and family relationships are common predictors of maltreatment for all children. ConclusionThis paper highlights gender differences in the risk of DCM among children in rural China, reveals the Confucian culture behind DCM and gender, and provides Chinese evidence for building an international dialogue.

Evaluation of psychological reactions among teenage married girls in Palestinian refugee camps in Jordan.

Girls married at an early age are more likely to be victims of violence from their husbands or their in-laws. This may lead them to experience mental problems such as post-traumatic stress, depression, and/or anxiety. There are a lack of data related to the psychological reactions among teenage married girls living at the Palestinians refugee camps. This study aimed to evaluate depression, anxiety, and stress symptoms among teenage married girls in Palestinian refugee camps in Jordan. It also aimed to identify factors correlating with the study selected psychological reactions. A cross-sectional, descriptive correlational design was used. The participants were recruited using non-probability sampling methods. The mental health symptoms were measured using the Depression, Anxiety, and Stress Scale (DASS). A total of 205 participants were included in the study. Their mean age was 16.90 (SD ± 0.96) years. Of the participants, 39.6%, 35.6%, and 9.8% experienced moderate to extremely severe levels of depression, anxiety, and stress symptoms, respectively. There were significant relationships between all the mental health symptoms and participant age, parent's educational level, and exposure to previous trauma. A high proportion of females living in Palestinian refugee camps married in their teenage years experienced moderate to severe mental health symptoms, particularly anxiety and depression. These results inform the need for psychological support to girls who are affected by teenage marriage.