Posttraumatic Research Articles

Efficacy of trauma-focused therapies for post-traumatic stress disorder in disaster-affected regions: insights from Minamisoma, Japan.

This study investigated the implementation and efficacy of trauma-focused psychotherapies at a psychiatric clinic in Minamisoma City, Fukushima, after the 2011 Great East Japan Earthquake and nuclear disaster. Analyzing medical records from April 2016 to March 2021, the authors identified a significant dropout rate of 43.2% among post-traumatic stress disorder (PTSD) patients within the first 5 years. These findings highlight the challenges and effectiveness of trauma-focused treatments like prolonged exposure therapy in disaster-stricken areas, where PTSD incidence is notably high. This study emphasizes the necessity to establish robust therapeutic frameworks capable of addressing PTSD in such contexts, considering the limited coverage of comprehensive psychotherapies by Japan's healthcare system.

Nursing as an earthquake survivor: A qualitative study on nurses traumatized by the Kahramanmaraş earthquake in Turkey.

Nurses' critical input and firsthand disaster management experience are vital to healthcare quality. This study aims to comprehend nurses' experiences during and after the earthquakes, their coping mechanisms for posttraumatic stress disorder (PTSD), and the consequent effects on their profession, given the nurses' crucial role in disaster response. A descriptive qualitative study using semistructured interviews was conducted between April and May 2024. Fifteen nurses were selected using criterion and snowball sampling methods from those working as earthquake survivor nurses in the affected areas. The COREQ guidelines for reporting qualitative research were followed. Five main themes were: emotional reactions/physical difficulties, career and motivation, PTSD and well-being, suggestions, and work performance. The results highlighted the significant psychological and professional challenges that nurses encounter, including the effects of severe PTSD symptoms, coping strategies, and the influence on their capacity to deliver care. Nurses dealing with earthquakes face unique challenges that test their resilience on all levels. Learning from their experiences and coping mechanisms can help healthcare systems support these frontline workers better. Investing in disaster preparedness and mental health resources for nurses is crucial for their well-being and the overall strength of the healthcare system during crises. Effectively managing workloads and rest periods can reduce physical fatigue and prevent burnout. Shift rotations and adequate staffing levels are necessary. Access to psychological mental health support is vital for nurses to recover from the psychological effects of disasters. Regular disaster preparedness training is imperative for physical safety and psychological resilience. Robust support systems, including safe accommodation and peer support groups, are crucial for nurses in disaster response.

Impact of surgery after injury on SDNN and posttraumatic stress disorder development over two years

Impact of surgery after injury on SDNN and posttraumatic stress disorder development over two years

Emerging pharmacological agents for post-traumatic stress disorder show promise, but more evidence is needed

Emerging pharmacological agents for post-traumatic stress disorder show promise, but more evidence is needed

“There is a Mental Resistance”: Experiences of Involving Refugee Parents in a Youth Trauma Recovery Program from the Perspective of Participating Youth, Parents and Facilitators

AbstractScalable light-touch programs that align with the Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) approach is becoming an established intervention model for refugee youth with symptoms of post-traumatic stress. Teaching Recovery Techniques (TRT) is one example and, as TF-CBT guidelines state, parent sessions are included as the model relies on parents to provide support and instigate the techniques. In addition to traumatic stress, refugee families are often subjected to acculturative, isolation and resettlement stress. This study sought to understand how refugee parental involvement in TRT functions in practice and how it is perceived by participating youth, parents, and facilitators in Sweden. Thirty semi-structured interviews (11 youth, 8 parents, and 11 TRT facilitators) were conducted by phone or videoconference, transcribed, and analyzed using Thematic Network Analysis. A global theme ‘Parental engagement in trauma recovery requires dedicated attention’ emerged. Three organizing themes sat within this global theme: (i) Shifting roles when adapting differently to a new context; (ii) Tendency to keep parents at a distance; and (iii) Parent sessions don’t just happen. Whilst the potential for refugee parent involvement was recognized, a number of factors preventing their participation were identified. Cultural adaptations within TRT facilitators’ training are recommended, including: raising awareness about contextual factors and changes in family dynamics with regard to trauma and migration; adopting culturally responsive ways to present parental involvement to youth and parents; adding positive parenting skills; addressing parental mental health and readiness; and preparing facilitators to redirect parents to adequate services, when needed.

Do Changing Times Call for Changing Definitions?

Scholars have noted changes in student engagement following the return to university classes after the COVID-19 lockdowns. The purpose of this study was to describe the perceptions of higher education instructors regarding student engagement over the past three years. The research team shared a link to an electronic questionnaire to recruit participants (n=108). Questions focused on common signs of disengagement and asked faculty about changes they perceived in students’ engagement prior to, during, and following the lockdowns. Following the return to classes, late work was perceived most often to signify disengagement. Behaviors participants interpreted as “student disengagement” are consistent with previously proposed definitions of post-traumatic stress. Although more research is needed to fully understand the phenomenon of student disengagement, it is likely educational practices within institutions of higher learning need to change to meet the needs of today’s students.

Differences in Post-Traumatic Stress Disorder (PTSD) Between U.S. Civilians and Military Veterans in the Gulf War and Post-9/11 War Eligibility Cohorts: A Research Note

Post-traumatic stress disorder (PTSD) is common among military veterans who experienced combat compared with those who did not. However, it is unknown how PTSD rates differ between veterans and nonveterans when accounting for combat status. We used a sample of 10,880 participants from the 2021 and 2022 National Wellbeing Survey—national annual cross-sectional surveys of U.S. adults aged 18 to 64—to assess relationships between military veteran-combat status and PTSD diagnosis among two war eligibility cohorts: the Gulf War and post-9/11 conflicts. We found that among both war eligibility cohorts, combat veterans were more likely than nonveterans to report a PTSD diagnosis: 3.42 times greater probability in the Gulf War eligibility cohort and 4.87 times greater probability in the post 9/11 cohort. Noncombat veterans had greater probability of PTSD (odds ratio [ OR] = 1.63) than nonveterans only in the post 9/11 cohort. These results underscore the importance of ensuring proper mental health care for combat veterans.

Effects of Shugan Tiaoshen acupuncture on anxiety-like behavior and PKC/ERK/CREB pathway in the bed nucleus of the stria terminalis in rats with post-traumatic stress disorder

To observe the effect of Shugan Tiaoshen acupuncture (acupuncture for soothing the liver and regulating the spirit) on the protein kinase C/extracellular signal-regulated kinase/cAMP response element-binding protein (PKC/ERK/CREB) signaling pathway in the bed nucleus of the stria terminalis (BNST) of rats with post-traumatic stress disorder (PTSD), and to explore the mechanism of acupuncture on alleviating anxiety and fear in PTSD. Fifty SPF-grade male SD rats were randomly divided into a blank group (10 rats) and a PTSD model group (40 rats). The PTSD model was induced by using a combination of closed electric shock and forced exhaustive swimming. Thirty successfully modeled rats were randomly assigned to a model group, a medication group, and an acupuncture group, with 10 rats in each group. The rats in the medication group were treated with paroxetine hydrochloride solution by gavage, once daily for 12 consecutive days. The rats in the acupuncture group were treated with acupuncture at "Baihui" (GV 20) and bilateral "Neiguan" (PC 6), "Shenmen" (HT 7), "Taichong" (LR 3). "Baihui" (GV 20) was needled daily, while the other acupoints were alternately needled on the left side on odd days and the right side on even days, once daily for 12 consecutive days. Anxiety and fear behaviors changes were assessed by using the open field test and elevated plus maze test. Histological changes in the BNST were observed by using HE staining and Nissl staining. The expression of PKC, phosphorylated PKC (p-PKC), ERK1/2, phosphorylated ERK1/2 (p-ERK1/2), and p-CREB proteins in the BNST were detected by using Western blot. Compared with the blank group, the model group showed decreased time and total distance spent in the center of the open field and on the open arms of the elevated plus maze (P<0.05); the BNST tissues in the model group exhibited a reduced number of neurons, disorganized cell arrangement, cell shrinkage, nuclear condensation, abnormal neuronal structure, uneven Nissl staining, and reduced Nissl bodies. The model group showed increased protein expression of p-PKC and p-PKC/PKC ratio (P<0.05) and decreased protein expression of p-ERK1/2, p-CREB, and p-ERK1/2/ERK1/2 ratio (P<0.05). Compared with the model group, the medication group and the acupuncture group showed increased time and total distance spent in the center of the open field and on the open arms of the elevated plus maze (P<0.05); the BNST tissues showed increased number of neurons, more organized cell arrangement, improved neuronal structure, and increased Nissl bodies; the medication group and the acupuncture group also showed decreased p-PKC protein expression and p-PKC/PKC ratio (P<0.05) and increased p-ERK1/2, p-CREB protein expression, and p-ERK1/2/ERK1/2 ratio (P<0.05). Shugan Tiaoshen acupuncture could alleviate anxiety and fear behaviors in PTSD rats, and improve neuronal damage in the BNST. The mechanism may be related to the regulation of the PKC/ERK/CREB signaling pathway in the BNST.

Protecting Emergency Responders with Evidence-Based Interventions (PEREI): protocol for a randomized controlled trial for early career emergency responders, significant others, and supervisors

ABSTRACT Background: Emergency service personnel perform roles associated with high levels of trauma exposure and stress, and not surprisingly experience greater risk for poor mental health including posttraumatic stress disorder (PTSD), depression, anxiety, and substance use relative to the general population. Although programs exist to minimise the risk of developing mental health problems, their efficacy to date has been limited or untested. We will test the efficacy of the three programs which form PEREI: Protecting Emergency Responders with Evidence-Based Interventions. PEREI consists of modified versions of internet-delivered cognitive training in resilience (iCT-R) for early career first responders, PEREI-S for supervisors, and Be Well for Significant Others (BW-SO). Method: Up to 450 members in their first 5 years of service across multiple agencies will be recruited, with their adult supports (significant others, friends) invited to participate. Up to 180 supervisors in the agencies will be recruited. Participants will be randomized to their respective program or to receive the standard practice for mental health offered by the service (or usual mental health support for significant others). Assessments will be conducted pre- and post-program, and at 6- and 12-month follow-up. Primary outcome is PTSD and depression severity and probable-diagnosis. Secondary measures will index hypothesized mediators and moderators of outcome and determine whether the programs are cost-effective. Conclusions: The results will provide evidence as to efficacious methods for reducing risk of mental health problems in high-risk occupations, a better understanding of how such interventions may work, and whether they are good value for money. Trial registration: www.anzctr.org.au (ACTRN12622001267741)

Prevalence of mental disorders and related risk factors in refugees and asylum seekers in Campania

IntroductionIn recent years, the increasing presence of refugees and asylum seekers displaced from their country of origin, determined significant social, economic, humanitarian and public health implications in host countries, including Italy. These populations are exposed to several potential stressful experiences which make them vulnerable to psychological distress. In fact, the majority of studies addressing the topic found a higher prevalence of mental disorders, especially post-traumatic stress disorder and major depressive disorder, in refugees and asylum seekers with respect to the general population. However, heterogeneous prevalence rates have been reported among studies, due to methodological factor as well as to the impact of a variety of risk factors related to stressful experiences lived in the country of origin, during the migration journey and in the host country.ObjectivesThe aim of the present study was to assess the prevalence of the main psychiatric diagnoses in a large group of adult refugees and asylum seekers (N=303) in the reception centers of two provinces of the Campania region, as well as to investigate the impact of potential risk factors on the occurrence of psychiatric disorders.MethodsThe diagnosis of psychiatric disorders and the identification of subjects at high risk to develop psychosis were carried out by means of structured diagnostic interviews. The following variables were explored as potential risk/protective factors to the occurrence of psychiatric disorders: socio-demographic variables, migration status (refugees/asylum seekers) and characteristics of the reception center,assessed by means of an ad hoc questionnaire; cognitive indices assessed by using standardized neuropsychological tests; traumatic experiences and level of political terror in the country of origin, assessed by means of reliable and valid self-report questionnaires.ResultsAt least one mental disorder was found in 29.7% of the sample. Most prevalent diagnoses were depressive disorders, anxiety disorders and PTSD. Women showed, with respect to men, a higher prevalence of anxiety disorders, higher trauma levels, and came from more at-risk countries. Higher trauma levels, better cognitive abilities and unemployment and refugee status were associated to the presence of a current psychiatric disorder in the whole sample.ConclusionsOur findings showed a higher prevalence of depressive disorders and PTSD in the sample of refugees and asylum seekers with respect to the general population and highlighted the role of potential risk factors whose identification may guide the implementation of preventive strategies and early treatments in these people.

Art as a Form of Communication for Trauma Survivors

This study investigates the importance of art as a communicative tool for trauma survivors, offering a form of self-expression and healing when words fail. Art therapy allows trauma survivors to express their emotions and experiences in a nonverbal way, assisting them in processing their suffering, reducing psychological distress, and promoting recovery. By studying various types of traumas and the use of art therapy, this research demonstrates how generating visual and poetic representations of trauma can serve as a bridge to emotional resilience and healing. The study also looks at the therapeutic advantages and success stories of art-based interventions, illustrating how creative expression may alter mental health therapy for trauma survivors. Keywords: Art therapy, Trauma survivors, Non-verbal communication, Emotional healing, Post-traumatic stress disorder (PTSD).

Music Therapy Sessions With Older Adults on YouTube: A Content Analysis for Academic Instruction

Abstract Prior research in music therapy has examined the availability and content of YouTube videos overall and in relation to veterans with post-traumatic stress disorder and pediatric medical music therapy. Anecdotally music educators use YouTube videos to provide students with clinical examples of music therapy sessions. It is unclear what clinical video content about music therapy with older adults is available. Therefore, this descriptive study aimed to examine the content of YouTube videos related to the clinical practice of music therapy with older adults for academic instruction. After conducting an initial search for music therapy clinical videos with older adults on YouTube, the authors completed a descriptive analysis of 23 videos that included clinical footage. Videos were analyzed to describe video-specific and therapy-specific content. In addition, the authors completed an exploratory analysis of diversity-specific content. Finally, the authors investigated the presence of American Music Therapy Association’s (AMTA) Competencies in clinical videos from the past 5 years (2018–2022). Results demonstrate varying amounts of video-specific, therapy-specific, and diversity-specific content leading to clinical and educational implications. The authors identify a need for future investigation of the use of videos in teaching by music therapy faculty, as well as student perceptions of music therapy content provided in clinical video clips.

Evocation of positive memories as complement to trauma-focused cognitive–behavioural therapy for intimate partner violence against women

ABSTRACT Background: Focusing on positive memories as a complement to trauma-focused interventions for intimate partner violence against women (IPVAW) could contribute to enhancing the recovery from trauma with the development of a more integrated and emotionally modulated autobiographical narrative. Objective: To test the effectiveness of a trauma-focused cognitive behavioural therapy (CBT) tailored for IPVAW that incorporates the evocation of positive memories. Methods: Female survivors of IPVAW entered a randomized controlled trial comparing trauma-focused CBT for IPVAW (CBT; n = 35) to a version that incorporates the evocation of positive memories (CBT-M+; n = 44) and to a waitlist (WL; n = 12) control group. Pre and post measures were obtained for: posttraumatic stress, meaning of trauma, affect, emotional regulation, associated symptoms, self-concept and overall functioning. Results: A total of 43.04% of women who entered treatment dropped out, without significant treatment differences. Pre–post changes were not significant for the WL; both treatments resulted in significant improvements, with good effect sizes, for posttraumatic stress (g = 0.78 and g = 1.00 for CBT and CBT-M+, respectively), meaning of trauma, affect, associated symptoms, self-concept and overall functioning, but not in emotional regulation. There were no significant differences between CBT and CBT-M+ in the direct comparisons; however, the effect sizes showed better effects of CBT for centrality of the IPVAW, whereas they favoured CBT-M+ for PTSD, depression, self-esteem and impairment measures. No clinically significant change was reached for the WL, while both treatments significantly reduced the percentage of women with PTSD and self-esteem problems; additionally, the percentage of women with depression and impairment problems in the CBT-M+ group was significantly decreased. Conclusions: Although there were few differences between both treatments, CBT-M+ seemed to have a greater effect, pointing to the potential of the inclusion of the evocation of positive memories that should be further researched.

Mantram Repetition Program for Posttraumatic Stress Disorder and Substance Use Disorders: Preliminary Evidence of Efficacy

Mantram Repetition Program for Posttraumatic Stress Disorder and Substance Use Disorders: Preliminary Evidence of Efficacy

Cost-effectiveness of midomafetamine-assisted therapy (MDMA-AT) in chronic and treatment-resistant post-traumatic stress disorder of moderate or higher severity: A health-economic model.

To explore the cost-effectiveness of midomafetamine-assisted therapy (MDMA-AT) compared to placebo with therapy (PT) in US healthcare settings. A health state-transition model was used to analyze the cost-effectiveness of MDMA-AT for treating patients with chronic PTSD of moderate or higher severity. Both treatment arms consisted of 3 preparation (90-min), 3 interventional (8-h), and 9 integration (90-min) sessions, lasting ~4 months total. All sessions included psychotherapy, with interventional also including MDMA or placebo. After receiving treatment, patients were distributed across health states of No PTSD (not meeting PTSD diagnostic criteria), Non-Severe PTSD (treatment responders), Severe PTSD (treatment non-responders), and death. Each state had unique healthcare costs and utilities sourced from real-world data analysis and patient data from MDMA-AT clinical trials (including long-term follow-up). The base-case analysis considered the payer's perspective with a 5-year horizon, 3.5% annual cost and effect discounts, and an assumed MDMA medication price of $12,000 per session. Trial-derived utilities and US life tables mortality data were used to calculate quality-adjusted life years (QALY). The main outcome was an incremental cost-effectiveness ratio (ICER) with a $150,000 willingness-to-pay (WTP) threshold. The base-case ICER was $83,845 per QALY. Total direct costs were $64,745 in the MDMA-AT and $33,132 in the PT arms ($31,613 increment). The costs of intervention were $48,376 for MDMA-AT and $12,376 for PT. The highest MDMA medication cost to fit under the WTP threshold was $20,314 per session. Costs related to PTSD healthcare visits and other PTSD treatments were lower with MDMA-AT than PT (-$2,511 and -$1,877 increments, respectively). Utility benefits were higher in MDMA-AT than PT, with 3.691 and 3.314 QALYs generated over 5 years, respectively (0.377 QALY increment). These data suggest MDMA-AT may be a cost-effective treatment compared to PT for patients with chronic PTSD of moderate or higher severity.

Post-traumatic Distress in Adults with Congenital Heart Disease: Protective Factors and Clinical Implications.

Due to various reasons explored in previous studies, adults with congenital heart disease (ACHD) are at risk of developing post-traumatic stress symptoms (PTSS). The aim of this study is to explore multiple potential psychosocial protective factors in ACHD and to understand their role in different complexities of congenital heart disease (CHD) and PTSS. This study was part of the "ABS-AHF" study, where 234 ACHD were recruited from November 2021 to August 2022 at a tertiary CHD care center. Data were collected on PTSS (PDS), resilience (RS-13), sense of coherence (SOC-L9), and social support (F-SozU K-14). The mean scores were 70.55 + / - 12.31 [21-91] for resilience, 35.83 + / - 4.81 [15-60] for sense of coherence (SOC), and 4.30 + / - 0.79 [0.93-5] for social support. SOC (OR, .91; p = .024 [.84; 9.98]) and social support (OR, .48; p = .001 [.29; 7.96]) were shown to reduce the likelihood of PTSS. Low resilience (OR, 2.40, p = .0248 [1.18; 5.18]) seems to increase this likelihood. Integrating parents and relatives early on seems to be an important protective resource. Parental support in childhood affects the development of SOC which is in line with social support related to lower PTSS. With regard to resilience and SOC, a brief and manageable screening option for personal resources is available to refer potentially vulnerable patients to specialized psychosocial care. Care offers should address coping styles and life with CHD. Offering multidisciplinary care, integrating the patient's social network, and education for patients to increase resilience and SOC might provide a way to enhance psychosocial outcomes, quality of life, and adherence in ACHD.

Psycho-Somatic Evolution of Patients with Multiple Traumatic Injuries

Background and Objective: In this study, we aimed to identify the factors that could impact the Stress-Related Growth Scale (SRGS) questionnaire administered to patients. Materials and Methods: Participants were asked to complete a written SRGS questionnaire (a translated and approved version in Romania) at varying time intervals relative to the traumatic event. The questionnaire was developed in accordance with legal regulations of the World Health Organization and the European Union for research involving human subjects for medical purposes. It took approximately 15 min to complete. The questionnaire was filled out by the patient or their legal guardian/parent for minors between January 2021 and January 2022. Results: The findings revealed the individual dimensions in the context of the traumatic impact, and the subsequent conclusions could be applied to a larger group with similar traumatic experiences. It is recognized that psychosomatic pathologies can hinder posttraumatic rehabilitation, leading to slower and more challenging recovery. Conclusions: Posttraumatic stress disorder often manifests as chronic development of symptoms characterized by reexperiencing traumatic scenes, avoidance behaviors, negative alterations in cognition, and heightened arousal. Posttraumatic stress disorder (PTSD) is a prevalent, persistent, and psychologically debilitating syndrome that can significantly impair an individual’s ability to cope with life. The etiology and manifestation of this disorder present numerous challenges due to the complexity of defining and diagnosing these conditions. The distribution of men and women affected by posttraumatic stress disorder varies across different sources and cannot be simplified into one explanation. While sex distribution is an important factor, it is not the sole determinant for understanding the various aspects of these disorders. The diversity of stressors has been shown to correlate with changes in SRGS scores, including subtle emotions like shame and guilt, which contribute to the moral injury resulting from trauma.

Prospective study of individual characteristics and posttraumatic stress disorder (PTSD) symptoms following childbirth: Birth satisfaction as a moderator.

The goal of this study was to (a) examine the association between childbirth-related posttraumatic stress disorder (CB-PTSD) symptoms and possible risk factors of previous trauma, individual characteristics (neuroticism, anxiety sensitivity, and resilience), type of birth, and birth satisfaction and (b) explore whether birth satisfaction moderates any association between individual characteristics and CB-PTSD symptoms. This was a longitudinal questionnaire study during pregnancy and postpartum. Pregnant women (N = 396) were recruited from antenatal clinics and completed questionnaires during mid-late pregnancy (Time 1) and 6-12 weeks after childbirth (Time 2). Time 1 questionnaires measured anxiety sensitivity (Anxiety Sensitivity Index), neuroticism (International Personality Item Pool-50, Neuroticism subscale), resilience (Brief Resilience Scale), and trauma history. Time 2 questionnaires measured birth satisfaction and CB-PTSD (Birth-Related and General Symptoms subscales). Regression analysis showed that previous sexual trauma, higher levels of neuroticism, and lower levels of birth satisfaction predicted higher levels of CB-PTSD symptoms. Anxiety sensitivity and resilience were not significant predictors of CB-PTSD. Additionally, birth satisfaction moderated the relationship between higher neuroticism and higher levels of CB-PTSD (total and general symptoms) and between lower resilience and higher CB-PTSD general symptoms. Effects were stronger when low birth satisfaction was reported. Individual characteristics and birth satisfaction interact in the development of posttraumatic stress disorder following childbirth, with previous traumatic experiences playing an additional role. These findings can inform screening and care pathways for women at greater risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Efficacy and safety of balovaptan for posttraumatic stress disorder: A randomized, placebo-controlled trial.

Posttraumatic stress disorder (PTSD) has a significant impact on quality of life and affects more than 13 million individuals in the United States, with limited treatments available. EXUVIA (NCT05401565) was a Phase 2, randomized, placebo-controlled, double-blind trial, conducted across eight sites in the United States. The study aimed to assess the efficacy, safety, and pharmacokinetics of balovaptan, a highly selective vasopressin 1a receptor antagonist, in adults with PTSD. Between August 2022 and October 2023, a total of 57 adult participants (aged 18-60 years) were screened, and 29 participants were randomly allocated (1:1) to receive either balovaptan (13/29 [44.8%]) or placebo (16/29 [55.2%]). No meaningful differences were observed for balovaptan (-17.2 [± 10.7]) versus placebo (-15.6 [± 10.7]) as measured by the primary endpoint of change from baseline at Week 12 in Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition total symptom severity score. No meaningful differences for balovaptan versus placebo were observed at Week 12 for any secondary endpoints. Balovaptan was well tolerated with no new safety findings. The number of participants with at least one adverse event of any intensity was 9/13 (69.2%) in the balovaptan group and 7/16 (43.8%) in the placebo group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Post-COVID condition: a focus on psychiatric symptoms and diagnoses in patients with cognitive complaints.

Cognitive and psychiatric symptoms are frequently reported after SARS-CoV-2 infection, but their interplay has been only partially explored. We investigated frequency and severity of psychiatric symptoms in patients with persistent cognitive complaints after COVID-19. We conducted a cross-sectional study. Neurologists assessed 101 patients reporting cognitive symptoms after COVID-19. Patients were invited to fill a screening battery with self-reported psychometric scales (Depression Anxiety Stress Scales-21, Impact of Event Scale-Revised, Insomnia Severity Index). Patients scoring above validated cut-offs in ≥1 scale were referred to psychiatrists who administered the Mini-International Neuropsychiatric Interview (M.I.N.I.), Hamilton Anxiety (HAM-A), and Hamilton Depression (HAM-D) rating scales and asked to complete the Personality Inventory for DSM-5-Brief Form (PID-5-BF). Out of the 57 referred patients, 38 (64.4%) accepted to undergo the psychiatric examination. Among these, 18 (47.4%) were diagnosed with adjustment disorder (23.7%), anxiety disorder (10.5%), major depressive disorder (7.9%), and post-traumatic stress disorder (2.6%). Pharmacologic treatment before post-COVID condition (present in 12 patients, 31.6%) was associated with a score above cut-off on the HAM-A and HAM-D scales. A longer duration of untreated psychiatric illness after COVID-19 was associated with worse scores on the same scales. Patients with a higher PID-5-BF total score had a higher probability of receiving a psychiatric diagnosis. Almost half of patients with post-COVID-19 conditions reporting cognitive symptoms were found to suffer from a psychiatric condition after psychiatric evaluation. The application of a psychiatric screening in a population suffering from long-term effects of COVID-19 can lead to early diagnosis and timely treatment.