Prévalence et facteurs prédicteurs des troubles post-traumatiques chez les accidentés de la voie publique / Prevalence and predictors of post-traumatic stress disorder in road traffic accidents

Introduction: les troubles post-traumatiques survenant à la suite d'un accident de la route ont un impact tant sanitaire qu'économique. Méthodes: notre étude prospective, vise à déterminer la prévalence de ces troubles, et de dégager leurs facteurs de risque auprès de sujets victimes d'accidents de la route et hospitalisés au service de chirurgie orthopédique et de traumatologie du Centre Hospitalo-Universitaire de Sfax-Tunisie. Résultats: soixante-dix sujets ont été inclus dans notre étude. La prévalence de l'état de stress aigu était de 37,1% et il a été associé au sexe féminin, au niveau scolaire bas, à la présence d'antécédents médicochirurgicaux, à la passivité au cours de l'accident, à la sévérité des lésions, et à la présence d'une symptomatologie anxieuse et dépressive. Le trouble stress post traumatique était constaté chez 40% des sujets et il a été associé au milieu de résidence urbain, à la passivité au cours de l'accident, et à la symptomatologie anxieuse et dépressive. Des scores faibles des stratégies de coping fonctionnelles et des scores élevés des stratégies de coping dysfonctionnelles ont été significativement associés à ces deux troubles. Le niveau scolaire bas, la résidence en milieu urbain, un niveau élevé d'anxiété et de dépression et la stratégie de coping de déni apparaissent comme des facteurs de risque indépendants de l'état de stress aigu et du trouble stress post traumatique. Conclusion: il s'avère ainsi important de déterminer un profil de personnes plus exposées aux troubles post-traumatique afin de permettre un dépistage précoce par les médecins avec lesquels les accidentés pourraient avoir des contacts dans les suites de leurs accidents.

ntroduction: Post-traumatic stress disorder following a road accident has both a health and an economic impact. Methods: we conducted a prospective study to determine the prevalence of this disorder, and to identify risk factors in subjects victims of road accidents and hospitalized in the Department of Orthopedic Surgery and Traumatology of the University Hospital Center of Sfax-Tunisia. Results: a total of sixty-ten subjects were included in this study. The prevalence of acute stress was 37.1% and was associated with female sex, low educational level, previous medical and surgical history, passivity during the accident, severity of injuries and the presence of anxious and depressive symptoms. Post-traumatic stress disorder was observed in 40% of subjects and was associated with urban residential environment, passivity during the accident and anxious and depressive symptoms. Low scores for functional coping strategies and high scores for dysfunctional coping strategies were significantly associated with both disorders. Low educational level, urban residential environment, high levels of anxiety and depression, and denial coping strategy appear to be independent risk factors for acute stress and post-traumatic stress disorder. Conclusion: It is therefore important to determine the profile of people at greater risk of post-traumatic stress disorder, to enable early diagnosis in victims of road accidents.

Estrés agudo y crónico en la reparación ósea: un enfoque actualizado desde las neurociencias / Acute and chronic stress in bone repair: an updated approach from the neurosciences

Los mecanismos moleculares fisiológicos asociados a la respuesta ante el estrés agudo y crónico permiten entender los cambios que éstos pueden producir en los diversos tejidos del cuerpo. Diversas investigaciones resaltan el papel del estrés crónico en el desarrollo de disfunciones que afectan el equilibrio corporal; sin embargo, hay que considerar que los mecanismos relacionados con el estrés agudo, también pueden influir en el desarrollo de patologías y de la progresión de las manifestaciones deletéreas del estrés crónico. Por otro lado, uno de los tejidos más estudiados en los últimos años ha sido el tejido óseo, ya que éste se encuentra influenciado por factores nerviosos, endocrinos e inmunológicos. Esta revisión busca analizar las bases neurocientíficas de los mecanismos moleculares del estrés y su relación en el proceso de reparación ósea. Para esto, se realizó una búsqueda de la literatura en las bases de datos de Pubmed, Scopus y ScienceDirect, concluyendo que el estrés modifica la liberación de neurotransmisores, la acción del sistema nervioso autónomo, la liberación de hormonas corticotrópicas y la actividad de diversas citocinas; lo que conlleva al desequilibrio de los procesos de regulación y reparación del tejido óseo sometido a carga o lesión.

The physiological molecular mechanisms associated with the response to acute and chronic stress allow us to understand the changes that these can produce in the various tissues of the body. Various investigations highlight the role of chronic stress in the development of dysfunctions that affect body balance; However, it must be considered that the mechanisms related to acute stress can also influence the development of pathologies and the progression of the deleterious manifestations of chronic stress. On the other hand, one of the most studied tissues in recent years has been bone tissue, since it is influenced by nervous, endocrine and immunological factors. This paper seeks to analyze the neuroscientific bases of the molecular mechanisms of stress and their relationship in the bone repair process. Therefore, a literature search was carried out in the Pubmed, Scopus and ScienceDirect databases. Concluding that stress modifies the release of neurotransmitters, the action of the autonomic nervous system, the release of corticotropic hormones and the activity of various cytokines; which leads to the imbalance of the regulation and repair processes of the bone tissue subjected to load or injury.

Risk factors and clinical nursing strategies of acute stress disorder in patients with liver cirrhosis, portal hypertension and upper gastrointestinal bleeding / 中国基层医药

Acute stress disorder is a transient mental disorder caused by sudden and unusual stressful life events or persistent difficulties in a period of time after acute traumatic events. Cirrhotic patients with portal hypertension complicated by upper gastrointestinal bleeding suffer from immediate or rapidly developing symptoms, which often lead to acute stress disorder. This review summarizes risk factors and clinical nursing strategies of acute stress disorder, so as to provide evidence for starting early intervention, strengthening clinical nursing, and improving prognosis and mood.

Frequency of acute stress disorder in health care workers of a tertiary level pediatric hospital during the National Safe Distance Strategy for COVID-19 prevention / Frecuencia de trastorno por estrés agudo en el personal de salud de un hospital pediátrico de tercer nivel durante la Jornada Nacional de Sana Distancia para la prevención de la COVID-19

Abstract Background: Acute stress disorder (ASD) is one of the most frequent mental illnesses occurring during sanitary emergencies. This study aimed to estimate the frequency of ASD in health care workers of a tertiary level pediatric hospital during the coronavirus disease (COVID-19) pandemic. Methods: We conducted a cross-sectional study in which health care workers completed a virtual questionnaire, including sociodemographic information and the ASD scale. Results: We analyzed 206 questionnaires. The population was divided into three groups: attending physicians, medical residents, and nursing personnel. The frequency of health care workers who showed at least nine symptoms of ASD was 88.8%. No significant differences were found between the studied groups. Conclusions: ASD is a frequent condition in health care workers in the context of the COVID-19 pandemic. We need to investigate further and assess risk and protective factors for developing this and other psychopathologies in this population.

Resumen Introducción: El trastorno por estrés agudo es una de las enfermedades mentales más frecuentemente manifestadas en emergencias sanitarias. El objetivo de este estudio fue conocer la frecuencia con la que se presentó el trastorno por estrés agudo en el personal de salud de un hospital pediátrico de tercer nivel durante la epidemia de COVID-19. Método: Se realizó un estudio transversal en el que trabajadores de la salud contestaron un cuestionario virtual que incluyó datos sociodemográficos y la Escala de Trastorno por Estrés Agudo. Resultados: Se analizaron 206 encuestas. La población se dividió en tres grupos: médicos adscritos, residentes y personal de enfermería. El 88.8% de los trabajadores de la salud reportaron más de nueve síntomas de trastorno por estrés agudo. No se encontraron diferencias significativas entre los grupos de estudio. Conclusiones: Los síntomas del trastorno por estrés agudo son frecuentes en los trabajadores de la salud en el contexto de la COVID-19. Es necesario investigar acerca de los factores de riesgo y protectores asociados al desarrollo de esta y otras psicopatologías en dicha población.

Distinct Effects of Social Stress on Working Memory in Obsessive-Compulsive Disorder / 神经科学通报·英文版

Stress might exaggerate the compulsion and impair the working memory of patients with obsessive-compulsive disorder (OCD). This study evaluated the effect of stress on the cognitive neural processing of working memory in OCD and its clinical significance using a “number calculation working memory” task. Thirty-eight patients and 55 gender- and education-matched healthy controls were examined. Stress impaired the performance of the manipulation task in patients. Healthy controls showed less engagement of the medial prefrontal cortex and striatum during the task under stress versus less stress, which was absent in the patients with OCD. The diagnosis × stress interaction effect was significant in the right fusiform, supplementary motor area, precentral cortex and caudate. The failure of suppression of the medial prefrontal cortex and striatum and stress-related hyperactivation in the right fusiform, supplementary motor area, precentral cortex, and caudate might be an OCD-related psychopathological and neural response to stress.

Study on the relationship between acute stress disorder and symptom group in stroke patients with motor impairment / 中国综合临床

Objective:To explore the influence of symptom group of stroke patients with exercise disorder on acute stress disorder.Methods:Patients with stroke and motor impairment hospitalized in the Department of Neurology and surgery of North China University of technology from October 2018 to August 2019 were selected as the research objects.The general information of patients, brain injury subscale (BIS) and Stanford acute stress reaction questionnaire (SARSQ) were investigated by questionnaire.Results:A total of 324 patients with stroke and motor disorders were investigated.The demographic characteristics of education, age, degree of motor function, number of combined dysfunction and Activity Of Daily Living Scale(ADL) grade had effects on acute stress disorder, and the differences were statistically significant( P<0.05). The score of acute stress disorder in stroke patients with motor disorders was (99.60±13.69 ) points.From the highest to the lowest symptom group, the scores were obsessive symptom (11.35±2.71), depression (7.44±1.86), hostility (7.23±2.26), somatization (3.69±1.42) and psychosis (2.81±1.09). The results of correlation analysis showed that somatization, depression, obsessiveness, hostility and psychosis were positively correlated with the total score of acute stress disorder and the scores of each dimension ( r=0.164, 0.355, 0.329, 0.298, 0.279, all P<0.05), the symptoms were also positively correlated with all the dimensions of acute stress disorder(all P<0.05). Multiple linear regression analysis showed that age(Regression coefficient=7.682, 95% CI: 4.930-10.435, P<0.001), the number of combined dysfunction(Regression coefficient=3.937, 95% CI: 0.268-7.605, P=0.036), depression(Regression coefficient=1.662, 95% CI: 0.727-2.597, P=0.001) had influence on ASD of stroke patients. Conclusion:The level of acute stress disorder in stroke patients with motor impairment is on the high side, and the characteristics of symptom group are obvious, which has a positive correlation with acute stress disorder.Medical staff should pay attention to the characteristics of symptom group and acute stress reaction level of stroke patients with motor impairment, so as to provide targeted intervention strategies to avoid disease recurrence and improve the quality of life.

Síndrome de burnout e engajamento em profissionais de saúde: um estudo transversal / Burnout syndrome and engagement among critical care providers: a cross-sectional study

RESUMO Objetivo: Avaliar a frequência de síndrome de burnout grave em profissionais de terapia intensiva e correlacioná-la com o engajamento com o trabalho. Métodos: Foi distribuído um questionário autoaplicável que incluía o Inventário de Burnout de Maslach, a Escala de Depressão Ansiedade e Estresse e o questionário Gallup. Todas as análises foram estratificadas por local de trabalho (unidade de terapia intensiva ou unidade semi-intensiva) e por grupo profissional (enfermeiros versus médicos versus fisioterapeutas). Resultados: Entre fevereiro de 2017 e junho de 2017, 206 dos 325 profissionais convidados (63,4%) responderam aos questionários. Destes, 55 eram médicos (26,7%), 88 eram fisioterapeutas (42,7%) e 63 eram enfermeiros (30,6%). A frequência de burnout grave foi de 34,3% (27,9 - 41,4%), e não se identificaram diferenças entre os grupos profissionais ou locais de trabalho. A frequência de casos graves ou muito graves de depressão, ansiedade ou estresse foi de 12,9%, 11,4% e 10,5%, respectivamente. O escore mediano (intervalo interquartil) observado pelo questionário Gallup foi 41 (34 - 48), e não se observaram diferenças entre os grupos profissionais ou locais de trabalho. Houve correlação negativa entre burnout e engajamento com o trabalho (r = -0,148; p = 0,035). Conclusão: A frequência de burnout grave foi elevada entre os profissionais de saúde que trabalham na unidade de terapia intensiva e na unidade semi-intensiva. Existe uma correlação negativa entre burnout e engajamento com o trabalho.

ABSTRACT Objective: To evaluate the frequency of severe burnout syndrome among critical care providers and to correlate it with work engagement. Methods: A self-administered survey including the Maslach Burnout Inventory, Depression Anxiety and Stress Scales, and Gallup questionnaire was distributed. All analyses were stratified by setting (intensive care unit or step-down unit) and by professional group (nurses versus physicians versus physiotherapists). Results: Between February 2017 and June 2017, 206 out of 325 invited professionals (63.4%) answered the questionnaires. Of these, 55 were physicians (26.7%), 88 were physiotherapists (42.7%) and 63 were nurses (30.6%). The frequency of severe burnout was 34.3% (27.9 - 41.4%), and no difference was found between professional groups or settings. The frequency of severe or very severe cases of depression, anxiety or stress was 12.9%, 11.4% and 10.5%, respectively. The median (interquartile range) score observed on the Gallup questionnaire was 41 (34 - 48), and no differences were found between professional groups or settings. There was a negative correlation between burnout and work engagement (r = -0.148; p = 0.035). Conclusion: There is a high frequency of severe burnout among critical care providers working in the intensive care unit and step-down unit. There was a negative correlation between burnout and work engagement.

Subjective versus Objective Assessment of Short Term Occupational Stress: Bias and Analysis of Self-Assessment of High Stress Levels

Aims: Experiments undertaken with two professions (engineers and anesthesiologists) have shown the possible overestimation of perceived stress by subjects when self-assessing stress through questionnaires for high levels of acute stress. Previous analyses having demonstrated that the overestimation was effective, the present study aimed at analyzing a possible effect due to professional traits.Study Design:Data were compared with models of professional personality: Myers-Briggs Type Indicator approach, Holland’s theory of careers and vocational choice and the Five-Factor model of personality.Place and Duration of Study:Data from previous studies were used: A sample of engineers working at the nuclear power plant of Chinon in France (published in 2014) and a sample of anesthesiologists working at the University Hospital of Angers, France (published in 2015).Methodology:Anesthesiologists (N=11, 50% male, 25 to 35 years old) experienced a stress episode in an operating theater simulator. Engineers (N=8, 38% male, 25 to 35 years old) underwent a stress-test in their office. Heart rate was measured for each subject. Comparison was examined between the stress perceived by the subjects through the Post-traumatic Disorder Inventory and the expected levels of stress estimated using the heart rate data. Characterization of the difference was undertaken using models of professional personality.Results:While a Myers-Briggs Type Indicator approach did not provide any relevant information, an approach based on Holland’s theory of careers and vocational choice and on the Five-Factor model of personality showed that overestimation of stress was linked with occupational preoccupations specific to the professions. Limitations, perspectives and scientific implications are discussed.Conclusion:As a major recommendation for researchers, during experiments inducing high levels of acute stress, it is worth to consider the possibility to compare self-assessment of stress with physiological measurements in order to detect a possible overestimation of perceived stress

Evaluation of BDNF levels in patients hospitalized for physical trauma at an emergency hospital in Porto Alegre, southern Brazil / Avaliação dos níveis de BDNF em pacientes hospitalizados por trauma físico em um hospital de emergência de Porto Alegre, sul do Brasil

Abstract Objective To assess the association between brain-derived neurotrophic factor (BDNF) levels and acute stress disorder (ASD) in patients who have suffered physical trauma. Methods Data were collected at an emergency hospital in Porto Alegre, state of Rio Grande do Sul, southern Brazil. Participants were over 18 years of age, victims of physical trauma, and had been hospitalized for a minimum of 48 hours. A total of 117 hospitalized patients who agreed to participate in the research were grouped according to the shift in which blood was collected (38 subjects from the morning shift and 79 from the afternoon shift), had their BDNF levels measured and responded to other questionnaires. Respondents were further grouped by age into three ranges: 18-30, 31-50 and 51-70 years. Results We found a significant difference in the distribution of BDNF between the two shifts in which blood samples were collected, with the afternoon group having higher BDNF levels (U = 1906.5, p = 0.018). A difference was observed only between the 18-30 group and the 51-70 group in the afternoon shift (Umorning = 1107, pmorning = 0.575; Uafternoon = 7175, pafternoon = 0.028). Conclusions The population whose blood samples were collected in the afternoon showed significantly higher values of BDNF compared to those of the morning shift. This same population presented lower BDNF levels when associated with ASD subtypes A1, A2, and A. We hypothesize that the lower values of BDNF measured in the morning shift were due to a response to the circadian cycle of cortisol, whose action inhibits the expression of serum neurotrophins.

Resumo Objetivo Verificar a associação entre os níveis de fator neurotrófico derivado do cérebro (brain-derived neurotrophic factor [BDNF]) e transtorno de estresse agudo (TEA) em pacientes que sofreram trauma físico. Métodos Os dados foram coletados em um hospital de emergência de Porto Alegre, Rio Grande do Sul, Brasil. Os participantes eram maiores de 18 anos, vítimas de trauma físico e estavam hospitalizados por um período mínimo de 48 horas. Um total de 117 pacientes hospitalizados que concordaram em participar da pesquisa foram agrupados de acordo com o turno de realização da coleta de sangue (38 sujeitos no turno da manhã e 79 sujeitos no turno da tarde), tiveram seus níveis de BDNF medidos e responderam a outros questionários. Os entrevistados também foram agrupados por idade em três faixas etárias: 18-30, 31-50 e 51-70 anos. Resultados Encontramos uma diferença significativa na distribuição de BDNF entre os turnos, sendo que o grupo da tarde apresentou níveis maiores de BDNF (U = 1906,5, p = 0,018). Houve diferença entre o grupo de 18-30 anos e o de 51-70 anos no turno da tarde (Umanhã = 1107, pmanhã = 0,575; Utarde = 7175, ptarde = 0,028). Conclusões A população cuja coleta ocorreu à tarde apresentou valores significativamente maiores de BDNF em relação à coleta do turno da manhã. Esta mesma população apresentou menores níveis dessa neurotrofina quando associada com os subtipos A1, A2 e A de TEA. É possível hipotetizar que os menores valores de BDNF aferidos na coleta do turno da manhã se devam a uma resposta ao ciclo circadiano do cortisol, cuja ação inibe a expressão de neurotrofinas séricas.

Predictores de sintomatología postraumática aguda y crecimiento post-estrés tras un accidente laboral reciente / Predictors of Acute Posttraumatic Symptoms and Post- Stress Growth After a Recent Work Accident

Resumen El propósito de este estudio fue evaluar un modelo predictivo de sintomatología postraumática aguda (SPT) y de crecimiento post-estrés (CPE) en trabajadores que sufrieron un accidente laboral reciente. Se encuestaron 246 trabajadores (23.2% mujeres) entre los 18 y los 73 años. Se encontró que los principales predictores de la SPT son: severidad subjetiva del evento, afrontamiento religioso negativo, reinterpretación positiva y rumiación de tipos intrusiva, negativa y deliberada. A su vez, los principales predictores de CPE fueron: rumiación deliberada y afrontamiento religioso positivo. Se realizó un análisis de sendero para evaluar un modelo en el cual la rumiación intrusiva y la deliberada cumplen una función mediadora, obteniendo adecuados índices de ajuste. Se plantea la necesidad de contar con un método de evaluación temprana de las respuestas psicológicas tras un accidente.

Abstract The aim of this study is to evaluate a predictive model of acute posttraumatic symptomatology (PTS) and post-stress growth (PSG) in workers who suffered a recent work accident. To this end, 246 workers (23.2% women) were surveyed, aged between 18 and 73 years. The main predictors of PTS were subjective severity of event, negative religious coping, positive reinterpretation, and intrusive, brooding and deliberate rumination. At the same time, the main predictors of PSG were deliberate rumination and positive religious coping. A path analysis was performed to evaluate a model in which intrusive and deliberate rumination fulfill a mediating function, obtaining adequate goodness-of-fix indices. The need to have a method of early evaluation of psychological responses after an accident is proposed.

A cross sectional study of socio-demographic profile and acute stress disorder in suicidal burn patients

Background: The experience of being burnt and the treatment that follows for the survivors are one of the most frightening and painful experience known to humanity. It carries a huge psychological burden on patients. Acute stress disorder which occurs in the first month and post-traumatic stress disorder that occurs after one month are more common after burns than other forms of injury. Aim and objectives: To study socio demographic profile in suicidal attempters by burns, to access for acute stress reaction in those patients. Materials and methods: A total of 60 cases of suicidal burns patients fulfilling criteria for study were taken. Semi -structured proforma for socio demographic and clinical variables were used. Becks suicidal intent scale and impact of event scale were administered to the patients. The data was analyzed using SPSS. Results: There was high preponderance of female subjects in the study and mostly of the patients belonged to lower socio economic status in the study. Most of the subjects were either illiterates or having primary education and belongs to nuclear family. There was high percentage of marital disharmony and strained inter personal relationship in the subjects. Almost all were deep burns in the study and most common vehicle used was kerosene. Patient of high risk group had more risk of developing acute stress reaction and post-traumatic stress disorders than in medium risk group. High risk group had more scores on both intrusive and avoidance subscale of impact of event scale. Conclusion: There was high preponderance of female subjects in the study. There was higher representation of lower socio economic status in the study. Most of the subjects were either illiterates or having primary education. Many of the subjects belonged to nuclear family. There was high percentage of marital disharmony and strained inter personal relationship in the subjects. Patient of J. Mayurnath Reddy, CH. Siva Kumar. A cross sectional study of socio-demographic profile and acute stress disorder in suicidal burn patients. IAIM, 2019; 6(7): 17-27. Page 18 high risk group had more risk of developing acute stress reaction and post-traumatic stress disorders than in medium risk group. High risk group had more scores on both intrusive and avoidance subscale of impact of event scale.

14-3-3γ Haploinsufficient Mice Display Hyperactive and Stress-sensitive Behaviors

14-3-3γ plays diverse roles in different aspects of cellular processes. Especially in the brain where 14-3-3γ is enriched, it has been reported to be involved in neurological and psychiatric diseases (e.g. Williams-Beuren syndrome and Creutzfeldt-Jakob disease). However, behavioral abnormalities related to 14-3-3γ deficiency are largely unknown. Here, by using 14-3-3γ deficient mice, we found that homozygous knockout mice were prenatally lethal, and heterozygous mice showed developmental delay relative to wild-type littermate mice. In addition, in behavioral analyses, we found that 14-3-3γ heterozygote mice display hyperactive and depressive-like behavior along with more sensitive responses to acute stress than littermate control mice. These results suggest that 14-3-3γ levels may be involved in the developmental manifestation of related neuropsychiatric diseases. In addition, 14-3-3γ heterozygote mice may be a potential model to study the molecular pathophysiology of neuropsychiatric symptoms.

Degree of social support in patients after coronary artery bypass grafting and its influence on acute stress disorder / 中国实用护理杂志

Objective@#To explore the degree of social support in patients after Coronary Artery Bypass Grafting(CABG) and its influence on Acute Stress Disorder (ASD), in order to provide theory evidence for nursing intervention.@*Methods@#From June 2017 to Mar 2018, 359 patients after CABG in Tangshan Workers Hospital were recruited for the study. Their general information were collected, SASRQ, SSRS and PSS-Fa were used for professional evaluation.@*Results@#The degree of social support in patients after CABG was at medium level, the total score of social support was (41.69±0.28), higher than the normal domestic value[(34.56±3.73)score, n=128]; character (F=29.652), employment (t=6.526)and the type of health insurance (F=20.547)impacted on the degree of social support (P<0.05). Total score of social support had negative correlation with SASRQ total score (r=-0.528, P<0.05); character (β=0.262), family support (β=-0.281) and social support (β=-0.267) were picked in the regression equation (P<0.05), the results showed that introversion was a risk factor for ASD in patients after CABG, high degree of family support and social support were protective factors for ASD in patients after CABG.@*Conclusions@#Social support of patients after CABG needs to be improved, so as to reduce the incidence of acute stress disorder.

The correlation between symptom clusters and acute stress disorder in patients with brain injury / 中华行为医学与脑科学杂志

Objective To explore the relationship between brain injury related symptom groups and acute stress disorder( ASD). Methods Totally 301 patients with brain injury hospitalized in the Affiliated Hospital of North China University of Technology from March 2017 to March 2018 were recruited. The pa-tients were assessed by Stanford Acute Stress Response Questionnaire ( SASRQ), Brain Trauma Subscale (BIS) and Pittsburgh Sleep Quality Index (PSQI). Results The prevalence of acute stress disorder pa-tients with brain injury was 46. 51% (140/301). The SASRQ score of all patients with brain injury was (70. 78±28. 00). Univariate analysis showed that there were significant differences in age (χ2= 4. 172,P=0. 041),personality type (χ2= 57. 281,P<0. 001),sleep quality ( χ2= 70. 785,P<0. 001),hospitalization frequency (χ2= 43. 547,P<0. 001),depression,obsessive-compulsive and hostile symptoms between pa-tients with and without ASD ( P<0. 05). The scores of depression and obsessive-compulsive symptoms were significantly correlated with SASRQ scores(P<0. 05). The scores of hostility symptoms were significantly cor-related with SASRQ scores except for patients who lost their temper uncontrollably ( r=0. 176-0. 698,P<0. 05). Personality ( OR=0. 243,95% CI=0. 142-0. 415),sleep disorders( OR=0. 072,95% CI=0. 029-0. 178),hospitalization times(OR=0. 129,95%CI=0. 054-0. 306),depressive symptoms( OR=1. 260,95% CI=1. 061-1. 497),obsessive-compulsive symptoms(OR=1. 419,95%CI=1. 239-1. 625) and hostile symp-toms(OR=1. 253,95%CI=1. 058-1. 482) were the influencing factors of ASD in patients with brain injury (P<0. 05). Conclusion The incidence of ASD is higher in patients with brain injury. Personality type,hos-pitalization,sleep quality,depressive symptoms,obsessive-compulsive symptoms and hostile symptoms are the influencing factors,which should be paid more attention.

Degree of social support in patients after coronary artery bypass grafting and its influence on acute stress disorder / 中国实用护理杂志

Objective To explore the degree of social support in patients after Coronary Artery Bypass Grafting(CABG) and its influence on Acute Stress Disorder (ASD), in order to provide theory evidence for nursing intervention. Methods From June 2017 to Mar 2018, 359 patients after CABG in Tangshan Workers Hospital were recruited for the study. Their general information were collected, SASRQ, SSRS and PSS-Fa were used for professional evaluation. Results The degree of social support in patients after CABG was at medium level, the total score of social support was (41.69±0.28), higher than the normal domestic value[(34.56 ± 3.73)score, n=128]; character (F=29.652), employment (t=6.526)and the type of health insurance (F=20.547)impacted on the degree of social support (P＜0.05). Total score of social support had negative correlation with SASRQ total score (r=-0.528, P＜0.05); character (β=0.262), family support (β=-0.281) and social support (β=-0.267) were picked in the regression equation (P＜0.05), the results showed that introversion was a risk factor for ASD in patients after CABG, high degree of family support and social support were protective factors for ASD in patients after CABG. Conclusions Social support of patients after CABG needs to be improved, so as to reduce the incidence of acute stress disorder.

Acute stress symptoms and related factors of traffic accident survivors / 中国心理卫生杂志

Objective:Traffic accidents is one of the most common causes of acute stress disorder (ASD), and it will affect the health of patients.This study aimed to investigate the acute stress symptoms and related factors in traffic accident survivors.Methods:A cross-sectional survey was conducted.The general information questionnaire, Acute Stress Disorders Scale (ASDS), Patient health questionnaire-9 (PHQ-9) and Patient' s Health Questionnaire (PHQ-15) were used to investigate survivors in admission 2-30 days.Results:Fourteen survivors had acute stress symptoms in 63 (22.2％) survivors.Stepwise multiple regression analysis showed that survivors with depression, more serious physical symptoms and whether alone when the accident happened was a common experience accounted for 66.8％ of the survivors' acute stress disorder.Conclusion:This study suggests the detection of acute stress symptoms in traffic accident survivors is higher, and there is a correlation with survivors' depression, physical symptoms, and whether alone when the accident happened.Acute stress symptoms could be screened in time for survivors with depressive and severe somatic symptoms.

The Molecular Signatures of Acute-immobilization-induced Antinociception and Chronic-immobilization-induced Antinociceptive Tolerance

In the present study, the productions of antinociception induced by acute and chronic immobilization stress were compared in several animal pain models. In the acute immobilization stress model (up to 1 hr immobilization), the antinociception was produced in writhing, tail-flick, and formalin-induced pain models. In chronic immobilization stress experiment, the mouse was enforced into immobilization for 1 hr/day for 3, 7, or 14 days, then analgesic tests were performed. The antinociceptive effect was gradually reduced after 3, 7 and 14 days of immobilization stress. To delineate the molecular mechanism involved in the antinociceptive tolerance development in the chronic stress model, the expressions of some signal molecules in dorsal root ganglia (DRG), spinal cord, hippocampus, and the hypothalamus were observed in acute and chronic immobilization models. The COX-2 in DRG, p-JNK, p-AMPKα1, and p-mTOR in the spinal cord, p-P38 in the hippocampus, and p-AMPKα1 in the hypothalamus were elevated in acute immobilization stress, but were reduced gradually after 3, 7 and 14 days of immobilization stress. Our results suggest that the chronic immobilization stress causes development of tolerance to the antinociception induced by acute immobilization stress. In addition, the COX-2 in DRG, p-JNK, p-AMPKα1, and p-mTOR in the spinal cord, p-P38 in the hippocampus, and p-AMPKα1 in the hypothalamus may play important roles in the regulation of antinociception induced by acute immobilization stress and the tolerance development induced by chronic immobilization stress.

Randomized controlled study of immune nutrition in patients with acute stress / 中华急诊医学杂志

Objective To explore the effects of immune-enhanced enteral nutrition support on the clinical outcome and nutritional status of patients with acute stress.Methods From December 2014 to August 2015,120 patients with acute stress were enrolled in this study in the First Affiliated Hospital of Zhengzhou University.The patients were randomly divided into the control group and the experimental group,60 cases in each group.Besides of medical treatment,the control group received routine enteral nutrition,while the experimental group received immune-enhanced nutrition for 8 days.The main parameters related to nutritional status,immune function,blood glucose,infection control of patients were collected.Results No significance of parameters listed above were observed between patients in the two groups at baseline.After intervention,the levels of prealbumin and lymphocyte counts in the experimental group were higher than those in the control group [(162.5±29.7) mg/L and (136.6±15.1) mg/ L,(1.86±0.9) × 109/L and (1.45±0.710) × 109/L,P=0.021 and P=0.012].The levels of C-reactive protein in the experimental group were lower than those in the control group [(47.2±22.1) mg/L and (82.6±13.4) mg/L,P--0.043].Moreover,the level of blood glucose in the experimental group was lower than that in the control group [(5.4±1.7) mmol/L and (6.6±3.5) mmol/L,P=0.009].The patients in the experimental group had better intestinal tolerance (8.3％ vs 25％,P=0.014) but lower mortality (6.7％ vs 20％,P=0.032) than those in the control group.Conclusions Immune-enhanced enteral nutrition can reduce level of blood glucose and alleviate inflammatory responses of patients with acute stress,thus improving intestinal tolerance,and reducing mortality.

Three years after Typhoon Ondoy until Habagat rains: Prevalence of acute stress disorder and post-traumatic stress disorder among residents of Barangay Tumana, Marikina: A cross-sectional analytical study

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to determine the prevalence of Acute Stress Disorder and Post Traumatic Stress Disorder among residents of Barangay Tumana, Marikina exposed to Typhoon Ondoy in September 2009 and Habagat rains in August 2012.</p><p style="text-align: justify;"><strong>METHODOLOGY:</strong> The Acute Stress Disorder Scale (ASDS) and Impact of Events Scale-Revised (IESR) were administered to 212 subjects. Trauma history was also obtained. When screened positive for Acute Stress Disorder (ASD) and/or Post Traumatic Stress Disorder (PTSD), a confirmatory diagnosis was done through psychiatric clinical interview.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The study showed a prevalence rate of 10% for ASD and 5% for PTSD. Co-morbid ASD and PTSD were seen in 4% of the subjects. Frequency and type of prior traumatic events were not significantly different among subjects who were positive or negative for ASD/PTSD diagnoses.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> There was a significant prevalence of ASD/PTSD diagnoses among residents exposed to Typhoon Ondoy and Habagat, thus the need for developing a means of early detection and immediate therapeutic intervention in Filipino communities exposed to natural disasters.</p>

Effect of mindfulness music training on sleep-wakefulness behavior in patients with acute stress disorder sleep disorder with cerebral hemorrhage / 中国神经精神疾病杂志

Objective To explore the effect of mindfulness-based music therapy (MBMT) on sleep-wakefulness behavior in patients with acute stress disorder (ASD) coexisting sleep disorder with cerebral hemorrhage. Methods A total of 70 patients with cerebral hemorrhage and ASD coexisting sleep disorders were randomly divided into two groups (n=35 each group). The study group was treated with mindfulness and soothing music training on the basis of routine treatment for 28 consecutive days. The control group only received routine treatment. Polysomnography (PSG) was used to compare sleep-wake behavior before and after intervention. Results After the intervention, the numbers of awakenings, awakenings greater than 5 min, micro awakenings, NREM micro awakenings, micro awakenings in phase 1, micro awakenings in phase 2, and REM awakenings were decreased in both groups (P<0.05). The degree of reduction of those parameters were greater and the proportion of total sleep time to recording time was longer in the study group than in the control group (P<0.05). Conclusion Music therapy based on mindfulness can effectively improve the sleep-wakeful behavior of ASD patients with cerebral hemorrhage, change the sleep process, and improve their sleep quality.