Cognitive deficits and memory disturbances in patients with chronic post-traumatic stress disorder

Some studies have demonstrated high cognitive deficits in patients with post-traumatic stress disorder [PTSD]. Considering the limited available information about this issue, we decided to assess the cognitive deficits and memory disturbances in these patients. The present study is a case control research conducted on 50 patients with post-traumatic stress disorder who were admitted to Ibn-e-Sina psychiatric hospital in Mashhad, in north-eastern part of Iran in 2008. The control group included 50 people of first degree relatives of these patients who met the inclusion criteria of the study. Case and control groups were selected by simple sampling method; and for all of them, a questionnaire of demographic information, Wechsler memory scale, and mini mental status examination [MMSE] were completed. The gathered data were analyzed using SPSS 14th edition by chi square, t-test, and analyze of variance. The mean score of Wechsler memory scale in patients with PTSD [80.78 +/- 18.39] was significantly higher than control group [67.92 +/- 7.38] [p=0.001]. The mean score of MMSE was significantly lower in patients with PTSD compared to control group [p=0.001]. The determined disability level assessed by Iranian veterans' organization and also comorbidity of other psychiatric disorders with PTSD did not have a significant relationship with cognitive deficits, but the duration of PTSD and age of patients were significantly related to the level of cognitive deficits. Cognitive deficits and memory disturbances are higher in patients with PTSD than general population.

Haloperidol versus risperidone: a comparison of beneficial effect on cognitive function of patients with chronic schizophrenia

The current study was performed to evaluate the cognitive improvements of the chronic schizophrenic patients treated with risperidone in comparison with those treated with haloperidol according to Wisconsin Card Sorting Test [WCST]. In a double blind clinical trial, 65 patients with a diagnosis of chronic schizophrenia were randomly allocated into two groups. They received a 7 days washout and then during an eight weeks period one group was treated with risperidone 4-8 mg daily while patients in the other group received haloperidol 10-15 mg daily. Patients of the two groups were assessed by positive and Negative Syndrome Scale [PANSS] and Brief Psychiatric Rating Scale [BPRS]. Patients' cognitive abilities were assessed by WCST. Treatment side effects were also evaluated in both groups. The overall PANSS score, the scores of the positive and negative subscales and BPRS scores revealed that risperidone was significantly superior to haloperidol in the treatment of psychotic symptoms [p<0.001]. Risperidone caused less marked dyskinetic side effects in comparison with halopridol [p<0.001]. Haloperidol produced more symptoms of parkinsonism and tardive dykinesa than risperidone. The positive cognitive effect of risperidone was significantly better than haloperidol at 4[th] [p<0.001] and 8[th] [p<0.001] weeks. Apart from being more effective in improving positive and negative symptoms of psychotic disorders, risperidone is also more beneficial in reducing the symptoms of cognitive impairment in chronic and long standing form of schizophrenia. It also seems to be better tolerated than haloperidol

Post-traumatic strees disorder and related orthopedic traumas

The purpose of this study was to determine the prevalence of posttraumatic stress disorder among patients visited following an orthopedic traumatic injury and to identify changes in vital signs and demographic variables associated with the disorder. Descriptive study. The study was done on one hundred patients admitted to outpatient orthopedic clinic in Imam Reza Hospital [Mashhad, IRAN]. The study was carried out during spring and summer of 2006. Upon admission, demographic information, pain intensity according to patient's sense, pulse rate, blood pressure were assessed and General Health Questionnaire-28 was filled for the patients. Then symptoms of PTSD were evaluated on the beginning and after one and three months follow up based on DSM-IV criteria. The initial data from the patients developing PTSD after one and three months were compared with those without the disease. After one month, 5 patients [8.3%] and after three months 6 patients [12.8%] had complete PTSD criteria and 10 patients [16.7%] after one month and 6 patients [12.8%] after three months developed subsyndromal PTSD. Presence of high pulse rate [P=0.000], high intensity of the tolerated pain [p=0.000], more somatization symptoms [p=0.041] and more anxiety symptoms [p=0.039] predicted the development of PTSD after one month and presence of high pulse rate [P=0.000], high intensity of the tolerated pain [P=0.000], high maximum blood pressure [P=0.047], more somatization symptoms [P=0.019] and more anxiety symptoms [P=0.024] predicted the development of PTSD after three months. High Blood Pressure, pulse rate and pain as well as more anxiety and somatization symptoms upon experience of trauma may increase rate of PTSD in sever orthopedic patients