Symptoms of Posttraumatic Stress Disorder and Mental Health in Women Who Escaped Prostitution and Helping Activists in Shelters

PURPOSE: This study compared the mental symptoms, especially symptoms of posttraumatic stress disorder (PTSD), of women who escaped prostitution, helping activists at shelters, and matched control subjects. MATERIALS AND METHODS: We assessed 113 female ex-prostitutes who had been living at a shelter, 81 helping activists, and 65 control subjects using self-reporting questionnaires on demographic data, symptoms related to trauma and PTSD, stress-related reactions, and other mental health factors. RESULTS: Female ex-prostitutes had significantly higher stress response, somatization, depression, fatigue, frustration, sleep, smoking and alcohol problems, and more frequent and serious PTSD symptoms than the other 2 groups. Helping activists also had significantly higher tension, sleep and smoking problems, and more frequent and serious PTSD symptoms than control subjects. CONCLUSION: These findings show that engagement in prostitution may increase the risks of exposure to violence, which may psychologically traumatize not only the prostitutes themselves but also the people who help them, and that the effects of the trauma last for a long time. Future research is needed to develop a method to assess specific factors that may contribute to vicarious trauma of prostitution, and protect field workers of prostitute victims from vicarious trauma.

Diagnosis, and Treatment of Generalized Anxiety Disorder in Primary Practice

Generalized anxiety disorder (GAD) is highly prevalent psychiatric disorder in primary care population and is a source of major morbidity. However, the underawareness and undertreatment of GAD, which is due to insufficient knowledge about the disorder, often hinder the proper management of this chronic condition. Other characteristic features such as chronic course of GAD, frequent comorbidity with other anxiety and depressive disorders, and the controversy regarding the best diagnostic criteria should be fully discussed. First of all, proper and accurate diagnosis is crucial for an appropriate management. Primary care management of GAD and associated comorbidities includes education about the nature of GAD and counseling about treatment alternatives and coping strategies is an important first step. The most effective treatment of GAD is combined psychotherapeutic and pharmacotherapeutic approach. The major psychotherapeutic approaches to GAD are cognitive-behavioral therapy with relaxation techniques. Pharmacological treatment for GAD includes benzodiazepine, buspirone, and antidepressants. In this review, these combined treatment at the view point of primary practitioners was described.

Transcranial Magnetic Stimulation Treatment in Patients with Posttraumatic Stress Disorder / 신경정신의학

OBJECTIVES: Transcranial magnetic stimulation (TMS) is a novel, noninvasive method of brain stimulation. As the knowledge of the neuroanatomical abnormalities of posttraumatic stress disorder (PTSD) has been increased, therapeutic application of TMS has been suggested in patients with PTSD. Thus we reviewed the literatures to look into the effectiveness of TMS for the treatment of PTSD. METHODS: We described the published clinical studies of TMS in patients with PTSD using literature review and our preliminary results of clinical trial for integrating the future direction of TMS research in the treatment of PTSD. RESULTS: Although the previous studies for the treatment of PTSD were scanty, TMS might be an tolerable and safe option for the intervention of PTSD. Several studies suggested that repeated rhythmic TMS (rTMS) to right prefrontal cortex might be useful for the treatment of PTSD. The accurate mechanism of rTMS has not been known yet. However, it is supposed that rTMS may have the ability to normalize brain metabolism, improve neuronal functional connectivity and modulate the neuronal circuitry in patients with PTSD. This capability has raised the possibility of the use of rTMS as a novel therapeutic tool for PTSD. CONCLUSION: In order to optimize rTMS for therapeutic use in PTSD, it is necessary to determine rTMS treatment parameters, such as frequency, intensity, pulse duration and stimulation site, pulse width, intertrain interval, coil type, numbers of sessions, and interval between sessions. rTMS would be a relatively new and noninvasive method for exploring the regional brain circuitry of PTSD.

Polymorphisms of TAP2 Gene in Schizophrenia / 신경정신의학

OBJECTIVES: The genes for transporters associated with antigen processing (TAP) are located near to HLA class II coding regions and related to antigen presentation. Therefore polymorphisms of TAP might alter the T-cell mediated immune response and influence susceptibility to schizophrenia, which is known to have alterations in T-cell immunity. The aim of this study was to verify the relationship between schizophrenia and polymorphisms of TAP2 genes. METHODS: 257 patients with schizophrenia and 184 normal controls participated in this study. TAP2 polymorphic residues at positions 379, 565 and 665 were typed using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) and single-strand conformation polymorphism (SSCP). The resulted products, TAP2379, TAP2565 and TAP2665 were assessed. RESULTS: The frequency of TAP2 alleles did not differ between patients with schizophrenia and controls. The polymorphic sites TAP2379, TAP2565 and TAP2665 did not show any difference in their amino acid substitution frequencies. CONCLUSION: This study did not show the association of the TAP2 gene with schizophrenia in Korean population. Further studies are needed to test the informative value of haplotypes including other polymorphic sites.