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PURPOSE@#Posttraumatic stress disorder (PTSD) is a significant global mental health concern, especially in the military. This study aims to estimate the efficacy of mindfulness meditation in the treatment of military-related PTSD, by synthesizing evidences from randomized controlled trials.@*METHODS@#Five electronic databases (Pubmed, EBSCO Medline, Embase, PsychINFO and Cochrane Library) were searched for randomized controlled trials focusing on the treatment effect of mindfulness meditation on military-related PTSD. The selection of eligible studies was based on identical inclusion and exclusion criteria. Information about study characteristics, participant characteristics, intervention details, PTSD outcomes, as well as potential adverse effects was extracted from the included studies. Risk of bias of all the included studies was critically assessed using the Cochrane Collaboration's tool. R Statistical software was performed for data analysis.@*RESULTS@#A total of 1902 records were initially identified and screened. After duplicates removal and title & abstract review, finally, 19 articles in English language with 1326 participants were included through strict inclusion and exclusion criteria. The results revealed that mindfulness meditation had a significantly larger effect on alleviating military-related PTSD symptoms compared with control conditions, such as treatment as usual, present-centered group therapy and PTSD health education (standardized mean difference (SMD) = -0.33; 95% CI [-0.45, -0.21]; p < 0.0001). Mindfulness interventions with different control conditions (active or non-active control, SMD = -0.33, 95% CI [-0.46, -0.19]; SMD = -0.49, 95% CI [-0.88, -0.10], respectively), formats of delivery (group-based or individual-based, SMD = -0.30, 95% CI [-0.42, -0.17], SMD = -0.49, 95% CI [-0.90, -0.08], respectively) and intervention durations (short-term or standard duration, SMD = -0.27, 95% CI [-0.46, -0.08], SMD = -0.40, 95% CI [-0.58, -0.21], respectively) were equally effective in improving military-related PTSD symptoms.@*CONCLUSION@#Findings from this meta-analysis consolidate the efficacy and feasibility of mindfulness meditation in the treatment of military-related PTSD. Further evidence with higher quality and more rigorous design is needed in the future.
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There has been a long history since human beings began to realize the existence of post-traumatic symptoms. Posttraumatic stress disorder (PTSD), a diagnostic category adopted in 1980 in the Diagnostic and Statistical Manual of Mental Disorders-Ⅲ, described typical clusters of psychiatric symptoms occurring after traumatic events. Abundant researches have helped deepen the understanding of PTSD in terms of epidemiological features, biological mechanisms, and treatment options. The prevalence of PTSD in general population ranged from 6.4% to 7.8% and was significantly higher among groups who underwent major public traumatic events. There has been a long way in the studies of animal models and genetic characteristics of PTSD. However, the high comorbidity with other stress-related psychiatric disorders and complexity in the pathogenesis of PTSD hindered the effort to find specific biological targets for PTSD. Neuroimage was widely used to elucidate the underlying neurophysiological mechanisms of PTSD. Functional MRI studies have showed that PTSD was linked to medial prefrontal cortex, anterior cingulate cortex and sub-cortical structures like amygdala and hippocampus, and to explore the functional connectivity among these brain areas which might reveal the possible neurobiological mechanism related to PTSD symptoms. For now, cognitive behavior therapy-based psychotherapy, including combination with adjunctive medication, showed evident treatment effects on PTSD. The emergence of more effective PTSD pharmacotherapies awaits novel biomarkers from further fundamental research. Several natural disasters and emergencies have inevitably increased the possibility of suffering from PTSD in the last two decades, making it critical to strengthen PTSD research in China. To boost PTSD study in China, the following suggestions might be helpful: (1) establishing a national psychological trauma recover project, and (2) exploring the mechanisms of PTSD with joint effort and strengthening the indigenized treatment of PTSD.
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To evaluate the therapeutic effect of Potentilla discolor on 2,4,6-trinitrobenzensulfonic acid(TNBS)-induced experimental ulcerative colitis(UC) in rats and to determine its therapeutic mechanism through mitochondrial autophagy, immune cells, and cytokines. A rat model of UC was established by TNBS-ethanol enema. Rats were divided into six groups: control, UC model, sulfasalazine(positive drug), and high-dose, moderate-dose, and low-dose ethanol extract groups. After 14-day continuous administration of the corresponding drugs, the disease activity index(DAI) and hematoxylin and eosin(HE) were evaluated. The morphological structure of mitochondria was observed by using transmission electron microscope(TEM), mitophagy-related mRNA expression was detected by using Real-time quantitative polymerase chain reaction(qRT-PCR), immune cell differentiation in rat serum was detected by using flow cytometry(FCM), and cytokine expression in colon tissues of rats was detected by protein microarray. The results showed that compared with the model group, each dose group of P. discolor could significantly reduce the DAI of UC model rats, and decrease the degree of inflammatory cells infiltration in the colon tissue of UC model rats. Meanwhile the expressions of T cells and Th cells in the serum increased significantly, the expression of Tc cells in the serum decreased significantly. Transmission electron microscope found that there was fusion of mitochondria and lysosomes in the colon tissue of the administration group. The expressions of mitochondrial autophagy related genes NF-κB, p62 and parkin were significantly increased in colon tissues. The results of protein chip showed that compared with the model group, the high dose group of P. discolor could significantly regulate the expression of cytokines. In conclusion, these results suggested that P. discolor improved TNBS-induced acute ulcerative colitis in rats by regulating the mitochondrial autophagy and the inflammatory factor expression.
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Animais , Ratos , Autofagia , Colite Ulcerativa/genética , Colo , Mitocôndrias , Potentilla/genéticaRESUMO
Post-traumatic stress disorder (PTSD) is an anxiety disorder that develops usually in response to an overwhelmingly terrifying or a life-threatening event.The symptoms including intrusion,flashback,re-experiencing,hyperarousal and avoidance can seriously impair the cognitive functions.At present,the researches have found PTSD patients had the difficulty in retrieving autobiographical memory and narrative disorder,attention bias toward traumatic stimulus and intellectual decline.Decrease in hippocampus and amygdala's volumes,excess endoplasmic reticulum stress,medial prefrontal cortex's low activation and highly excited response of the amygdala to the traumatic stimulus may be the neural mechanisms of cognitive abnormalities.Indepth research on cognitive abnormalities provides directions for PTSD prevention and treatment,and the cognitive treatment by prolonged exposure and attention control may be the effective method.
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Objective To investigate the sleep quality and personality of staffs suffering long-term chronic stress. Methods A total of 100 staffs working in a showcase unit in Shanghai for over 1 year (with long-term chronic stress) were assessed with Pittsburgh sleep quality index (PSQI), Eysenck personality questionnaire (EPQ) and sel-rating symptom scale (SCL-90). The sleep quality and mental health status were compared between staffs with different personalities. Results Totally 97 valid questionnaires were collected and the valid response rate was 97%. (1) Under long-term chronic stress the mean score of PSQI was (2. 76±1. 85) for the 97 staffs, and 18. 6% (18/97) of them had sleeping disorders (PSQI ≥5). taffs of different genders, ages, educational backgrounds and seniorities showed no significant difference in sleeping disorder incidence (P>0. 05). (2) The psychoticism and neuroticism scores of EPQ in the 97 staffs were significantly lower than the norms, while their extraversion-introversion dimension of EPQ was significantly higher than the norms (P<0. 05). (3) The emotion stable staffs (66) had significantly lower PSQI and SCL-90 scores compared with the intermediate staffs (31, P< 0. 05); the extravert staffs (72) also had significantly lower PSQI and SCL-90 scores compared with the intermediate staffs (25, P<0. 05). (4) Compared with the norms, the total scores and the scores of somatization, obsessive-compulsive, interpersonal relationship, depression, anxiety, hostility, phobic anxiety, and paranoid ideation of SCL-90 were significantly lower in staffs under long-term chronic stress (P<0. 05). (5) It showed that the score of extraversion-introversion dimension of EPQ was negatively correlated with the scores of obsessive-compulsive, interpersonal relationship, depression, anxiety, phobic anxiety, paranoid ideation and psychoticism factors of SCL-90, while the neuroticism score of EPQ was positively correlated withall factors of SCL-90 (P<0. 05). Conclusion The prevalence of sleep disorder of staffs under the long-term chronic stress is 18. 6% in our study. The personality of staffs under the long-term chronic stress is extravert and emotionally stable. Staffs with extravert personality and stable type are less likely to have psychological and sleep quality problems.