Levels of the potential biomarker p11 in peripheral blood cells distinguish patients with PTSD from those with other major psychiatric disorders.

Posttraumatic stress disorder (PTSD) is a severely debilitating anxiety disorder. Over 80% of patients with PTSD also exhibit other psychiatric condition, such as bipolar disorder (BP) or major depression (MDD). Previously, it has been found that p11 mRNA expression was significantly changed in post mortem cortex of patients with PTSD and depression. We hypothesize that p11 mRNA levels in the peripheral blood cells will be a potential biomarker for PTSD with heterogeneity in terms of type of trauma, time since trauma and duration of illness. We examined the peripheral blood mononuclear cell (PBMC) P11 mRNA of patients with PTSD (n=13), major depressive disorder (MDD, n=16), bipolar disorder (BP, n=24), and schizophrenia (SCZ, n=12) or controls (n=14) using quantitative real-time PCR and the circulating levels of cortisol in blood plasma and saliva of PTSD using radioimmunoassay kit CORT-CT2. The Hamilton Rating Scale for Depression (HAMD) and Anxiety (HARS), the Chinese version of the Davidson Trauma Scale-Frequency (CDTS-F) and the Chinese version of the Davidson Trauma Scale-Severity (CDTS-S), and Impact of Event Scale-Revised (IES-R) were administered. We found that patients with PTSD had lower levels of p11 mRNA than control subjects, while those with MDD, BP and SCZ had significantly higher p11 levels than the controls. P11 mRNA levels were positively correlated with the scores of HAMD (r=0.62, p<0.05), CDTS-F (r=0.71, p<0.05) and CDTS-S (r=0.62, p<0.05), while they did not correlate with scores of HARS and IES-R. Basal levels of plasma and salivary cortisol of PTSD patients were not statistically different from those of controls. Our findings suggest that PBMC p11 mRNA expression levels may serve as a potential biomarker to distinguish PTSD from BP, MDD and SCZ.

The injury profile after the 2008 earthquakes in China.

UNLABELLED: The 8.0 magnitude earthquake that struck China on May 12, 2008, was the deadliest earthquake in 30 years. Most hospitals were destroyed and limited facilities were available for medical service in the earthquake regions. Over the first 5 days, three general hospitals and one children's hospital admitted 1770 injured individuals. METHODS: We retrospectively collected data on 1770 injured subjects in three general hospitals (n=1723) and one children's hospital (n=47) in the quake-area during the first 5 days after the event. The diagnosis for the injuries was based on the final hospital diagnosis made by the physicians and classified by two-independent researchers using the International Statistical Classification of Diseases and Related Health Problems ICD-10 (WHO ICD-10 Code.1993). To ensure the accuracy of the information, any questionable data was reviewed by phone with hospital staff. RESULTS: In three general hospitals, 848 patients (48%) were male and 922 (52%) were female. Nine percent (n=84) of females and 8.8% (n=75) of males were over the age of 75. Four (0.4%) females and 5 (0.5%) males were less than 1-year old. The most common injuries were the injuries of the knee, lower leg, ankle and foot (36%), followed by head injuries (18%). In the children's hospital, 31 (65%) of the patients were males and 16 (35%) were females. 40% of the subjects were 10-14, while 21% were less than 1-year old. The most frequently seen injuries were also of the knee, lower leg, ankle or foot (19%), and of the abdomen, lower back, lumbar spine and pelvis, and hip and thigh (15%). CONCLUSIONS: We gathered information from resources in Chinese, which at the time contained more records on this event than any documents in English. The age of the patients ranged from 7 days to 84 years old. Subjects over age 75 and children between 10 and 14 were the largest population in their respective hospitals, indicating that these groups required the greatest medical resources. The injury profile presented here serves as a reference not only for present injury intervention but also for future earthquake disaster response.

Anxiety and abnormal eating behaviors associated with cyclical readiness testing in a naval hospital active duty population.

Studies of abnormal eating behaviors in active duty military personal have found rates similar to or higher than the general population. We have reviewed these studies and extended the research to examine abnormal eating behaviors in a heterogeneous population at a major military medical center. We found high rates of body dissatisfaction, abnormal eating behaviors, and worry about passing the semiannual personal fitness assessment in both men and women. Abnormal eating behaviors were associated with worrying about the personal fitness assessment, and these measures were associated with body mass index and gender. Our data extend previous research indicating that cyclic or external pressure to maintain body weight within specified standards can produce unsafe eating and dieting behaviors. We recommend changes to the current system to incorporate treatment programs aimed at recognizing and treating eating disorders with a goal of producing more fit and healthy service members.

Crisis intervention in a military population: a comparison of inpatient hospitalization and a day treatment program.

We describe transition from an inpatient psychiatric crisis intervention model to an outpatient program for nonpsychotic young adult active duty males presenting in crisis. We reviewed 300 medical records of comparable patients from each program. Demographics, clinical outcomes, and cost analysis are presented. Primary stressors were occupational and relational for both groups. Discharge diagnoses were similar with 98% patients in both groups having diagnosis adjustment disorder, personality disorder, occupational problem, or partner relational problem. Significantly more inpatients (59%) than outpatients (18%) were recommended for separation from the military for personality disorder or inability to adjust. Cost of inpatient treatment was $764 per day compared with $54.81 per day for outpatients. In the first year of operation of the outpatient program, inpatient admissions for crisis intervention in the population described declined by 195. Not only was the outpatient program much more cost-effective, it appeared to have superior clinical results.