Effects of eye movement desensitization and reprocessing on ICU memory and post-traumatic stress disorder among patients with ventilator associated pneumonia / 中国实用护理杂志

Objective:To investigate eye movement desensitization and reprocessing on ICU memory and post-traumatic stress disorder among patients with ventilator associated pneumonia.Methods:Totally, 66 cases of ICU patients with ventilator associated pneumonia enrolled at Guangzhou Red Cross Hospital from August 2017 to August 2020 were collected as research object, they were randomly divided into intervention group and control group, with 33 cases in each groups. The control group received routine nursing care and cognitive training, in the intervention group, patients implemented EMDR therapy for 8 times. Before and after intervention, the effect was assessed by ICU memory scale and PTSD Checklist-Civilian Version, respectively.Results:After intervention, the scores of factual memories, emotional memories, delusional memories dimension and total ICUMS were (19.48±5.14), (10.45±2.62), (7.06±2.62) and (37.00±6.12) in the intervention group, those scores in the control group were (24.58±7.38), (13.58±4.07), (9.48±3.57) and (47.64±9.99), the difference was statically significant (t values were 3.14-5.22, all P<0.05). The re-experiencing, avoidance, hyperarousal dimensions scores and total PCL-C scores were (8.09±2.13), (10.42±2.62), (7.24±2.69) and (25.76±4.25) in the intervention group, and in the control group those scores were (9.30±2.35), (12.73±2.11), (9.24±2.51) and (31.27±4.97), the difference was statically significant (t values were 2.20-4.85, all P<0.05). Conclusions:Eeye movement desensitization and reprocessing therapy can effectively alleviate ICU memory and improve PTSD symptoms of patients with ventilator associated pneumonia.

Estrés post-traumático en la atención de emergencias y rescates / Post-traumatic stress disorder in emergency response

Introducción: Los trabajadores de emergencias están expuestos a situaciones potencialmente traumáticas, por lo que sería de interés evidenciar si existe relación entre dichos profesionales y el Trastorno de Estrés Postraumático (TEPT). Nuestro objetivo es conocer si existe evidencia de relación causal entre el desarrollo de TEPT y ser profesional de rescate, además de identificar factores de vulnerabilidad asociados e intervenciones preventivas y terapéuticas eficaces. Método: Revisión sistemática mediante búsquedas bibliográficas en MEDLINE en bases de datos PUBMED, SCOPUS, EMBASE, WOS, Cochrane Library Plus, IBECS, LILACS y CISDOC, usando términos MeSH «emergency responders» y «stress disorder, post-traumatic». Se aplicaron estándares de calidad CONSORT, STROBE y comprobamos la evidencia mediante el sistema SIGN. Resultados: Se seleccionaron 6 ECA (n=783) y 1 estudio de cohortes históricas (n=4487). Se describen como factores de riesgo más frecuentes: sexo femenino 2.93(1.42-6.07), diagnóstico de depresión o ansiedad 4.72(2.33-9.57) en cronicidad y abuso de sustancias 5.12(2.62-9.97) en empeoramiento del TEPT. No hay mejoras en las intervenciones preventivas (p=0.712-0.749) y (p=0.246-0.881). En 2 ECA se evidenció una reducción en la gravedad de los síntomas del TEPT mediante Terapia Cognitivo Conductual (TCC) (p=0.001 y 0.05). Existen 2 ECA con oxitocina que revelan impacto en regiones neurales para gestión emocional (p=0.0024-0.044). Conclusiones: Existe relación causal entre el TEPT y los trabajadores de emergencias (evidencia 2+). Como tratamiento, la TCC resulta efectiva para la reducción de síntomas de TEPT (evidencia 1+). Se mostraron como principales los factores de vulnerabilidad antes mencionados (evidencia 1+). La oxitocina mostró evidencia como aliado terapéutico (evidencia 1+). (AU)

Introduction: Emergency workers are exposed to potentially traumatic situations, so it would be of interest to show whether there is a relationship between these professionals and the development of Post-Traumatic Stress Disorder (PTSD). The aim is to know if there is evidence of such relationship, in addition to identify associated vulnerability factors and effective preventive and therapeutic interventions. Method: Systematic review through bibliographic research in MEDLINE in PUBMED, SCOPUS, EMBASE, WOS, Cochrane Library Plus, IBECS, LILACS and CISDOC databases, using MeSH terms «emergency responders» and «stress disorder, post-traumatic». CONSORT, STROBE quality standards were applied and we checked the evidence using the SIGN system. Results: They were selected 6 RCTs (n = 783) and 1 historical cohort study (n = 4487). The most frequent risk factors are: female sex 2.93 (1.42-6.07), diagnosis of depression or anxiety 4.72 (2.33-9.57) in chronicity and substance abuse 5.12 (2.62-9.97) in worsening of PTSD. There are no improvements in preventive interventions (p = 0.712-0.749) and (p = 0.246-0.881). In 2 RCTs, a reduction in the severity of PTSD symptoms was evidenced by Cognitive Behavioral Therapy (CBT) (p = 0.001 and 0.05). There are 2 RCTs with oxytocin that reveal an impact on neural regions for emotional management (p = 0.0024-0.044). Conclusions: There is a causal relationship between PTSD and emergency workers (evidence 2+). As a treatment, CBT is effective in reducing PTSD symptoms (evidence 1+). The aforementioned vulnerability factors were shown as the most important (evidence 1+). Oxytocin showed evidence as a therapeutic ally (evidence 1+). (AU)

Role and Mechanism of Intestinal NDRG2 Mediating Visceral Hypersensitivity Following Exposure to PTSD / 胃肠病学

Background: Visceral hypersensitivity is considered as a key pathophysiological mechanism involved in functional gastrointestinal disorders (FGIDs). Visceral nociception and hyperalgesia is existed extensively following exposure to post-traumatic stress disorder (PTSD), however, its molecular mechanism in intestinal tract is unclear. Aims: To explore the potential role of N-Myc downstream-regulated gene 2 (NDRG2) in intestinal tract for mediating visceral hypersensitivity following exposure to PTSD. Methods: PTSD model was established by single prolonged stress (SPS). SD rats were divided into normal control group, CTX group, PTSD group and PTSD+CTX group. Mice were divided into normal control group, PTSD group, NDRG2

Predictors of posttraumatic stress following transient ischemic attack: An observational cohort study.

OBJECTIVE: Transient ischemic attack (TIA) has been reported to be frequently followed by symptoms of post-TIA posttraumatic stress disorder (post-TIA PTSD). Risk factors for post-TIA PTSD remain largely unknown. We aimed to identify predictors of post-TIA PTSD development to enable post-TIA PTSD risk assessment and inform future development of treatment and prevention interventions. METHOD: TIA patients were examined twice for this observational cohort study. Symptoms of post-TIA PTSD, depression and anxiety were assessed shortly after TIA during in-hospital stay (T1) and three months after TIA (T2). The impact of known general PTSD risk factors (psychiatric history, peritraumatic dissociation, social support), psychological resilience factors (sense of coherence, mindfulness, attachment style) and TIA characteristics (affected circulatory territory, symptom type and duration) at T1 on post-TIA PTSD symptom severity at T2 was tested using hierarchical multiple linear regression. RESULTS: Sixty-one patients (83.6%) completed the study at T2. Fifteen patients (24.6%) were classified as post-TIA PTSD⊕ at T2. In multiple linear regression analysis, age, sex, psychiatric history, peritraumatic dissociation and social support together explained 39.9% of variance of post-TIA posttraumatic stress symptom severity. Sense of coherence and mindfulness explained further 17.8% of variance. Clinical TIA characteristics were not associated with post-TIA PTSD. CONCLUSIONS: Post-TIA PTSD is a common phenomenon. General PTSD risk factors can be applied for post-TIA PTSD risk assessment. Sense of coherence and mindfulness are promising target variables for post-TIA PTSD treatment and prevention interventions.

[Mental health survey of medical staff in a tertiary infectious disease hospital for COVID-19].

Objective: To investigate the mental health of clinical first-line medical staff in COVID-19 epidemic and provide theoretical basis for psychological intervention. Methods: The mental health status of the first-line medical staff was investigated by Self-rating Anxiety Scale(SAS) and Post-Traumatic Stress Disorder Self- rating Scale (PTSD-SS). From February 7 to 14, 2020, 246 medical staff participated in the treatment of COVID-19 were investigated using cluster sampling, and received 230 responses, with a recovery rate of 93.5%. Results: The incidence of anxiety in medical staff was 23.04% (53/230) , and the score of SAS was(42.91±10.89). Among them, the incidence of severe anxiety, moderate anxiety and mild anxiety were 2.17%(5/230) , 4.78%(11/230) and 16.09%(37/230) , respectively. The incidence of anxiety in female medical staff was higher than that in male [25.67%(48/187) vs 11.63%(5/43) , Z=-2.008, P=0.045], the score of SAS in female medical staff was higher than that in male [(43.78±11.12) vs (39.14±9.01) , t=-2.548, P=0.012]. The incidence of anxiety in nurses was higher than that in doctors[26.88% (43/160) vs 14.29% (10/70) , Z=-2.066, P=0.039], and the score of SAS in nurses was higher than that in doctors [ (44.84±10.42) vs (38.50±10.72) , t=-4.207, P<0.001]. The incidence of stress disorder in medical staff was 27.39% (63/230) , and the score of PTSD-SS was (42.92±17.88) . The score of PTSD-SS in female medical staff was higher than that in male[ (44.30±18.42) vs (36.91±13.95) , t=-2.472, P=0.014]. Conclusion: In COVID-19 epidemic , the incidence of anxiety and stress disorder is high among medical staff. Medical institutions should strengthen the training of psychological skills of medical staff. Special attention should be paid to the mental health of female nurses.

Structural and Resting-State Brain Alterations in Trauma-Exposed Firefighters: Preliminary Results.

Purpose: To analyze the altered brain regions and intrinsic brain activity patterns in trauma-exposed firefighters without posttraumatic stress disorder (PTSD). Materials and Methods: Resting-state functional MRI (rsfMRI) was performed for all subjects. Thirty-one firefighters over 40 years of age without PTSD (31 men; mean age, 49.8 ± 4.7 years) were included. Twenty-six non-traumatized healthy controls (HCs) (26 men; mean age, 65.3 ± 7.84 years) were also included. Voxel-based morphometry was performed to investigate focal differences in the brain anatomy. Seed-based functional connectivity analysis was performed to investigate differences in spontaneous brain characteristics. Results: The mean z-scores of the Seoul Verbal Learning Test for immediate and delayed recall, Controlled Oral Word Association Test (COWAT) score for animals, and COWAT phonemic fluency were significantly lower in the firefighter group than in the HCs, indicating decreased neurocognitive function. Compared to HCs, firefighters showed reduced gray matter volume in the left superior parietal gyrus and left inferior temporal gyrus. Further, in contrast to HCs, firefighters showed alterations in rsfMRI values in multiple regions, including the fusiform gyrus and cerebellum. Conclusion: Structural and resting-state functional abnormalities in the brain may be useful imaging biomarkers for identifying alterations in trauma-exposed firefighters without PTSD.

Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19 / 中华劳动卫生职业病杂志

Objective To investigate the mental health of clinical first-line medical staff in COVID-19 epidemic and provide theoretical basis for psychological intervention. Method The mental health status of the first-line medical staff was investigated by Self-rating Anxiety Acale (SAS) and Post-Traumatic Stress Disorder Self-rating Scale(PTSD-SS). From February 7 to 14, 2020, 246 medical staff were investigated who participated in the treatment of COVID-19 using cluster sampling , and received 230 responses, with a recovery rate of 93.5%. Results The incidence of anxiety in medical staff was 23.04% (53/230), and the score of SAS was (42.91 ± 10.89). Among them, the incidence of severe anxiety, moderate anxiety and mild anxiety were 2.17% (5/230), 4.78% (11/230) and 16.09% (37/230), respectively. The incidence of anxiety in female medical staff was higher than that in male [25.67% (48/187) vs 11.63% (5/43), Z =-2.008, P =0.045], the score of SAS in female medical staff was higher than that in male [(43.78±11.12) vs (39.14 ± 9.01), t =-2.548, P =0.012]. The incidence of anxiety in nurses was higher than that in doctors [26.88% (43/160) vs 14.29% (10/70), Z =-2.066, P =0.039], and the score of SAS in nurses was higher than that in doctors [(44.84±10.42) vs (38.50±10.72), t =-4.207, P <0.001]. The incidence of stress disorder in medical staff was 27.39% (63/230), and the score of PTSD-SS was (42.92 ± 17.88). The score of PTSD-SS in female medical staff was higher than that of male [(44.30±18.42) vs (36.91 ± 13.95), t =-2.472, P =0.014]. Conclusions In COVID-19 epidemic, the incidence of anxiety and stress disorder is high among medical staff. Medical institutions should strengthen the training of psychological skills of medical staff. Special attention should be paid to the mental health of female nurses.

Relationships among Traumatic Experiences, Posttraumatic Stress Symptoms, and Mental Health-related Characteristics in Young Adults / 정신간호학회지

PURPOSE: The purpose of this study was to investigate the level of traumatic experiences, posttraumatic stress symptoms and mental health-related characteristics in young adults and identify relationships among the variables. METHODS: In this descriptive cross-sectional study, data were collected through a Web-based survey (N=568). Structured instruments included valid measures of traumatic experiences, posttraumatic stress symptoms, depression, somatization symptoms, insomnia, and alcohol use. Collected data were analyzed using descriptive statistics, t-tests, χ2 tests, ANOVA, and Pearson correlation coefficient with SPSS statistics 23. RESULTS: Among study participants, 76.8% reported traumatic experiences. The severity of trauma was associated with high levels of posttraumatic stress symptoms, depression, somatization symptoms, insomnia, and alcohol use. Women showed more severe posttraumatic stress and depressive symptoms than men. There were positive correlations for trauma experiences with posttraumatic stress symptoms, depression, somatization symptoms, and insomnia. CONCLUSION: Findings indicate the need to develop nursing intervention programs to relieve posttraumatic stress symptoms and improve mental health related characteristics targeting young adults, and to establish a national policy that addresses characteristics of trauma experienced in Korea.

Neuroticism-related personality traits are associated with posttraumatic stress after abortion: findings from a Swedish multi-center cohort study.

BACKGROUND: Most women who choose to terminate a pregnancy cope well following an abortion, although some women experience severe psychological distress. The general interpretation in the field is that the most consistent predictor of mental disorders after induced abortion is the mental health issues that women present with prior to the abortion. We have previously demonstrated that few women develop posttraumatic stress disorder (PTSD) or posttraumatic stress symptoms (PTSS) after induced abortion. Neuroticism is one predictor of importance for PTSD, and may thus be relevant as a risk factor for the development of PTSD or PTSS after abortion. We therefore compared Neuroticism-related personality trait scores of women who developed PTSD or PTSS after abortion to those of women with no evidence of PTSD or PTSS before or after the abortion. METHODS: A Swedish multi-center cohort study including six Obstetrics and Gynecology Departments, where 1294 abortion-seeking women were included. The Screen Questionnaire-Posttraumatic Stress Disorder (SQ-PTSD) was used to evaluate PTSD and PTSS. Measurements were made at the first visit and at three and six month after the abortion. The Swedish universities Scales of Personality (SSP) was used for assessment of Neuroticism-related personality traits. Multiple logistic regression analyses were performed to investigate the risk factors for development of PTSD or PTSS post abortion. RESULTS: Women who developed PTSD or PTSS after the abortion had higher scores than the comparison group on several of the personality traits associated with Neuroticism, specifically Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility and Embitterment. Women who reported high, or very high, scores on Neuroticism had adjusted odds ratios for PTSD/PTSS development of 2.6 (CI 95% 1.2-5.6) and 2.9 (CI 95% 1.3-6.6), respectively. CONCLUSION: High scores on Neuroticism-related personality traits influence the risk of PTSD or PTSS post abortion. This finding supports the argument that the most consistent predictor of mental disorders after abortion is pre-existing mental health status.

Predictors of Anxiety and PTSD in Battered Women / 성인간호학회지

PURPOSE: The purpose of this study is to examine predictors of anxiety and PTSD in battered women. METHOD: The data were collected from 555 women who were stratified samples according to 15,000:1 from a target population in Korea from November 18, 2004 to February 18, 2005. The data was analysed using the SPSS program. RESULTS: Predictors of anxiety were self esteem, stress, state anger, social support, trait anger, negotiation, and psychological violence. These variables explained 55.8% of anxiety. Predictors of PTSD were self esteem, state anger, trait anger, psychological violence, stress, and anger-in. These variables explained 43.2% of PTSD. CONCLUSION: It is considered that the importance of separating the effects of the different types of violence when taking into account its effects on women's mental health. To promote women's mental health, it is needed to develop self esteem improvement programs, and anger and stress management programs.

Serum Lipid Concentrations in Croatian Veterans with Post-traumatic Stress Disorder, Post-traumatic Stress Disorder Comorbid with Major Depressive Disorder, or Major Depressive Disorder

The aim of this study was to assess eventual differences in serum cholesterol, low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDLC), triglycerides, LDL-C/HDL-C ratio between veterans with combat-related posttraumatic stress disorder (PTSD) only or comorbid with major depressive disorder (MDD), veterans with combat experiences with MDD, and healthy control group. PTSD and/ or MDD were diagnose according to structured clinical interview based on DSM-IV criteria. Additional criteria to diagnose PTSD were Clinician Administered PTSD Scale (CAPS), and to diagnose MDD Montgomery-Asberg Depression Rating Scale (MADRAS). Serum lipid concentrations were determined by using the enzyme-assay method. Veterans with combat-related PTSD as well as veterans with combat-related PTSD comorbid with MDD showed significantly higher concentrations of cholesterol (F=9.858, p<0.01), triglycerides (F=10.112, p<0.01), LDL-C (F=11.145, p<0.01), and LDL-C/HDL-C ratio (F=8.346, p<0.01) vs. veterans with MDD or healthy control group. Contrary healthy control group and veterans with MDD showed significantly higher concentrations of HDL-C (F=8.421, p<0.01), vs. veterans with PTSD or PTSD comorbid with MDD. In conclusion, there are no differences in serum lipid concentrations between veterans with combat-related PTSD and PTSD comorbid with MDD, but they have higher lipid concentrations than veterans with MDD or healthy control subjects.