scholarly journals Treatment of Post-Traumatic Stress Disorders with the Alpha-1 Adrenergic Antagonist Prazosin

2016 ◽  
Vol 62 (3) ◽  
pp. 186-198 ◽  
Author(s):  
Philippe Yves Rémy Simon ◽  
Pierre-François Rousseau
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Stress Disorders ◽  
Present Review ◽  
Pharmacologic Treatment ◽  
Post Traumatic Stress ◽  
Adrenergic Antagonist ◽  
Significant Difference ◽  
Post Traumatic

Objective: The present review aims to assess the clinical efficacy and safety of the α-1-adrenergic antagonist prazosin as primary pharmacologic treatment for post-traumatic stress disorder (PTSD). Method: A systematic review was performed using keywords (i.e., prazosin, α-1-adrenergic antagonist, α-1-blocker, post-traumatic stress disorder) in the databases PubMed/Medline (1966–May 2016), Embase (1966–May 2016), ScienceDirect (1823–May 2016), OvidSP (1946–May 2016) and Nature (1845–May 2016). To be considered for inclusion, studies had to test the efficacy of prazosin either alone or added to ongoing treatment in adults with PTSD, use validated tools to assess and monitor the disorders, allow comparisons on the basis of univariate analyses (i.e., p-values of t-tests and effect sizes) and list the identified adverse reactions. Results: 12 studies were included: 5 randomized controlled trials, 4 open-label prospective trials and 3 retrospective file reviews. The evaluation concerned 276 patients exposed to civilian trauma (19%) or war trauma (81%). Prazosin significantly decreases trauma nightmares, avoidance, hypervigilance and improves patient status in all studies. No significant difference of blood pressure was observed at the end of trials. Conclusions: Beyond the methodological and clinical biases of these studies, the present review not only confirms the effectiveness and good tolerability of prazosin, but also suggests its possible use as primary pharmacologic treatment for PTSD. Uncertainties remain, however, regarding the prescription modalities and dosages.

scholarly journals Investigation of relationship between post-traumatic stress disorder and quality of life among firefighters in Birjand City at 2018

2020 ◽  
Author(s):  
M Sadeghi khorashad ◽  
E Rezaieyan ◽  
A Abdolahnezhad
Keyword(s):  
Quality Of Life ◽  
Statistical Analysis ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Stress Disorders ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Post Traumatic

Introduction: Firefighters are at high risk of developing post-traumatic stress disorder (PTSD), and that Quality of Life (QoL) is seriously compromised in individuals who have PTSD. This study was designed to assess the relationship between post-traumatic stress disorders and quality of life among firefighters. Materials and Methods: In this analytical and cross-sectional study, all firefighters in Birjand city were selected by census method (N = 96) in 2018. PTSD and QoL status was assessed by the Persian version of the Mississippi (Eshel) and WHOQOL-BREF questionnaires, respectively. Using Cronbach's α, the Iranian version of these two scales' internal reliability has been reported to be 0.92 and more than 0.7, respectively. Data analysis using SPSS software version 21 and independent T-test, ANOVA, Tukey's test, and Pearson correlation coefficient were used for statistical analysis. Results: The results showed that most firefighters (70.5%) were suffered from moderate PTSD symptoms (79.2± 11.7). Based on the self-report scale, 53.7% of the firefighters rated their quality of life as Good, and 43.2% of the firefighters were satisfied with their health. Statistical analysis showed that there is a statistically significant inverse relationship between PTSD score and areas of mental health (P = 0.03), social relations (P = 0.002), and environmental health (P = 0.004). Between PTSD score and physical health, no statistically significant relationship was found (P = 0.08). Conclusion: This study has proven a high rate of PTSD among firefighters and its negative correlation with the quality of their life. However, most firefighters rated their health and quality of life as good. Implementing strategies to combat mental disorders among firefighters improves the quality of their life and increases their job productivity.

scholarly journals Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis

2014 ◽  
Vol 204 (5) ◽  
pp. 335-340 ◽  
Author(s):  
Eva Alisic ◽  
Alyson K. Zalta ◽  
Floryt van Wesel ◽  
Sadie E. Larsen ◽  
Gertrud S. Hafstad ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Mental Health Treatment ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Interpersonal Trauma ◽  
Post Traumatic Stress ◽  
Significant Difference ◽  
Post Traumatic

BackgroundIt is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma.AimsTo determine the incidence of PTSD in trauma-exposed children and adolescents as assessed with well-established diagnostic interviews and to examine potential moderators of the estimate.MethodA systematic literature search identified 72 peer-reviewed articles on 43 independent samples (n = 3563). Samples consisting only of participants seeking or receiving mental health treatment were excluded. Main analyses involved pooled incidence estimates and meta-analyses of variance.ResultsThe overall rate of PTSD was 15.9% (95% CI 11.5–21.5), which varied according to the type of trauma and gender. Least at risk were boys exposed to non-interpersonal trauma (8.4%, 95% CI 4.7–14.5), whereas girls exposed to interpersonal trauma showed the highest rate (32.9%, 95% CI 19.8–49.3). No significant difference was found for the choice of assessment interview or the informant of the assessment.ConclusionsResearch conducted with the best available assessment instruments shows that a significant minority of children and adolescents develop PTSD after trauma exposure, with those exposed to interpersonal trauma and girls at particular risk. The estimates provide a benchmark for DSM-5 and ICD-11.

scholarly journals Psychological rehabilitation of participants of anti-terrorist operation: mechanism of supply

HUMANITARIUM ◽  
2019 ◽  
Vol 41 (1) ◽  
pp. 168-178
Author(s):  
Yulianna Yasenchuk
Keyword(s):  
Social Support ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Stress Disorders ◽  
Rehabilitation Services ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Military ◽  
The Impact

The article outlines the main aspects of provision of rehabilitation services for servicemen and participants in the antiterrorist operation. The concept of psychological rehabilitation in the context of a systematic approach is considered in details and its main features are formed. Special attention is paid to the study of previous work, to the mechanism of providing rehabilitation services to all servicemen. In the context of the current tasks, the legal base on this issue, the approved and priority initiatives was investigated. The most frequent distribution among the demobilized soldiers of antiterrorist operation is occupied by people with the main characteristics of post-traumatic stress disorder. The percentage correlation with such features in 2015-2017 was investigated and the main aspects of the mechanism of ensuring the full maintenance of social support were formed.Military actions and the conduct of the antiterrorist operation led to increase in the number of psychological stress disorders among the military. In the course of work we managed to find out that since the beginning of the antiterrorist operation and to date, the system of psychological rehabilitation of the military is gradually improving, but the question remains its effective functioning and compliance with world standards.After returning to a peaceful life, soldiers should be involved in rehabilitation activities and receive comprehensive complex rehabilitation in accordance with individual programs.The question was also raised on the issue of soldiers with post-traumatic stress, who had undergone rehabilitation and rehabilitation and required long-term social support. The most effective in reducing the impact of post-traumatic stress disorder is the integration of the soldiers’ negative experience in order to use it for personal growth, self-development, self-realization.

scholarly journals Post Traumatic Stress Disorder (PTSD) and It’s Associated Factors among Secondary Level Students in Chautara Municipality, Nepal

2019 ◽  
Vol 5 (1) ◽  
pp. 63-66
Author(s):  
Trima Gurung ◽  
Damaru Prasad Paneru
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Associated Factors ◽  
Stress Disorder ◽  
Secondary Level ◽  
Cross Sectional Study ◽  
Stress Disorders ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Post Traumatic

Children and adolescents are more prone to developing Post Traumatic Stress Disorders. Objective of this study was to assess the magnitude of Post Traumatic Stress Disorder and associated factors among secondary level students in Chautara Municipality, Nepal. A cross sectional study was conducted among 249 secondary level students. Data were collected using population proportionate sampling method along with UCLA PTSD RI with 31 questionnaires DSM V tool was used to assess the PTSD symptom. Questionnaire was design to obtain socio demographic factor and earthquake exposure. Factor associated with PTSD development was assessed through chi square and binary logistic regression. Mean age of respondents was 15.42±1.079 years. Majority of them were middle adolescents (74.3%) and 25.7 percent were early adolescents. More than half of respondents were female 54.6 percent. This study revealed that PTSD was found to be among 27(10.8%) respondents and dissociative subtype PTSD was among 14(5.6%) respondents. Age was significantly associated with development of PTSD. Earthquake exposures like financial constraints after earthquake food deficiency displacement due to earthquake was the major factors associated with PTSD development. Psychological tutorship for PTSD is found to be protective factors for PTSD development in adolescents. PTSD was quite high among the secondary level students after six month of earthquake in Chautara municipality, Sindupalchwok district and psychological tutorship and humanitarian program for traumatized students could prevent development of PTSD. Key words: Post traumatic stress disorder; Associated factors; Earthquake; Secondary levels students

scholarly journals Endorphinergic Enhancement Attenuation of Post-Traumatic Stress Disorder (PTSD) via Activation of Neuro-immunological Function in the Face of a Viral Pandemic

2021 ◽  
Vol 09 ◽  
Author(s):  
Kenneth Blum ◽  
Edward J. Modestino ◽  
David Baron ◽  
Raymond Brewer ◽  
P. K. Thanos ◽  
...  
Keyword(s):  
Immune System ◽  
Adaptive Immunity ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Molecular Genetic ◽  
Stress Disorders ◽  
Immunological Function ◽  
Post Traumatic Stress ◽  
Post Traumatic

Introduction: Polymorphic gene variants, particularly the genetic determinants of low dopamine function (hy-podopaminergia), are known to associate with Substance Use Disorder and a predisposition to PTSD. Addiction research and molecular genetic applied technologies supported by the National Institutes of Health (NIH) have revealed the com-plex functions of brain reward circuitry and its crucial role in addiction and PTSD symptomatology. Discussion: It is noteworthy that Israeli researchers compared mice with a normal immune system with mice lacking adaptive immunity and found that the incidence of PTSD increased several-fold. It is well established that raising endor-phinergic function increases immune response significantly. Along these lines, Blum’s work has shown that D-Phenylalanine (DPA), an enkephalinase inhibitor, increases brain endorphins in animal models and reduces stress in hu-mans. Enkephalinase inhibition with DPA treats Post Traumatic Stress Disorder (PTSD) by restoring endorphin function. The Genetic Addiction Risk Score (GARS) can characterize relevant phenotypes, genetic risk for stress vulnerability vs. resilience. GARS could be used to pre-test military enlistees for adaptive immunity or as part of PTSD management with customized neuronutrient supplementation upon return from deployment. Conclusion: Based on GARS values, with particular emphasis on enhancing immunological function, pro-dopamine regu-lation may restore dopamine homeostasis. Recognition of the immune system as a “sixth sense” and assisting adaptive immunity with Precision Behavioral Management (PBM), accompanied by other supportive interventions and therapies, may shift the paradigm in treating stress disorders.

scholarly journals Psychometric validation of the revised child injury scale (Cries-13) in Greek population

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Kallianezos ◽  
M Bakola ◽  
K S Kitsou ◽  
C Petropoulos ◽  
X Sinopidis ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Psychometric Validation ◽  
Post Traumatic Stress ◽  
Significant Difference ◽  
Post Traumatic

Abstract Background Children and adolescents have an increased risk of post-traumatic stress following exposure to traumatic events. Thus, timely, valid and reliable assessment of the symptoms of the disorder is crucial. The purpose of the study was the psychometric validation of The Child Revised Impact of Events Scale (CRIES 13), following the preceding linguistic validation. Further goal was to evaluate post-traumatic stress disorder (PTSD) in children 6 to 14 years of age with mild traumatic brain injury (mTBI). Methods The questionnaire was consecutively administered to 175 parents coming to the Emergency Department of the Pediatric Hospital of Patras, after mTBI of their children. They were asked to respond one week and one month after the accident to assess PTSD of their children. For psychometric validation, exploratory (EFA) and confirmatory (CFA) factor analysis was performed. The questionnaire consists of 13 items rated on a non-linear scale ranging from 0 to 65, and higher scores indicate more PTSD symptoms with a threshold of 30. Results The Psychometric validation showed very good reliability (= 0.79) and EFA confirmed the factor structure of the original tool. In addition, CFA showed satisfactory fit for the three-factor model. Parents estimated post-traumatic stress one week after injury in 19% of the children. Statistically significant difference was observed only in monthly income, with parents of low income reporting higher levels of stress in their children (p = 0.046). Conclusions A reliable and valid questionnaire is now available in Greek for assessing the risk of PTSD in children. In one of five children presented in our hospital we observed a higher risk of developing post-traumatic stress one week after mild traumatic brain injury. Key messages There is reliable and valid questionnaire in Greek for assessing the risk of post-traumatic stress disorder in children.

Post-traumatic Stress Disorder in Middle Age and Beyond

2021 ◽  
Vol 36 (4) ◽  
pp. 191-206
Author(s):  
Leisa L. Marshall ◽  
Renée L. Hayslett
Keyword(s):  
Older People ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Clinical Manifestations ◽  
Stress Disorders ◽  
Pharmacologic Therapy ◽  
Post Traumatic Stress ◽  
Line Therapy ◽  
Post Traumatic

OBJECTIVE: To review the clinical manifestations and treatment of post-traumatic stress disorder (PTSD) in adults and older people. DATA SOURCES: Articles indexed in PubMed, Embase, psychology databases, and the Cochrane library over the past 10 years using the key words "post-traumatic stress disorder," "stress disorders," and "post-traumatic stress disorder and treatment." STUDY SELECTION AND DATA EXTRACTION: Sixty-seven publications were reviewed and criteria supporting the primary objective were used to identify useful resources. DATA SYNTHESIS: The literature included practice guidelines; review articles; original research articles; and product prescribing information for the clinical manifestations, diagnosis, and treatment of PTSD. CONCLUSION: Psychotherapy is the first-line therapy for PTSD. Pharmacologic therapy is recommended, as second-line therapy, for adults living with PTSD who do not have access to psychotherapy or refuse psychotherapy. Pharmacologic therapy may also be considered in cases of partial, or no, response to psychotherapy. Current guidelines recommend prescribing one of 3 selective serotonin-reuptake inhibitors, either fluoxetine, paroxetine, or sertraline, or prescribing the serotonin norepinephrine reuptake inhibitor venlafaxine, for adult patients who do not have access to psychotherapy or prefer not to use psychotherapy. Unfortunately, these recommended medications have additional cautions for use in older people so may not be appropriate for many older people living with PTSD. Therapy for older people should be tailored to patient-specific symptoms, with careful consideration of the potential benefits and risks of the therapy and coexisting medical conditions of each patient.

scholarly journals The Effectiveness of Music on Quality of Life and Anxiety Symptoms in the Post Traumatic Stress Disorder in Bustan Hospital of Ahvaz City

2016 ◽  
Vol 8 (3) ◽  
pp. 237
Author(s):  
Ebtesam Jasemi Zergani ◽  
Farah Naderi
Keyword(s):  
Quality Of Life ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Anxiety Symptoms ◽  
Stress Disorders ◽  
Control Group ◽  
Post Traumatic Stress ◽  
Post Traumatic

<p>The present study aims at investigating the effectiveness of music on quality of life and anxiety symptoms of the veterans with post traumatic stress disorder in Bustan hospital of Ahvaz City. 40 persons were selected by simple random sampling method from the aforementioned population. The research design was an experimental one of type pretest-posttest with control group. Quality of Life inventory SF-36 (2005) and Spielberger Anxiety inventory (2005) were used for collecting the data. After selecting groups randomly, pretest was implemented on both experiment group (20 persons) and control group (20 persons). Then, music therapy intervention was implemented on the experiment group during 20 sessions each of which with 45 minutes. At the end of subject program, both groups were given posttest. Data were analyzed by using the multivariate covariance analysis. Results showed that presenting music can affect quality of life and anxiety symptoms of the veterans with posttraumatic stress disorders and this effect remained stable after one month of follow-up. Therefore, presenting music can be effective in treating the veterans with stress disorders after the accident.</p>

scholarly journals Glucocorticoid-related predictors and correlates of post-traumatic stress disorder treatment response in combat veterans

2014 ◽  
Vol 4 (5) ◽  
pp. 20140048 ◽  
Author(s):  
Rachel Yehuda ◽  
Laura C. Pratchett ◽  
Matthew W. Elmes ◽  
Amy Lehrner ◽  
Nikolaos P. Daskalakis ◽  
...  
Keyword(s):  
Treatment Response ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Clinical State ◽  
Post Traumatic Stress ◽  
Glucocorticoid Receptor Gene ◽  
Significant Difference ◽  
Post Traumatic

The identification of biomarkers for post-traumatic stress disorder (PTSD) and resilience/recovery is critical for advancing knowledge about pathophysiology and treatment in trauma-exposed persons. This study examined a series of glucocorticoid-related biomarkers prior to and in response to psychotherapy. Fifty-two male and female veterans with PTSD were randomized 2 : 1 to receive either prolonged exposure (PE) therapy or a weekly minimal attention (MA) intervention for 12 consecutive weeks. Psychological and biological assessments were obtained prior to and following treatment and after a 12-week naturalistic follow-up. Response was defined dichotomously as no longer meeting criteria for PTSD at post-treatment based on the Clinician Administered PTSD Scale for DSM-IV (CAPS). Clinical improvement on the CAPS was apparent for both PE and MA, with no significant difference according to treatment condition. Biomarkers predictive of treatment gains included the BCLI polymorphism of the glucocorticoid receptor gene. Additional predictors of treatment response were higher bedtime salivary cortisol and 24 h urinary cortisol excretion. Pre-treatment plasma dehydroepiandrosterone/cortisol ratio and neuropetide Y (NPY) levels were predictors of reductions in PTSD symptoms, and, for NPY only, of other secondary outcomes as well, including anxiety and depression ratings. Glucocorticoid sensitivity changed in association with symptom change, reflecting clinical state. It is possible to distinguish prognostic and state biomarkers of PTSD using a longitudinal approach in the context of treatment. Identified markers may also be relevant to understanding mechanisms of action of symptom reduction.

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