scholarly journals Prevalence and Risk Factors for Post-Traumatic Stress in Hospitalized and Non-Hospitalized COVID-19 Patients

Author(s):  
Gunnar Einvik ◽  
Toril Dammen ◽  
Waleed Ghanima ◽  
Trond Heir ◽  
Knut Stavem

This population-based study assessed the prevalence and determinants of symptom-defined post-traumatic stress disorder (PTSD) in a cohort of hospitalized and non-hospitalized patients about 1.5–6 months after their COVID-19 onset. The data were acquired from two mixed postal/web surveys in June–September 2020 from patients all aged ≥18 years with a positive polymerase chain reaction for severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) until 1 June 2020, comprising both hospitalized and non-hospitalized subjects. The catchment areas of the two included hospitals covers about 17% of the population of Norway. In total, 211 hospitalized and 938 non-hospitalized subjects received invitation. The prevalence of symptom-defined PTSD was assessed using the PTSD checklist for DSM-5 (PCL-5). Determinants of symptom-defined PTSD and PTSD symptoms were analyzed using multivariable logistic and linear regression analysis. In total, 583 (51%) subjects responded at median 116 (range 41–200) days after COVID-19 onset. The prevalence of symptom-defined PTSD was 9.5% in hospitalized and 7.0% in non-hospitalized subjects (p = 0.80). Female sex, born outside of Norway, and dyspnea during COVID-19 were risk factors for persistent PTSD symptoms. In non-hospitalized subjects, previous depression and COVID-19 symptom load were also associated with persistent PTSD symptoms. In conclusion, COVID-19 symptom load, but not hospitalization, was associated with symptom-defined PTSD and PTSD symptom severity.

2013 ◽  
Vol 43 (12) ◽  
pp. 2657-2671 ◽  
Author(s):  
O. J. Bienvenu ◽  
J. Gellar ◽  
B. M. Althouse ◽  
E. Colantuoni ◽  
T. Sricharoenchai ◽  
...  

BackgroundSurvivors of critical illnesses often have clinically significant post-traumatic stress disorder (PTSD) symptoms. This study describes the 2-year prevalence and duration of PTSD symptoms after acute lung injury (ALI), and examines patient baseline and critical illness/intensive care-related risk factors.MethodThis prospective, longitudinal cohort study recruited patients from 13 intensive care units (ICUs) in four hospitals, with follow-up 3, 6, 12 and 24 months after ALI onset. The outcome of interest was an Impact of Events Scale – Revised (IES-R) mean score ⩾1.6 (‘PTSD symptoms’).ResultsDuring the 2-year follow-up, 66/186 patients (35%) had PTSD symptoms, with the greatest prevalence by the 3-month follow-up. Fifty-six patients with post-ALI PTSD symptoms survived to the 24-month follow-up, and 35 (62%) of these had PTSD symptoms at the 24-month follow-up; 50% had taken psychiatric medications and 40% had seen a psychiatrist since hospital discharge. Risk/protective factors for PTSD symptoms were pre-ALI depression [hazard odds ratio (OR) 1.96, 95% confidence interval (CI) 1.06–3.64], ICU length of stay (for a doubling of days, OR 1.39, 95% CI 1.06–1.83), proportion of ICU days with sepsis (per decile, OR 1.08, 95% CI 1.00–1.16), high ICU opiate doses (mean morphine equivalent ⩾100 mg/day, OR 2.13, 95% CI 1.02–4.42) and proportion of ICU days on opiates (per decile, OR 0.83, 95% CI 0.74–0.94) or corticosteroids (per decile, OR 0.91, 95% CI 0.84–0.99).ConclusionsPTSD symptoms are common, long-lasting and associated with psychiatric treatment during the first 2 years after ALI. Risk factors include pre-ALI depression, durations of stay and sepsis in the ICU, and administration of high-dose opiates in the ICU. Protective factors include durations of opiate and corticosteroid administration in the ICU.


Author(s):  
Ingrid Kvestad ◽  
Tormod Bøe ◽  
Nawar Sayyad ◽  
Jens Christoffer Skogen ◽  
Sølve Randal ◽  
...  

AbstractBuilding knowledge on how child welfare services (CWS) should tailor services for unaccompanied refugee minors (URMs) is important. URMs and youth in foster care are high-risk groups taken care of by the CWS in Norway. Little is known on whether knowledge gained from youth in foster care can inform services for URMs, and if these groups are comparable in terms of experiences of potential traumatic events (PTEs) and post-traumatic stress disorder (PTSD) symptom load. Eighty-one URMs reported PTEs and PTSD-symptoms using an adapted version of the Child and Adolescent Trauma Screen (CATS). Responses were described and compared with a sample of 303 youth in foster care in linear regression models. We present relative risks (RR) and standardized mean differences (SMD) for the PTEs and the PTSD subscale and total score between the groups in forest plots. URMs had experienced a mean (standard deviation) of 6.4 (3.4) PTEs and 43.9% reported to have PTSD-symptoms at or above the clinical cut off. Compared to the foster youth, URMs reported more exposures of interpersonal violence outside of the family (RRs ranging from 66.4 [95%CI 18.1; 243.5) to 1.3 (1.0, 1.5)], and more PTSD-symptoms in the re-experiencing subscale [SMD = 0.3 (95% CI 0.1, 0.6)]. The frequency and types of PTEs and the PTSD-symptom load and profile among URMs and youth in foster care differed. Findings underscore the importance of qualified and targeted care for URMs, and that this care should differ to that of other high-risk groups in the CWS.


2017 ◽  
Vol 12 (4) ◽  
pp. 486-492 ◽  
Author(s):  
Shneha Acharya ◽  
Dharma Nanda Bhatta ◽  
Sawitri Assannangkornchai

AbstractObjectiveThe 2015 earthquake in Nepal affected the country in terms of economy, and by causing damage and stress reactions. This study aimed to estimate the prevalence and determine individual child- and family-level predictors of post-traumatic stress disorder (PTSD) symptoms.MethodsA community-based cross-sectional study was carried out in Kathmandu district 15 months after the earthquake. Multistage cluster sampling was adopted to collect 800 earthquake-affected children aged 7-16 years and a face-to-face interview was conducted. Trauma exposure questionnaire and Child PTSD Symptoms Scale were used for assessment of the level of exposure and PTSD symptoms. Multilevel generalized linear regression analysis was used to explore individual and family-level predictors.ResultsAmong the children, 51% had moderate-to-severe PTSD symptoms. Children of school age (adjusted odds ratio=2.83 [1.45-5.49]), those attending lower-secondary school (2.26 [1.21-4.21]), those having a higher exposure to the severity of the earthquake, and those with low psychosocial acuity [1.70 (1.10-2.60)] were more likely to have more severe PTSD symptoms compared with those who were adolescents and in higher-secondary school, whereas children from a family living in an urban (0.33 [0.19-0.59]) setting and following Hindu religion (0.31 [0.16-0.60]) were less likely to have PTSD symptoms compared with children from suburban areas and those following Buddhist religion.ConclusionPTSD symptoms were prevalent among children of Nepal more than a year following the earthquake. Family-level indicators cannot be excluded when studying children’s trauma reactions. (Disaster Med Public Health Preparedness. 2018;12:486–492)


2008 ◽  
Vol 26 (6) ◽  
pp. 934-941 ◽  
Author(s):  
Sophia K. Smith ◽  
Sheryl Zimmerman ◽  
Christianna S. Williams ◽  
John S. Preisser ◽  
Elizabeth C. Clipp

Purpose A large body of evidence suggests that being diagnosed with and treated for cancer adversely affects functioning and quality of life, yet less is known about longer term outcomes. Therefore, this study aims to estimate the prevalence of post-traumatic stress disorder (PTSD) symptoms in survivors of adult non-Hodgkin's lymphoma (NHL) who are at least 2 years postdiagnosis and identify the risk factors associated with PTSD symptoms, with a focus on those that are amenable for screening and modifiable. Patients and Methods A total of 886 NHL survivors identified from the cancer registries of two hospitals in North Carolina participated, ranging in age from 25 to 92 years old and ranging from 2 to 44 years postdiagnosis. Survivors were mailed a survey that assessed PTSD symptoms and quality of life. Results Participants averaged 10.2 years postdiagnosis, and most (61%) reported no PTSD symptoms. The adjusted prevalence for full PTSD was 7.9%, with an additional 9.1% meeting criteria for partial PTSD. Modifiable risk factors that were independently associated with PTSD in multiple linear regression included less social support, negative appraisals of life threat and treatment intensity, and more employment and insurance issues. Additionally, several demographic characteristics (nonwhite race, less education, and younger age) and clinical or health-related factors (active disease, more recent diagnosis, and more comorbidity) were independently associated with PTSD. Conclusion Although only 8% of survivors met PTSD diagnostic criteria, the impact of a cancer diagnosis and treatment persists for many survivors, as evidenced in 39% of this sample. Early identification of those at risk could enable treatment to minimize PTSD symptomatology.


Author(s):  
Bingqing Lu ◽  
Wenqi Zeng ◽  
Zhuyue Li ◽  
Jin Wen

Abstract Aims To investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms in the hard-hit areas 10 years after the Wenchuan earthquake, and explore the risk factors of long-term PTSD among Wenchuan earthquake survivors. Methods A matched case–control study was conducted. The involving participants were from the hard-hit areas 10 years after the Wenchuan earthquake. The collected information includes demographic characteristics, socioeconomic status, behaviour habits, earthquake exposure, perceived social support, physical health and mental health. Mental health status was measured using the PTSD Checklist-Civilian Version (PCL-C). Respondents with PCL-C score ⩾38 were classified as cases, and then the cases and controls were matched based on age (±3 years) and community location according to a ratio of 1:3. Results We obtained 86 cases and 258 controls. After controlling for confounding factors, it was found that lower income (OR 2.42; 95% CI 1.16–5.03), chronic diseases (OR 3.00; 95% CI 1.31–6.88) and death of immediate families in the earthquake (OR 7.30; 95% CI 2.36–22.57) were significantly associated with long-term PTSD symptoms. Conclusion Even 10 years after the Wenchuan earthquake, the survivors in the hard-hit areas still suffered from severe mental trauma. Low income, chronic diseases and death of immediate families in the earthquakes are significantly associated with long-term PTSD symptoms. Interventions by local governments and health institutions to address these risk factors should be undertaken to promote the health of survivors.


Author(s):  
Gabriella Tyson ◽  
Jennifer Wild

The coronavirus pandemic has resulted in many journalists repeatedly covering stories related to human suffering. This study investigates whether these journalists experienced higher rates of psychological distress, post-traumatic stress disorder (PTSD) and depressive symptoms than those who have been working during the pandemic yet covering stories other than COVID-19 and aims to identify what factors may protect journalists from developing trauma-related symptoms. We assessed journalists (n = 120) working during the COVID-19 pandemic using self-report measures. Journalists repeatedly covering COVID-19 stories had significantly higher psychological distress (η2 = 0.04) and PTSD symptoms (η2 = 0.08), but not depression, compared to journalists who did not report on COVID-19. Rumination and numbing in response to unwanted memories predicted PTSD symptoms (R2 = 0.53) and may be risk factors for PTSD in this population. Unhelpful resilience appraisals distinguished journalists who reported on COVID-19 and who developed distressing re-experiencing symptoms from those who similarly reported on distressing material and who did not develop symptoms. Targeting resilience appraisals may be helpful in reducing re-experiencing symptoms after trauma exposure.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying Liu ◽  
Lan Zhang ◽  
Nafei Guo ◽  
Hui Jiang

Abstract Background Despite the increased global interest from researchers in postpartum depression (PPD) and postpartum post-traumatic stress disorder (PP-PTSD), studies of PPD in China have shown a wide range of variability. Indeed, the prevalence and risk factors for PP-PTSD have received little attention in China. Aim To determine the prevalence of PPD and PP-PTSD in China, and to examine the relationships between a range of sociodemographic, pregnancy-related, and newborn-related variables, and PPD and PP-PTSD. Methods A cross-sectional study involving 1136 women who returned to the obstetrics clinic for routine postpartum examination were enrolled. The sociodemographic, pregnancy-related, and newborn-related characteristics were collected. Social support, and PPD and PP-PTSD symptoms were measured by the Perceived Social Support Scale (PSSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Post-traumatic Stress Questionnaire (PPQ). Results The prevalence rates of PPD and PP-PTSD symptoms were 23.5 and 6.1%, respectively. A multivariate model showed that the presence of PP-PTSD was the strongest risk factor for PPD symptoms and vice versa. Other risk factors for PPD included low sleep quality, low social support and newborn’s incubator admission. In terms of PP-PTSD symptoms, risk factors included the presence of PPD symptoms, non-Han ethnicity, and low social support, while having one child was a protective factor. Conclusions This study addressed some gaps in the literature and provided a better understanding of PPD and PP-PTSD in China, which may contribute to early detection and intervention. Attention should be paid to women who are most susceptible to PPD and/or PP-PTSD, including those with low social support, low sleep quality, newborn’s incubator admission, non-Han ethnicity, and women with siblings.


2013 ◽  
Vol 20 (6) ◽  
pp. 429-433 ◽  
Author(s):  
Aaron Khitab ◽  
John Reid ◽  
Vern Bennett ◽  
G Camelia Adams ◽  
Lloyd Balbuena

BACKGROUND: Several recent studies have reported that post-traumatic stress disorder (PTSD) is a frequent occurrence in survivors of an intensive care unit (ICU) admission.OBJECTIVE: To assess the frequency of PTSD symptoms at three and nine months post-ICU admission and examine possible risk factors that predispose to the development of PTSD symptoms.METHOD: Using the following scales: Davidson Trauma Scale, Impact of Event Scale and the Post-traumatic Symptom Scale, 69 ICU survivors were assessed for PTSD symptoms at three months post-ICU admission. Of the original 69 patients, 37 completed the same questionnaires at the second follow-up at nine months post-ICU admission. Mean symptom levels for avoidance, intrusive thoughts and hyperarousal were calculated, and risk factors for the development of PTSD symptomatology were examined.RESULTS: Depending on which scale was used, 16% to 33% of ICU survivors met the criteria for PTSD at either three or nine months. Younger age and the use of a prescription psychoactive medication at time of ICU admission were both independently associated with a higher risk of developing PTSD symptoms. Interestingly, symptoms of hyperarousal worsened during the follow-up interval for female patients, while they remained constant for males.CONCLUSION: The frequency of PTSD symptoms was high in patients who survived an admission to the ICU. Depending on sex, symptoms may present and evolve differently. The adoption of screening tools and a multicentre ICU database in Canada is recommended to identify patients who are most at risk.


Author(s):  
Susanne Fischer ◽  
Tabea Schumacher ◽  
Christine Knaevelsrud ◽  
Ulrike Ehlert ◽  
Sarah Schumacher

Abstract Background Less than half of all individuals with post-traumatic stress disorder (PTSD) remit spontaneously and a large proportion of those seeking treatment do not respond sufficiently. This suggests that there may be subgroups of individuals who are in need of augmentative or alternative treatments. One of the most frequent pathophysiological findings in PTSD is alterations in the hypothalamic–pituitary–adrenal (HPA) axis, including enhanced negative feedback sensitivity and attenuated peripheral cortisol. Given the role of the HPA axis in cognition, this pattern may contribute to PTSD symptoms and interfere with key processes of standard first-line treatments, such as trauma-focused cognitive behavioural therapy (TF-CBT). Methods This review provides a comprehensive summary of the current state of research regarding the role of HPA axis functioning in PTSD symptoms and treatment. Results Overall, there is preliminary evidence that hypocortisolaemia contributes to symptom manifestation in PTSD; that it predicts non-responses to TF-CBT; and that it is subject to change in parallel with positive treatment trajectories. Moreover, there is evidence that genetic and epigenetic alterations within the genes NR3C1 and FKBP5 are associated with this hypocortisolaemic pattern and that some of these alterations change as symptoms improve over the course of treatment. Conclusions Future research priorities include investigations into the role of the HPA axis in day-to-day symptom variation, the time scale in which biological changes in response to treatment occur, and the effects of sex. Furthermore, before conceiving augmentative or alternative treatments that target the described mechanisms, multilevel studies are warranted.


2021 ◽  
pp. 088626052110219
Author(s):  
Matthew M. Yalch ◽  
Sloane R. M. Rickman

Intimate partner violence (IPV) is a common problem for women in the United States and is associated with symptoms of post-traumatic stress disorder (PTSD) as well as hazardous use of substances like alcohol and drugs. However, not all subtypes of IPV (i.e., physical, sexual, and psychological) are equally predictive of PTSD and hazardous substance use. Although previous research suggests that psychological IPV has the strongest relative effect on PTSD symptoms and substance use, there is less research on IPV subtypes’ cumulative effects. In this study, we examined the relative and cumulative effects of physical, sexual, and psychological IPV on PTSD symptoms and hazardous substance use in a sample of women in the United States recruited via Amazon’s Mechanical Turk ( N = 793) using bootstrapped multiple regression and configural frequency analyses. Results suggest that physical IPV had the most pronounced influence (medium-large effect sizes) on substance use across women, but that the cumulative effects of all three IPV subtypes were most closely associated with diagnostic levels of both PTSD and substance use at the level of groups of women. These findings clarify and extend previous research on the differential effects of IPV subtypes and provide directions for future research and clinical intervention.


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