Abnormal REM Sleep Atonia Control in Chronic Post-Traumatic Stress Disorder

Study Objectives Post-traumatic stress disorder (PTSD) and REM sleep behavior disorder (RBD) share some common features including prominent nightmares and sleep disturbances. We aimed to comparatively analyze REM sleep without atonia (RSWA) between patients with chronic PTSD with and without dream enactment behavior (DEB), isolated RBD (iRBD), and controls. Methods In this retrospective study, we comparatively analyzed 18 PTSD with DEB (PTSD+DEB), 18 PTSD without DEB, 15 iRBD, and 51 controls matched for age and sex. We reviewed medical records to determine PTSD clinical features and quantitatively analyzed RSWA. We used non-parametric analyses to compare clinical and polysomnographic features. Results PTSD patients, both with and without DEB, had significantly higher RSWA than controls (all p < 0.025, excepting submentalis phasic duration in PTSD+DEB). Most RSWA measures were also higher in PTSD+DEB than in PTSD without DEB patients (all p <0.025). Conclusions PTSD patients have higher RSWA than controls, whether DEB is present or not, indicating that REM sleep atonia control is abnormal in chronic PTSD. Further prospective studies are needed to determine whether neurodegenerative risk and disease markers similar to RBD might occur in PTSD patients.

Associations of Embeddedness and Posttraumatic Stress Disorder among 9/11 Survivors

Following exposures to traumatic events on 9/11, survivors have reported heightened levels of posttraumatic stress disorder (PTSD). Multiple factors contribute to both the exacerbation and amelioration of PTSD symptoms, including social integration and support. This cross-sectional study aimed to understand and identify associations of embeddedness and psychosocial risk factors by PTSD status for survivors and first responders of 9/11. Results indicate that those with chronic PTSD had the lowest prevalence of both social and emotional embeddedness and many who reported no PTSD symptoms following 9/11 reported moderate levels of social and emotional embeddedness. Overall, our findings suggest those individuals who reported little to no PTSD also reported the most social/emotional embeddedness; whereas those individuals who report greater or chronic PTSD report the least social/emotional embeddedness. As such, it may be beneficial for clinicians across multiple care disciplines and contexts to consider and address the social lives and needs of those individuals experiencing symptoms of PTSD to ensure their emotional and physical needs are truly being met.

Ketamine for the multivariate effect of PTSD: Systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to examine the efficacy, anti-effect of ketamine (intervention) for post-traumatic stress disorder (PTSD) patients during analgesia proceeding and mental illness treatment methods, in comparison with control (midazolam, opioid, saline or placebo). The bibliographic databases Cochrane, Embase, Pubmed and Web of Science were searched from inception to 23 May 2021 for randomized controlled trials, case-control and cohort studies included. For continuous and dichotomous outcomes, respectively, we calculated the mean difference using the inverse-variance method and the risk ratio with the Mantel-Haenszel method. In all, ten trials with 705 patients were included. Confirmed by meta-analysis, ketamine didn't increase the prevalence of PTSD by a risk ratio (95 % CI) of 0.86 (0.61 to 1.20), p = 0.38 in 3 trials with 503 patients. Evidence of a difference was found in the PTSD-scales taken between ketamine and control during short durations (months), with a mean difference (95 % CI) of 2.45 (1.33 to 3.58), p < 0.001 in three trials with 65 patients. Another evidence is shown in chronic PTSD (years), with a mean difference (95 % CI) of -3.66 (-7.05 to -0.27), p = 0.03 in three trials with 91 patients. Sub-group analysis underlined the increased benefit of ketamine administration for those in whom the procedure was more than one week in the chronic PTSD group. The adoption of ketamine for the short duration of PTSD is in avoidance, but for chronic PTSD is recommended and, in the opinion of the authors, should be considered as a new therapy in view of its potential to ameliorate arousal, avoidance and dissociative symptoms, neuroticism after trauma needing more animal research and clinical trials.

Shared or unique trajectories of PTSD and depression in children over time since an earthquake

Posttraumatic stress disorder (PTSD) and depression are common outcomes in children and adolescents following natural disasters. However, because of the comorbidity of PTSD and depression, their mutual relationship affects their relative trajectories over time. Therefore, this study examined the joint trajectories of PTSD and depression and assessed their consistency over time. Using self-report questionnaires, we surveyed 303 children in the worst-affected area of the Ya’an earthquake at 6 months, 1 year, and 18 months post-disaster. Four latent joint trajectories of PTSD and depression were identified: a chronic depression-delayed PTSD symptoms group ( n = 59, 19.5%), a chronic PTSD-delayed depressive symptoms group ( n = 10, 3.3%), a low-symptoms group ( n = 208, 68.6%), and a chronic depression-PTSD symptoms recovery group ( n = 26, 8.6%). Companionship and affirmative value were more likely to be observed in the low-symptoms group. These findings illustrate that PTSD and depression development are heterogeneously distributed, and various types of social support fill different roles in differentiating distinct joint trajectories of PTSD and depression.