Objective:To examine the effects of coronavirus disease-2019(COVID-19)exposure,expressive suppression/cognitive reappraisal,and demographic variables on post-traumatic stress symptoms(PTS)among Chinese.Methods:Partici...Objective:To examine the effects of coronavirus disease-2019(COVID-19)exposure,expressive suppression/cognitive reappraisal,and demographic variables on post-traumatic stress symptoms(PTS)among Chinese.Methods:Participants were recruited by social media through We Chat and 6049 Chinese(aged from 17 to 63 years;median=24)from 31 provinces were included in the study.PTS symptoms,expressive suppression,and cognitive reappraisal were assessed after the outbreak of COVID-19.A regression mixture analysis was conducted in Mplus 7.Results:A regression mixture model identified three latent classes that were primarily distinguished by differential effects of COVID-19 exposures on PTS symptoms:(1)Class 1(mildly PTS symptoms,80.9%),(2)Class 2(moderate PTS symptoms,13.0%),and(3)Class 3(high PTS symptoms,6.1%).The results demonstrated that the young,women and people with responsibilities and concerns for others were more vulnerable to PTS symptoms;and they had more expression inhibition and less cognitive reappraisal in three latent classes.Conclusions:The findings suggest that more attention needs to be paid to vulnerable groups such as the young,women and people with responsibilities and concerns for others.Therapies to encourage emotional expression and increase cognitive reappraisal may also be helpful for trauma survivors.展开更多
Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(...Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(OSA),also occurs frequently in PTSD,and emerging research indicates OSA fuels chronic insomnia.Scant research has investigated the impact of OSA treatment on insomnia outcomes(Insomnia Severity Index,ISI)in trauma survivors.Methods:OSA patients with moderately severe posttraumatic stress symptoms were studied in a retrospective chart review.Ninety-six patients who failed CPAP therapy due to expiratory pressure intolerance or complex sleep apnea or both underwent manual titration with advanced PAP modes[autobilevel(ABPAP);adaptive servo-ventilation(ASV)],which were subsequently prescribed.PAP use measured by objective data downloads divided the sample into three groups:compliant regular users(C-RU):n=68;subthreshold users(SC-RU):n=12;and noncompliant users(NC-MU):n=16.The average follow-up was 11.89±12.22 months.Baseline and posttreatment ISI scores were analyzed to assess residual insomnia symptoms as well as cure rates.Results:The C-RU group showed significant improvements in insomnia with very large effects compared to those in the NC-MU reference group(P=0.019).Insomnia severity significantly decreased in all three groups with large effects(C-RU,P=0.001;SC-RU,P=0.027;NC-MU,P=0.007).Hours of weekly PAP use and insomnia severity were inversely correlated(P=0.001,r=–0.321).However,residual insomnia symptoms based on established ISI cut-offs were quite common,even among the C-RU group.Post hoc analysis showed that several categories of sedating medications reported at baseline(hypnotics,anti-epileptic,opiates)as well as actual use of any sedating medication(prescription or nonprescription)were associated with smaller insomnia improvements than those in patients not using any sedating agents.Conclusions:In a retrospective,nonrandomized analysis of a select sample of sleep clinic patients with OSA and PTSD symptoms,advanced PAP therapy was associated with significant improvement in insomnia severity for both compliant and partial users.However,residual insomnia symptoms persisted,indicating that PAP therapy provides only limited treatment.RCTs are warranted to assess the effect of ABPAP and ASV modes of therapy on adherence and sleep outcomes,and their potential impact on posttraumatic stress symptoms.Treatment arms that combine PAP with CBT-I would be expected to yield the greatest potency.展开更多
Families of patients in the intensive care unit often experience sever stress. Understanding their experience is important for providing family-centered care during this difficult period. Little is known about the exp...Families of patients in the intensive care unit often experience sever stress. Understanding their experience is important for providing family-centered care during this difficult period. Little is known about the experience of families of patients admitted to the intensive care unit (ICU). To evaluate the prevalence and factors associated with acute stress symptoms among families of patients admitted to the ICU, we carried out a cross-sectional study at a teaching and advanced treatment hospital. The mean total Impact of Event Scale-Revised (IES-R) score differed significantly between planned and unplanned ICU admissions (t = 4.03, p < 0.05), indicating a main effect of admission type (F = 18.5, p < 0.05). There was no significant main effect of relationship (F = 0.05, p = 0.82) or interaction effect of admission type and relationship (F = 0.54, p = 0.47). Multiple regression analysis indicated that admission type was significantly associated with acute stress symptoms (B = 18.09, β = 0.47, p < 0.01), and explained 22% of the variance in total IES-R score. Whether a patient had a planned or unplanned admission to the ICU influenced symptoms associated with acute stress symptoms of family members more than did getting support from nurses, being the patient’s spouse, or the severity of illness of the patient.展开更多
Although primarily affecting the respiratory system,growing attention is being paid to the neuropsychiatric consequences of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infections.Acute and sub-acute neu...Although primarily affecting the respiratory system,growing attention is being paid to the neuropsychiatric consequences of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infections.Acute and sub-acute neuropsychiatric manifestations of coronavirus disease 2019(COVID-19)disease and their mechanisms are better studied and understood currently than they had been when the pandemic began;however,many months or years will be necessary to fully comprehend how significant the consequences of such complications will be.In this editorial,we discuss the possible long-term sequelae of the COVID-19 pandemic,deriving our considerations on experiences drawn from past coronaviruses’outbreaks,such as the SARS and the middle east respiratory syndrome,and from the knowledge of the mechanisms of neurotropism and invasiveness of SARS-CoV-2.Acknowledging the global spread of COVID-19 and the vast number of people affected,to date amounting to many millions,the matter of this pandemic’s neuropsychiatric legacy appears concerning.Public health monitoring strategies and early interventions seem to be necessary to manage the possible emergence of a severe wave of neuropsychiatric distress among the survivors.展开更多
Post-traumatic stress disorder(PTSD)is a psychiatric disease that seriously affects brain function.Currently,selective serotonin reuptake inhibitors(SSRIs)are used to treat PTSD clinically but have decreased efficienc...Post-traumatic stress disorder(PTSD)is a psychiatric disease that seriously affects brain function.Currently,selective serotonin reuptake inhibitors(SSRIs)are used to treat PTSD clinically but have decreased efficiency and increased side effects.In this study,nasal cannabidiol inclusion complex temperature-sensitive hydrogels(CBD TSGs)were prepared and evaluated to treat PTSD.Mice model of PTSD was established with conditional fear box.CBD TSGs could significantly improve the spontaneous behavior,exploratory spirit and alleviate tension in open field box,relieve anxiety and tension in elevated plus maze,and reduce the freezing time.Hematoxylin and eosin and c-FOS immunohistochemistry slides showed that the main injured brain areas in PTSD were the prefrontal cortex,amygdala,and hippocampus CA1.CBD TSGs could reduce the level of tumor necrosis factor-a caused by PTSD.Western blot analysis showed that CBD TSGs increased the expression of the 5-HT1 A receptor.Intranasal administration of CBD TSGs was more efficient and had more obvious brain targeting effects than oral administration,as evidenced by the pharmacokinetics and brain tissue distribution of CBD TSGs.Overall,nasal CBD TSGs are safe and effective and have controlled release.There are a novel promising option for the clinical treatment of PTSD.展开更多
基金supported by the research grant from Hainan Medical University(No.XGZX2020003)the fund from Working Committee for Talents of Hainan Province(No.20192166)+2 种基金the Project of Basic Platform of National Science and Technology Resources of the Ministry of Sciences and Technology of China(No.TDRC-2019-194-30)Science and Technology Planning Project of Guangdong Province(No.2019B030316025)the 111 Project(No.B12003)
文摘Objective:To examine the effects of coronavirus disease-2019(COVID-19)exposure,expressive suppression/cognitive reappraisal,and demographic variables on post-traumatic stress symptoms(PTS)among Chinese.Methods:Participants were recruited by social media through We Chat and 6049 Chinese(aged from 17 to 63 years;median=24)from 31 provinces were included in the study.PTS symptoms,expressive suppression,and cognitive reappraisal were assessed after the outbreak of COVID-19.A regression mixture analysis was conducted in Mplus 7.Results:A regression mixture model identified three latent classes that were primarily distinguished by differential effects of COVID-19 exposures on PTS symptoms:(1)Class 1(mildly PTS symptoms,80.9%),(2)Class 2(moderate PTS symptoms,13.0%),and(3)Class 3(high PTS symptoms,6.1%).The results demonstrated that the young,women and people with responsibilities and concerns for others were more vulnerable to PTS symptoms;and they had more expression inhibition and less cognitive reappraisal in three latent classes.Conclusions:The findings suggest that more attention needs to be paid to vulnerable groups such as the young,women and people with responsibilities and concerns for others.Therapies to encourage emotional expression and increase cognitive reappraisal may also be helpful for trauma survivors.
基金small private donations to the Sleep&Human Health Institute.
文摘Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(OSA),also occurs frequently in PTSD,and emerging research indicates OSA fuels chronic insomnia.Scant research has investigated the impact of OSA treatment on insomnia outcomes(Insomnia Severity Index,ISI)in trauma survivors.Methods:OSA patients with moderately severe posttraumatic stress symptoms were studied in a retrospective chart review.Ninety-six patients who failed CPAP therapy due to expiratory pressure intolerance or complex sleep apnea or both underwent manual titration with advanced PAP modes[autobilevel(ABPAP);adaptive servo-ventilation(ASV)],which were subsequently prescribed.PAP use measured by objective data downloads divided the sample into three groups:compliant regular users(C-RU):n=68;subthreshold users(SC-RU):n=12;and noncompliant users(NC-MU):n=16.The average follow-up was 11.89±12.22 months.Baseline and posttreatment ISI scores were analyzed to assess residual insomnia symptoms as well as cure rates.Results:The C-RU group showed significant improvements in insomnia with very large effects compared to those in the NC-MU reference group(P=0.019).Insomnia severity significantly decreased in all three groups with large effects(C-RU,P=0.001;SC-RU,P=0.027;NC-MU,P=0.007).Hours of weekly PAP use and insomnia severity were inversely correlated(P=0.001,r=–0.321).However,residual insomnia symptoms based on established ISI cut-offs were quite common,even among the C-RU group.Post hoc analysis showed that several categories of sedating medications reported at baseline(hypnotics,anti-epileptic,opiates)as well as actual use of any sedating medication(prescription or nonprescription)were associated with smaller insomnia improvements than those in patients not using any sedating agents.Conclusions:In a retrospective,nonrandomized analysis of a select sample of sleep clinic patients with OSA and PTSD symptoms,advanced PAP therapy was associated with significant improvement in insomnia severity for both compliant and partial users.However,residual insomnia symptoms persisted,indicating that PAP therapy provides only limited treatment.RCTs are warranted to assess the effect of ABPAP and ASV modes of therapy on adherence and sleep outcomes,and their potential impact on posttraumatic stress symptoms.Treatment arms that combine PAP with CBT-I would be expected to yield the greatest potency.
文摘Families of patients in the intensive care unit often experience sever stress. Understanding their experience is important for providing family-centered care during this difficult period. Little is known about the experience of families of patients admitted to the intensive care unit (ICU). To evaluate the prevalence and factors associated with acute stress symptoms among families of patients admitted to the ICU, we carried out a cross-sectional study at a teaching and advanced treatment hospital. The mean total Impact of Event Scale-Revised (IES-R) score differed significantly between planned and unplanned ICU admissions (t = 4.03, p < 0.05), indicating a main effect of admission type (F = 18.5, p < 0.05). There was no significant main effect of relationship (F = 0.05, p = 0.82) or interaction effect of admission type and relationship (F = 0.54, p = 0.47). Multiple regression analysis indicated that admission type was significantly associated with acute stress symptoms (B = 18.09, β = 0.47, p < 0.01), and explained 22% of the variance in total IES-R score. Whether a patient had a planned or unplanned admission to the ICU influenced symptoms associated with acute stress symptoms of family members more than did getting support from nurses, being the patient’s spouse, or the severity of illness of the patient.
文摘Although primarily affecting the respiratory system,growing attention is being paid to the neuropsychiatric consequences of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infections.Acute and sub-acute neuropsychiatric manifestations of coronavirus disease 2019(COVID-19)disease and their mechanisms are better studied and understood currently than they had been when the pandemic began;however,many months or years will be necessary to fully comprehend how significant the consequences of such complications will be.In this editorial,we discuss the possible long-term sequelae of the COVID-19 pandemic,deriving our considerations on experiences drawn from past coronaviruses’outbreaks,such as the SARS and the middle east respiratory syndrome,and from the knowledge of the mechanisms of neurotropism and invasiveness of SARS-CoV-2.Acknowledging the global spread of COVID-19 and the vast number of people affected,to date amounting to many millions,the matter of this pandemic’s neuropsychiatric legacy appears concerning.Public health monitoring strategies and early interventions seem to be necessary to manage the possible emergence of a severe wave of neuropsychiatric distress among the survivors.
基金funded by the Beijing Municipal Natural Science Foundation,China(7202147 and 7172072,China)
文摘Post-traumatic stress disorder(PTSD)is a psychiatric disease that seriously affects brain function.Currently,selective serotonin reuptake inhibitors(SSRIs)are used to treat PTSD clinically but have decreased efficiency and increased side effects.In this study,nasal cannabidiol inclusion complex temperature-sensitive hydrogels(CBD TSGs)were prepared and evaluated to treat PTSD.Mice model of PTSD was established with conditional fear box.CBD TSGs could significantly improve the spontaneous behavior,exploratory spirit and alleviate tension in open field box,relieve anxiety and tension in elevated plus maze,and reduce the freezing time.Hematoxylin and eosin and c-FOS immunohistochemistry slides showed that the main injured brain areas in PTSD were the prefrontal cortex,amygdala,and hippocampus CA1.CBD TSGs could reduce the level of tumor necrosis factor-a caused by PTSD.Western blot analysis showed that CBD TSGs increased the expression of the 5-HT1 A receptor.Intranasal administration of CBD TSGs was more efficient and had more obvious brain targeting effects than oral administration,as evidenced by the pharmacokinetics and brain tissue distribution of CBD TSGs.Overall,nasal CBD TSGs are safe and effective and have controlled release.There are a novel promising option for the clinical treatment of PTSD.
