Response to De Nadai Letter Mittal, Vijay A; Cannon, Tyrone D; Bearden, Carrie E
The American journal of psychiatry,
05/2011, Letnik:
168, Številka:
5
Journal Article
Recenzirano
... in addition to the synergistic effects with serotonin noted by De Nadai et al., there is also evidence that melatonin may have antioxidant and neuroprotective effects (3).
Combat trauma Johnson, James D
2010., 2010, 2010-09-16
eBook
In this book, Johnson relates the stories of fifteen of his combat brothers to share with the world what their terror of four decades ago has done to them and how it affects them to this day. With ...candor and vivid detail, they reveal how their combat trauma symptoms still infect their thoughts, feelings, and behaviors on a daily basis.
Substantial empirical evidence has indicated impairment in the cognitive functioning of patients with obsessive-compulsive disorder (OCD) despite inconsistencies. Although several confounding factors ...have been investigated to explain the conflicting results, the findings remain mixed. This study aimed to investigate cognitive dysfunction in patients with OCD using a meta-analytic approach.
The PubMed database was searched between 1980 and October 2012, and reference lists of review papers were examined. A total of 221 studies were identified, of which 88 studies met inclusion criteria. Neuropsychological performance and demographic and clinical variables were extracted from each study.
Patients with OCD were significantly impaired in tasks that measured visuospatial memory, executive function, verbal memory and verbal fluency, whereas auditory attention was preserved in these individuals. The largest effect size was found in the ability to recall complex visual stimuli. Overall effect estimates were in the small to medium ranges for executive function, verbal memory and verbal fluency. The effects of potentially confounding factors including educational level, symptom severity, medication status and co-morbid disorders were not significant.
Patients with OCD appear to have wide-ranging cognitive deficits, although their impairment is not so large in general. The different test forms and methods of testing may have influenced the performance of patients with OCD, indicating the need to select carefully the test forms and methods of testing used in future research. The effects of various confounding variables on cognitive functioning need to be investigated further and to be controlled before a definite conclusion can be made.
This book presents a comprehensive overview of traumatic stress. Chapters address such topics as biomarkers in traumatic stress, the role of microglia activation, proliferation, and ...neuro-inflammation in the genesis of mental disorders and pain, the role of anger in the genesis and maintenance of hypertension, the role of anger and imagery in the maintenance of stress-related disorders, the role of oxidative stress in the etiology and maintenance of cardiovascular diseases, the mental health impacts of the COVID-19 pandemic, and much more.
Many millions of people are affected by the trauma of war. Psychologists have a good understanding of how experiences of war impact on memory, but the significance of external environmental ...influences is often disregarded. Memory, War and Trauma focuses on our understanding of the psychosocial impact of war in its broadest sense. Nigel C. Hunt argues that, in order to understand war trauma, it is critical to develop an understanding not only of the individual perspective but also of how societal and cultural factors impact on the outcome of an individual's experience. This is a compelling book which helps to demonstrate why some people suffer from post-traumatic stress while other people don't, and how narrative understanding is important to the healing process. Its multidisciplinary perspective will enable a deeper understanding of both individual traumatic stress and the structures of memory.
As journalists in Iraq and other hot spots around the world continue to face harrowing dangers and personal threats, neuropsychiatrist Anthony Feinstein offers a timely and important exploration into ...the psychological damage of those who, armed only with pen, tape recorder, or camera, bear witness to horror. Based on a series of recent studies investigating the emotional impact of war on the profession, Journalists under Fire breaks new ground in the study of trauma-related disorders.
Feinstein opens with an overview of the life-threatening hazards war reporters face—abductions, mock executions, the deaths of close colleagues—and discusses their psychological consequences: post-traumatic stress disorder, depression, deterioration of personal relationships, and substance abuse. In recounting the experiences of reporters who encounter trauma on the job, Feinstein observes that few adequate support systems are in place for them. He tells the stories of media veterans who have seen it all, only to find themselves and their employers blindsided by psychological aftershocks.
The book explores the biological and psychological factors that motivate journalists to take extraordinary risks. Feinstein looks into the psyches of freelancers who wade into war zones with little or no financial backing; he examines the different stresses encountered by women working in a historically male-dominated profession; and he probes the effects of the September 11 attacks on reporters who thought they had sworn off conflict reporting. His interviews with many of this generation's greatest reporters, photographers, and videographers often reveal extraordinary resilience in the face of adversity.
Journalists under Fire is a look behind the public persona of war journalists at a time when the profession faces unprecedented risk. Plucking common threads from disparate stories, Feinstein weaves a narrative that is as fascinating to read as it is sobering to contemplate. What emerges are unique insights into lives lived dangerously.
Objectives/AimsObsessive-Compulsive Disorder (OCD) is a common neuropsychiatric condition characterised by persistent endogenous repetitive and intrusive anxiogenic thoughts, feelings, or images ...often followed by anxiolytic mental or physical actions. Serotonin reuptake inhibitors (SRIs) are the mainstay of OCD treatment, used both as first line (SSRIs) and second line (Clomipramine) approaches. Despite their effectiveness in treatment of OCD, their anti-obsessive effects only start at eight to 12 weeks into treatment (Pittenger & Bloch, 2014), leaving an effectiveness time gap between diagnosis and treatment. Various treatment strategies have been tried but there is no consensus on the most effective approach. A single pharmacological agent with rapid anti-obsessive action would be an ideal candidate to manage this treatment gap. One such agent may be ketamine with its novel mechanism of action.Ketamine is assumed to increase neuroplasticity by synthesising neurotrophins in the cortex and has demonstrated to have rapid-onset anti-depressant effects (Bjrkholm & Monteggia, 2016). We reviewed the state of evidence for similar rapidly emerging anti- obsessive effects and report our findings here.MethodsEmbase, MEDLINE(R), and PsycINFO were searched to identify studies investigating rapid anti-obsessive effects of ketamine in humans, available in English. ClinicalTrials.org was further searched for grey literature. Other reviews were excluded.Results181 studies were identified after deduplication of which nine studies met inclusion criteria. Eight studies revealed rapid anti-obsessive effects, five of which display statistical significance. Combined, OCD scores decline by approximately 49.7% during the first hour following intravenous ketamine administration. Furthermore, a significant reduction of depressive symptoms and suicidality were reported in studies further investigating comorbid depression. Contrary to depression scores, anti-obsessive effects were not sustained. OCD scores increased within three hours post-administration and reversed back to baseline within seven days. One trial reported an extended length and margin of effect when combined with cognitive behavioural therapy.All studies were of small scale as the literature search primarily yielded pilot trials and case reports, suggesting statistical imprecision and reflecting the topics novelty.ConclusionsOur review points out the presence of preliminary research evidence to support the presence of anti-obsessive effects of ketamine and a potential for its usefulness as a rapidly acting intervention for OCD, thereby plugging an important gap in clinical management of OCD. However, as such effects are unsustained, their potential to complement existing pharmacological strategies may be limited.Greater awareness and randomised controlled trials are required before recommending the use of ketamine in OCD treatment.References Bjrkholm C, Monteggia LM. BDNF a key transducer of antidepressant effects. Neuropharmacology 2016;102. doi:10.1016/j.neuropharm.2015.10.034 Pittenger C, Bloch MH. Pharmacological treatment of obsessive-compulsive disorder. The Psychiatric clinics of North America 2014;37(3):375391. doi:10.1016/j.psc.2014.05.006
Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq. Early evidence suggests that the ...psychological toll of these deployments many involving prolonged exposure to combat-related stress over multiple rotations--may be disproportionately high compared with the physical injuries of combat. In the face of mounting public concern over post-deployment health care issues confronting OEF/OIF veterans, several task forces, independent review groups, and a Presidential Commission have been convened to examine the care of the war wounded and make recommendations. Concerns have been most recently centered on two combat-related injuries in particular: post-traumatic stress disorder and traumatic brain injury. With the increasing incidence of suicide and suicide attempts among returning veterans, concern about depression is also on the rise. The study discussed in this monograph focuses on post-traumatic stress disorder, major depression, and traumatic brain injury, not only because of current high-level policy interest but also because, unlike the physical wounds of war, these conditions are often invisible to the eye, remaining invisible to other servicemembers, family members, and society in general. All three conditions affect mood, thoughts, and behavior; yet these wounds often go unrecognized and unacknowledged. The effect of traumatic brain injury is still poorly understood, leaving a large gap in knowledge related to how extensive the problem is or how to address it. RAND conducted a comprehensive study of the post-deployment health-related needs associated with these three conditions among OEF/OIF veterans, the health care system in place to meet those needs, gaps in the care system, and the costs associated with these conditions and with providing quality health care to all those in need. This monograph presents the results of our study, which should be of interest to mental health treatment providers; health policymakers, particularly those charged with caring for our nation's veterans; and U.S. service men and women, their families, and the concerned public. All the research products from this study are available at http://veterans.rand.org. Data collection for this study began in April 2007 and concluded in January 2008. Specific activities included a critical review of the extant literature on the prevalence of post-traumatic stress disorder, major depression, and traumatic brain injury and their short- and long-term consequences; a population-based survey of servicemembers and veterans who served in Afghanistan or Iraq to assess health status and symptoms, as well as utilization of and barriers to care; a review of existing programs to treat servicemembers and veterans with the three conditions; focus groups with military servicemembers and their spouses; and the development of a microsimulation model to forecast the economic costs of these conditions over time. Among our recommendations is that effective treatments documented in the scientific literature, evidence-based care--are available for PTSD and major depression. Delivery of such care to all veterans with PTSD or major depression would pay for itself within two years, or even save money, by improving productivity and reducing medical and mortality costs. Such care may also be a cost-effective way to retain a ready and healthy military force for the future. However, to ensure that this care is delivered requires system-level changes across the Department of Defense, the Department of Veterans Affairs, and the U.S. health care system.
War Trauma and Its Wake Scurfield, Raymond Monsour; Platoni, Katherine Theresa
2013, 20120910, 2012, 2012-09-10
eBook
Decades after Charles Figley's landmark Trauma and Its Wake was published, our understanding of trauma has grown and deepened, but we still face considerable challenges when treating trauma ...survivors. This is especially the case for professionals who work with veterans and active-duty military personnel. War Trauma and Its Wake, then, is a vital book. The editors-one a Vietnam veteran who wrote the overview chapter on treatment for Trauma and Its Wake, the other an Army Reserve psychologist with four deployments-have produced a book that addresses both the specific needs of particular warrior communities as well as wider issues such as battlemind, guilt, suicide, and much, much more. The editors' and contributors' deep understanding of the issues that warriors face makes War Trauma and Its Wake a crucial book for understanding the military experience, and the lessons contained in its pages are essential for anyone committed to healing war trauma.
