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Background/Objectives: A person-under-train (PUT) incident is a traumatic event for train drivers that can result in serious health consequences. This systematic review aimed to identify and synthesize evidence on these health effects, including post-traumatic stress disorder (PTSD), sickness absence (SA), and other related mental health outcomes. Methods: Following the PECO scheme, we searched the PubMed, Web of Science, and Embase databases for studies published between 1980 and 2021. We included cross-sectional, case–control, prospective, and interventional studies focusing on train drivers exposed to PUT incidents. Data synthesis followed PRISMA guidelines, with quality appraisal using the Downs and Black checklist. Results: The search was conducted on 22 September 2022, resulting in 3673 records. Nine studies were included, involving a total of 3425 participants. PTSD prevalence ranged from 0% to 55.3%, depending on study design and timing of data collection. Risk factors included repeated exposure, lack of social support, and proximity to the victim. SA varied widely, with durations ranging from 1 day to over 6 months. Drivers frequently reported depression, somatoform disorders, and other long-term psychological impacts. Conclusions: PUT incidents significantly affect the mental health of train drivers and their ability to return to work, frequently leading to extended sickness absence. The timely identification of at-risk individuals and the implementation of best-practice interventions could mitigate long-term effects. Future research should explore standardized follow-up periods to improve comparability. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has profoundly affected mental health, with many survivors experiencing psychological challenges, including Post-Traumatic Stress Disorder (PTSD). This study assessed PTSD symptoms and Post-Traumatic Growth (PTG) among 62 individuals recovering from COVID-19 infection, all of whom were under the care of the Department of Pneumonology, Oncology, and Allergology at the Medical University of Lublin. Results revealed that 40.32% of participants exhibited PTSD symptoms. Key predictors of PTSD severity included cognitive symptoms and post-COVID self-rated health, with cognitive symptoms positively associated and self-rated health negatively associated with PTSD severity. A positive correlation was also found between PTSD severity and PTG, suggesting that while individuals endure significant psychological distress, they may also experience personal growth, such as enhanced resilience and a redefined life perspective. These findings highlight the dual psychological impact of COVID-19 infection, particularly for individuals with preexisting pulmonary conditions. They underscore the importance of holistic, integrated care that addresses both the reduction of PTSD symptoms and the promotion of meaningful psychological growth in COVID-19 survivors. [ABSTRACT FROM AUTHOR]

This study examines the psychological dimensions of trauma and identity fragmentation in Partition literature, focusing on Khushwant Singh’s Train to Pakistan and Saadat Hasan Manto’s Toba Tek Singh. Using the DSM-5 framework, the research bridges clinical psychology and literary studies to provide a nuanced understanding of trauma-related symptoms such as PTSD, dissociation, and depression. The analysis situates these symptoms within the cultural and historical context of Partition-era Punjab. Through a detailed exploration of character experiences, such as Hukum Chand’s emotional detachment and Bishan Singh’s identity confusion, the study reveals how trauma manifests in literary narratives. [ABSTRACT FROM AUTHOR]

Pandemic COronaVIrus Disease-19 (COVID-19) was a traumatic event that had a significant impact on the mental health of healthcare workers (HCWs), especially intensive care units (ICUs). Months of exposure and the threat of death can lead to post-traumatic stress disorder (PTSD), and high physical and emotional strain can lead to burnout syndrome (BOS). The purpose of this study was to assess the prevalence of PTSD and BOS among ICU HCWs during the COVID-19 pandemic. A case-control study was conducted in 2022 using a diagnostic survey method with 148 hCWs from two intensive care units: a temporary intensive care unit (tICU, n = 93) and a general intensive care unit (gICU, n = 55) in Cracow, Poland. The Impact of Events Scale (IES-R), Oldenburg Burnout Inventory (OLBI) and a proprietary questionnaire were used. The results obtained indicate that 46.62% (69) of HCWs had pronounced PTSD symptoms. In the tICU HCWs, 47.31% (44) had severe symptoms of PTSD, and in the gICU HCWs, 45.45% (25) were affected. HCWs in the tICU reported the highest score in the Hyperarousal domain (x = 1.52; SD = 0.87), while HCWs from the gICU reported higher scores in the Avoidance domain (xx = 1.45 SD = 0.81). HCWs presented moderate levels of job BOS in the domains of exhaustion (50.68%; 75) and lack of commitment (64.86%; 96). It was shown that lack of commitment to work was significantly more frequent in the tICU group than in the gICU group (p = 0.022). It was shown that the greater the level of exhaustion or withdrawal, the greater the severity of each PTSD symptom. Activity responsibility and fatigue were found to be the most stressful in the workplace. PTSD symptoms co-occurred with BOS. It is necessary to provide employees with targeted psychological support in dealing with the post-pandemic emotional crisis and support the retention of nurses in the profession. [ABSTRACT FROM AUTHOR]

• Different degrees of MS have varying effects on the susceptibility of adult rats to PTSD. • Rats subjected to short-term MS demonstrate adaptability when confronted with 'secondary stress'. • This process involves telomere shortening in the hippocampus, with notable gender differences. • The relative gene and protein expressions levels of TRF1 and TRF2 were upregulated. Early life stress (ELS) is thought to be a leading cause of mental disorders in adulthood, including PTSD. Recent studies have found that such stress has a gender and resilient specific effect on adult PTSD. This study aimed to assess emotion, and cognitive behavior, and to examine the sex differences and resilience of ELS on adult PTSD. At the same time, the expression of hippocampal telomere length and telomere repeat binding factors (TRF1 and TRF2) were detected to explore the mechanism of telomere length change. Rat offspring were separated from their dams (3 h/day or 6 h/day from PND2 ∼ PND14). Then, pups were treated with a single prolonged stress (SPS) procedure when they reached adulthood (PND80). Rats exposed early to MS and SPS showed anxiety-like and depression-like behaviors as well as impaired learning and memory. The rats exposed to MS3h showed reduced anxiety-like and depression-like behavior upon re-experiencing "secondary stress" compared to the SPS and MS6h groups. Behavioral results showed no significant gender difference. However, gender and SPS factors significantly affected telomere length and TRF1 and TRF2 gene expression in hippocampus. The SPS effect and MS*SPS interaction significantly impacted TRF1 and TRF2 protein expression. In conclusion, this study shows that MS has different effects on anxiety, depression, and cognitive memory deficits in rats experiencing "secondary stress" in adulthood and is accompanied by telomere shortening in the hippocampus. This reveals the potential impact of early MS on PTSD and provides a new perspective for further research in the field of psychological stress. [ABSTRACT FROM AUTHOR]

The authors, a museum educator and a psychiatrist, present a case study of their collaborative work to develop museum experiences for trauma survivors participating in an outpatient treatment program that uses Cognitive Processing Therapy. The thesis behind the program, now in its eighth year, was that an art museum experience could be designed to reinforce skills learned in CPT and to show participants that they could feel safe enough to take pleasure in a civic space. [ABSTRACT FROM AUTHOR]

Objective: Emotional granularity refers to the ability to recognize and distinguish between different emotional states, allowing individuals to respond appropriately to situations and manage their emotions more effectively. One of the main problems in post-traumatic stress disorder (PTSD) is the lack of clarity and emotional awareness that causes vulnerability to... [ABSTRACT FROM AUTHOR]

Purpose: This study examined the cross-cultural validity of nonviolent communication (NVC) behaviors as measured using the Nonviolent Communication Behaviors Scale (NVCBS) and explored their potential relationship with post-traumatic stress (PTS). Methods: We analyzed data from two samples (N = 412 Chinese adults and N = 283 English-speaking adults). Results: The best-fitting model of NVCBS was the proposed three-factor model ("self-connection," "authentic self-expression," and "empathic listening"), with configural, metric, and scalar invariance established across samples with different languages and sociocultural backgrounds. The NVCBS had satisfactory internal consistency and convergent validity and was negatively associated with PTS. The findings were replicated across the two samples. Discussion: NVC behaviors can be reliably and validly measured using the NVCBS. Given its brevity and measurement invariance across cultures, the NVCBS is a promising tool to facilitate future studies on NVC. Moreover, a lack of NVC behaviors may be a social-behavioral feature associated with PTS. [ABSTRACT FROM AUTHOR]

Background: The purpose of the Treatment for Harnessing Resiliency, Improving emotional regulation, and empowering indiViduals for a brighter future (THRIVE) study is to adapt an evidence-based posttraumatic stress disorder (PTSD) treatment for use among a polysubstance population receiving methadone maintenance treatment (MMT) at an opioid treatment program. Polysubstance use of high-risk combinations, such as illicit opioids and stimulants, is a critical public health issue. Individuals who engage in these high-risk combinations are more likely to have histories of childhood trauma, multiple traumas, PTSD, and greater PTSD severity as compared to mono-substance using individuals. Trauma, co-morbid mental health disorders such as PTSD, and polysubstance use complicate treatment outcomes. This study will use eight study phases to adapt an existing evidence-based PTSD intervention, Skills Training in Affective and Interpersonal Regulation with Narrative Therapy (STAIR-NT), via a massed treatment model (i.e., condensed treatment schedule) for patients in MMT who are engaged in sustained opioid-stimulant polysubstance use. Methods and analysis: The intervention is an adapted version of the STAIR-NT protocol. The massed version created includes four 60-min sessions of skill building and two weeks of four 60-min sessions of narrative therapy. A preliminary randomized controlled trial (RCT) with 80 participants, randomized 1:1, will be conducted to assess the intervention's implementation and impact on primary short-term outcomes of polysubstance use and PTSD symptoms. Ethics and dissemination: The results of this study will inform a fully-powered effectiveness trial for individuals with PTSD and polysubstance use receiving MMT. The findings are expected to provide valuable insights into improving both PTSD and substance use outcomes, and real-world implementation insights to integrating trauma-informed care in treatment settings for vulnerable populations. Registration: This study is registered at ClinicalTrials.Gov as NCT06307340. Registration date 03/2024. [ABSTRACT FROM AUTHOR]

This research examines the relationship between post-traumatic stress disorder (PTSD) and mental well-being (MWB) levels among employees who are not earthquake survivors. The devastating effects of earthquakes impact not only those directly affected but also all employees deeply. There have been no studies in the literature that address PTSD and MWB levels from the perspective of earthquakes, making this research an important contribution to the existing gap. The study was conducted with 203 voluntary employees. The status of employees not affected by the earthquake was assessed using the "Post-Traumatic Stress Disorder Checklist" and the "Warwick-Edinburgh Mental Well-Being Scale." Statistical analyses revealed a negative relationship between PTSD and MWB; as PTSD symptoms increased, MWB levels decreased. Additionally, it was found that demographic factors significantly influenced PTSD and MWB scores. These findings are considered to provide important contributions to improving employees' psychological health. [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) is a neuropsychiatric disorder that may develop after experiencing traumatic events. Preclinical studies use various methods to induce PTSD-like models such as fear-conditioning, single-prolonged stress (SPS), restraint stress, and social defeat. Brain-derived neurotrophic factor (BDNF) is a crucial neurotrophin in mood regulation. Evidence shows BDNF changes in different neuropsychiatric disorders particularly PTSD. This review examined BDNF alterations in preclinical rodent models of PTSD where we demonstrated a wide range of paradoxical changes in BDNF. We found that the fear-conditioning model produced the most inconsistent alterations in BDNF, and suggest that conclusions drawn from these changes be approached with caution. We suggest that BDNF maladaptive changes in social defeat and restraint stress models may be related to the duration of stress, while the SPS model appears to have more consistent results. Ultimately, we propose that evaluating BDNF alterations in the process of treating PTSD symptoms may not be a reliable factor. [ABSTRACT FROM AUTHOR]

Objectives: To develop a composite score for differential resilience to effects of combat‐related stressors (CRS) on persistent DSM‐IV post‐traumatic stress disorder (PTSD) among US Army combat arms soldiers using survey data collected before deployment. Methods: A sample of n = 2542 US Army combat arms soldiers completed a survey shortly before deployment to Afghanistan and then again two to three and 8–9 months after redeployment. Retrospective self‐reports were obtained about CRS. Precision treatment methods were used to determine whether differential resilience to persistent PTSD in the follow‐up surveys could be developed from pre‐deployment survey data in a 60% training sample and validated in a 40% test sample. Results: 40.8% of respondents experienced high CRS and 5.4% developed persistent PTSD. Significant test sample heterogeneity was found in resilience (t = 2.1, p = 0.032), with average treatment effect (ATE) of high CRS in the 20% least resilient soldiers of 17.1% (SE = 5.5%) compared to ATE = 3.8% (SE = 1.2%) in the remaining 80%. The most important predictors involved recent and lifetime pre‐deployment distress disorders. Conclusions: A reliable pre‐deployment resilience score can be constructed to predict variation in the effects of high CRS on persistent PTSD among combat arms soldiers. Such a score could be used to target preventive interventions to reduce PTSD or other resilience‐related outcomes. [ABSTRACT FROM AUTHOR]

This report presents the follow-up treatment course of a previously published case that demonstrated the effectiveness of prolonged exposure (PE) therapy for a disaster relief worker. The patient, a municipal employee in Fukushima Prefecture, developed post-traumatic stress disorder (PTSD) and mood disorders after the 2011 Great East Japan Earthquake and subsequent disasters. This follow-up focuses on the period from 2021 to early 2024, during which the patient experienced symptom recurrence after his father's death. This event revealed psychological patterns similar to his disaster-related responses. Schema therapy was introduced to address over-adaptive work behaviors and vulnerabilities in relationships, identified as relapse risk factors. Combined with antidepressants, schema therapy achieved sustained improvement. This longitudinal perspective demonstrates schema therapy's effectiveness in addressing underlying vulnerabilities when symptoms re-emerge after trauma-focused treatment. The findings underscore how initial trauma responses may interact with subsequent life events and suggest schema therapy's potential as a secondary intervention for disaster relief workers facing complex challenges. [ABSTRACT FROM AUTHOR]

Background The regulatory neuropeptide Y (NPY) is implicated in anxiety and post-traumatic stress disorder (PTSD)-related behaviors. NPY exerts its effects through 5 receptor subtypes, with Y1 and Y2 receptors being predominantly expressed in the rat brain. Activation of Y1 by full-length NPY1-36 induces anxiolytic effects, whereas Y2 binds truncated peptides, eliciting region-specific anxiogenic responses. Dipeptidyl peptidase-IV (DPP-IV) cleaves NPY, thereby modulating its functionality. Sitagliptin, a DPP-IV inhibitor (DPP-IV-I), inhibits the degradation of various vasoactive peptides, including cerebral NPY. As such, the therapeutic potential of DPP-IV-I following a traumatic event remains inconclusive. We assessed the effects of a highly selective DPP-IV-I, administered either shortly after the stressor or intermittently over 3 days, on behavioral outcomes using the predator scent stress (PSS) model of PTSD. Methods Rats exposed to PSS or sham-PSS received a single dose of sitagliptin (10 or 30 mg/kg) or saline 1 hour post-exposure, or repeated doses over 3 days (20 mg/kg). Behavioral outcomes were evaluated using the elevated plus maze and acoustic startle response at 7 days post-exposure. Additionally, rats exposed to PSS or sham-PSS were treated with sitagliptin (30 mg/kg) or saline, and their brains were prepared for immunofluorescence and enzyme-linked immunosorbent assay (ELISA). Results Sitagliptin did not attenuate anxiety-related behaviors or PTSD-related behavior prevalence compared to saline. Notably, the 30 mg/kg dose increased NPY levels in several brain regions without affecting NPY-Y1 levels. Conclusions The findings suggest that sitagliptin-induced upregulation of NPY levels shortly after PSS is insufficient to prevent the development of post-traumatic responses. The effectiveness of NPY signaling may be influenced by factors beyond peptide concentration alone, potentially limiting its therapeutic efficacy. Activation of NPY-Y1 receptors, rather than merely increasing NPY levels, appears to be crucial for modulating anti-anxiety and post-traumatic responses. [ABSTRACT FROM AUTHOR]

Background. Up to 30% of combatants are diagnosed with combat syndrome (post-traumatic stress disorder, PTSD), and 15% of veterans show symptoms even 10 years after the end of the war. Not only during hostilities, but also in peacetime, about 60% of people at different periods of their lives encounter traumatic events that can provoke a disorder that, in its totality of symptoms, resembles “combat syndrome”. Objective. PTSD is a multimodal disorder, the diagnosis and treatment of which requires an interdisciplinary approach. The article is devoted to a brief review of methods of psychophysiological (instrumental) diagnosis and neurorehabilitation of PTSD. Results. The key areas of psychophysiological research into the mechanisms of PTSD formation are highlighted. A review of the achievements and prospects of clinical psychophysiology in the development of instrumental methods for the diagnosis and neurorehabilitation of PTSD is presented. Conclusions. Methods of psychophysiology in combination with methods of psycho- and pharmacotherapy increase the effectiveness of treatment of PTSD and are indispensable in situations where patients do not trust the methods of conventional medicine or show insensitivity to traditional therapy. The most promising directions in the development of methods for instrumental diagnosis and correction of PTSD are the development of neurofeedback techniques and adaptive neural interfaces, TES and TMS methods, and the study of the contribution of genetic and epigenetic factors to the etiology of PTSD.

Abstract Background On October 7th, 2023, a mass terror attack was launched by Hamas militants, which was followed by the Israel-Hamas war. These events constitute a nationwide trauma with major ramifications for public mental health. This article presents an evidence-based model for the prediction of the prevalence of posttraumatic stress disorder (PTSD) related to the terrorist attack and the war. Main body: The creation of the model consisted of several steps. Firstly, the Israeli population was divided into six groups based on the intensity, context, and type of traumatic exposure (direct exposure to terror, close proximity to terror, soldiers in combat and support units, intense exposure to rocket attacks, moderate exposure to rocket attacks, and indirectly affected communities), and the population size of each group was assessed using official national databases. Secondly, an estimation of the expected prevalence of PTSD in each of the exposure groups was based on a review of the relevant literature. A random-effects meta-analysis of the prevalence rates was conducted separately per each exposure group. Finally, the predicted number of PTSD causalities in the population was calculated by multiplying the group size and the PTSD prevalence estimation. Based on population size and estimated PTSD prevalence within each exposure category, the model predicts that approximately 5.3% (N = 519,923) of the Israeli population (95% confidence interval, 1.64–9%), may develop PTSD as a result of the terrorist attack and the war. Conclusions The predicted number of individuals with PTSD following mass trauma is expected to be considerable. The presented model can assist policymakers, clinicians, and researchers in preparing and devising adequate interventions for the mental health needs of large populations. Moreover, this model can be applied in other instances of mass-trauma exposure.

Objective To investigate the prevalence of post-traumatic stress disorder (PTSD) in patients during the postoperative period following cardiac surgery and to identify its influencing factors. Methods Post-cardiac surgery patients hospitalized during Sep to Nov, 2023 were surveyed using questionnaires consisting of a general information questionnaire, PTSD checklist, resilience scale, social support rating scale, anxiety and depression self-rating scale, and simple coping style questionnaire. Then we analyzed the factors influencing PTSD symptoms after cardiac surgery. Results A total of 267 cases were enrolled. The mean PTSD score of the post-cardiac surgery patients was 16.51±12.31, with 29 patients at high risk for developing PTSD. Stepwise regression analysis revealed that low educational level, use of cardiopulmonary bypass, long stay in ICU, high pain scores, low levels of psychological resilience and social support, as well as high depression score were associated with higher PTSD scores in post-cardiac surgery patients (P<0.05) . Conclusion The occurrence of PTSD symptoms in patients after cardiac surgery is common and varies in severity. The influencing factors include the patient’s educational level, use of extracorporeal circulation during surgery, length of ICU stay, duration of ventilator use, pain, patient’s depression score, psychological resilience, and social support. Medical staff should pay more attention to the mental health level of high-risk patients and take targeted intervention measures in a timely manner. [ABSTRACT FROM AUTHOR]

Background: On October 7th, 2023, a mass terror attack was launched by Hamas militants, which was followed by the Israel-Hamas war. These events constitute a nationwide trauma with major ramifications for public mental health. This article presents an evidence-based model for the prediction of the prevalence of posttraumatic stress disorder (PTSD) related to the terrorist attack and the war. Main body: The creation of the model consisted of several steps. Firstly, the Israeli population was divided into six groups based on the intensity, context, and type of traumatic exposure (direct exposure to terror, close proximity to terror, soldiers in combat and support units, intense exposure to rocket attacks, moderate exposure to rocket attacks, and indirectly affected communities), and the population size of each group was assessed using official national databases. Secondly, an estimation of the expected prevalence of PTSD in each of the exposure groups was based on a review of the relevant literature. A random-effects meta-analysis of the prevalence rates was conducted separately per each exposure group. Finally, the predicted number of PTSD causalities in the population was calculated by multiplying the group size and the PTSD prevalence estimation. Based on population size and estimated PTSD prevalence within each exposure category, the model predicts that approximately 5.3% (N = 519,923) of the Israeli population (95% confidence interval, 1.64–9%), may develop PTSD as a result of the terrorist attack and the war. Conclusions: The predicted number of individuals with PTSD following mass trauma is expected to be considerable. The presented model can assist policymakers, clinicians, and researchers in preparing and devising adequate interventions for the mental health needs of large populations. Moreover, this model can be applied in other instances of mass-trauma exposure. [ABSTRACT FROM AUTHOR]

Background/Objectives. Burnout and occupational stress are significant issues among forensic professionals, impacting their well-being and job performance. This systematic review aims to provide an up-to-date overview of the occupational stress and burnout experienced by forensic personnel, exploring the profound and multifaceted impact on their physical, mental, professional, and interpersonal well-being. Methods. A systematic review was conducted following PRISMA guidelines using Scopus and WOS databases to search for articles published from 1 January 2000 to 31 August 2024. The search used keywords related to burnout and forensic professions. Inclusion criteria were original articles in English and French, while reviews, book chapters, editorials, and notes were excluded. A total of 10 studies were included after eliminating duplicates and excluding irrelevant articles. Results. The review identified seven key findings. (1) High levels of occupational stress and burnout among forensic personnel necessitate effective stress management strategies and resilience training; (2) autopsy technicians in Romania experience burnout and alexithymia, particularly related to traumatic events involving children, highlighting the need for specialized support systems; (3) disparities in burnout and post-traumatic stress disorder (PTSD) symptoms were observed in autopsy technicians and resident doctors, suggesting tailored mental health resources; (4) organizational factors, such as peer support and compensation satisfaction, significantly impact burnout and secondary traumatic stress (STS) among sexual assault nurse examiners; (5) burnout among forensic physicians, both in Romania and Egypt, is linked to personality traits, job satisfaction, and socio-demographic factors; (6) pathologists face a range of health issues, including musculoskeletal problems and psychological disorders, underscoring the need for industry-specific health measures; and (7) the lack of wellness resources for forensic professionals calls for improved mental health support and training. Conclusions. The findings highlight the pervasive issue of burnout and stress among forensic professionals globally. Addressing these challenges requires comprehensive stress management programs, tailored mental health resources, and organizational support. Future research should focus on developing and implementing effective interventions to enhance resilience and job satisfaction within this high-stress field. [ABSTRACT FROM AUTHOR]

Introduction: The Syrian refugee crisis has led to significant population displacement, with many seeking refuge and asylum in Nordic countries. While these countries offer safety and stability, the resettlement process combined with the refugees' own traumatic experiences can exacerbate existing or precipitate new mental health issues. Aim: This systematic review aims to comprehensively analyse the literature on mental health problems among Syrian refugees resettled in Nordic countries, exploring their prevalence and associated factors. Methods: A comprehensive literature search was conducted following PRISMA guidelines, utilizing databases including Web of Science, PubMed, MEDLINE, and Cochrane. The included studies focused on adult Syrian refugees or asylum seekers aged 18 and above, residing within Nordic countries, and investigated various mental health problems between March 2011 and January 2024, conducted in various Nordic countries. Results: Studies revealed high prevalence rates of PTSD (26%–45%), depression (40%–45%), and anxiety (30%–32%). Factors contributing to mental health problems included pre- and post-migration trauma, perceived discrimination, and socio-demographic variables. Pre-migration trauma exposure, such as witnessing violent events, was linked to trauma centrality and emotional suppression. Post-migration stressors like discrimination and financial strain, along with socio-demographic factors like gender and age, were associated with mental health issues. Specifically, female and older refugees reported higher levels of anxiety, depression, and low future expectations. Conclusion: The findings underscore the urgent need for comprehensive mental health assessment and services for Syrian refugees in Nordic countries. Addressing trauma, discrimination, and socio-economic challenges is crucial for improving their well-being and facilitating successful integration into host countries. [ABSTRACT FROM AUTHOR]

Forensic services have shifted their focus to the importance of forensic practice becoming more trauma informed. Trauma exposure is pervasive in forensic mental health populations and has been found to negatively impact the course of severe mental illness (SMI) and increase risk of violence. This study aimed to explore the trauma histories of adult male inpatients in a medium-secure psychiatric hospital, and examine childhood and adulthood trauma as predictors of diagnoses, self-harm, suicidality, hospital re-admissions, substance use, and nature of offense. The case files of 85 male patients in a medium secure unit in the UK were reviewed. Eighty-seven percent of patients had a schizophrenia diagnosis and 86% had extensive trauma histories, the most common trauma type being physical violence in childhood (44.7%). One patient had a PTSD diagnosis. Logistic regressions demonstrated that cumulative childhood and adulthood trauma significantly increased the odds of self-harm. Cumulative childhood trauma exposure was found to decrease the likelihood of having a schizophrenia diagnosis. There is a serious under-recognition of the extent and consequences of trauma exposure; trauma histories are likely greater than the findings of this study and existing literature suggests. Implications for clinical practice, trauma-informed care (TiC), and future research are proposed. [ABSTRACT FROM AUTHOR]

Public health crises can significantly impact the emotional well‐being of healthcare workers. Network analysis is a novel approach to exploring interactions between mental disorders at the symptom level. This study aimed to elucidate the characteristics of post‐traumatic stress disorder (PTSD), anxiety, depression, and insomnia symptoms network among frontline nurses under sudden public health crisis. A cross‐sectional survey was conducted online among 556 frontline nurses through convenience sampling in Hubei Province, China, from 21 February 2020, to 10 March 2020. Symptoms of PTSD, anxiety, depression, and insomnia were assessed by the Post‐Traumatic Stress Disorder Checklist (PCL‐5), Generalized Anxiety Disorder scale (GAD‐7), Patient Health Questionnaire (PHQ‐9) and Insomnia Severity Index, respectively. Central symptoms (the most important symptoms, activation has the strongest influence the other nodes) and bridge symptoms (nodes where deactivation can prevent activation from spreading from one disorder to another) were identified via centrality and bridge centrality indices, respectively. Network stability was examined using the case‐dropping procedure. We found that the correlation between PHQ‐9 item 9 'suicidal thoughts' and PCL‐5 item 16 'reckless or self‐destructive behaviour' was the strongest. Moreover, 'reckless or self‐destructive behaviour' was the strongest central symptom, and PHQ‐9 item 3 'sleep problems' was the most important bridge symptom. Other major symptoms included GAD‐7 item 6 'uncontrollable anxiety' and PHQ‐9 item 2 'depressed or sad mood'. Timely, systemic targeting interventions on central symptoms and bridge symptoms may effectively alleviate co‐occurring experiences of psychopathological symptoms among frontline nurses. [ABSTRACT FROM AUTHOR]

Background: Inadequate response to first- and second-line pharmacological treatments for psychiatric disorders is commonly observed. Ketamine has demonstrated efficacy in treating adults with treatment-resistant depression (TRD), with additional off-label benefits reported for various psychiatric disorders. Herein, we performed a systematic review and meta-analysis to examine the therapeutic applications of ketamine across multiple mental disorders, excluding mood disorders. Methods: We conducted a multidatabase literature search of randomized controlled trials and open-label trials investigating the therapeutic use of ketamine in treating mental disorders. Studies utilizing the same psychological assessments for a given disorder were pooled using the generic inverse variance method to generate a pooled estimated mean difference. Results: The search in OVID (MedLine, Embase, AMED, PsychINFO, JBI EBP Database), EBSCO CINAHL Plus, Scopus, and Web of Science yielded 44 studies. Ketamine had a statistically significant effect on PTSD Checklist for DSM-5 (PCL-5) scores (pooled estimate = ‒28.07, 95% CI = [‒40.05, ‒16.11], p < 0.001), Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) scores (pooled estimate = ‒14.07, 95% CI = [‒26.24, ‒1.90], p = 0.023), and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores (pooled estimate = ‒8.08, 95% CI = [‒13.64, ‒2.52], p = 0.004) in individuals with PTSD, treatment-resistant PTSD (TR-PTSD), and obsessive compulsive disorder (OCD), respectively. For alcohol use disorders and at-risk drinking, there was disproportionate reporting of decreased urge to drink, increased rate of abstinence, and longer time to relapse following ketamine treatment. Conclusions: Extant literature supports the potential use of ketamine for the treatment of PTSD, OCD, and alcohol use disorders with significant improvement of patient symptoms. However, the limited number of randomized controlled trials underscores the need to further investigate the short- and long-term benefits and risks of ketamine for the treatment of psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background: Mental healthcare for children and adolescents with a history of childhood abuse constitutes a major public health issue. Indeed, abuse exposes children to severe and complex post-traumatic stress disorder (cPTSD) but also to neurodevelopmental and psychological repercussions impacting the developmental trajectory. Trauma-focused care is essential to avoid the chronicization of symptoms and disorders. Objective: The aim of this prospective case series study was to investigate the efficacy of eye movement desensitization and reprocessing (EMDR) on complex post-traumatic symptoms and associated psychiatric disorders in adolescents with a history of abuse. Method: Twenty-two adolescents, aged 12 to 17, who had been abused during childhood were included. All adolescents met ICD-11 criteria for complex PTSD. Subjective measures of PTSD and associated psychiatric disorders were taken before (T0) and after 3 months of EMDR therapy (T1). Results: The average PTSD symptom score on the CPTS-RI significantly decreased from 40.2 to 34.4 after EMDR, indicating improvement in post-traumatic symptoms. A significant decrease in the average depression score (CDI from 18.2 at T0 to 10.6 at T1), anxiety score (R–CMAS from 21.3 at T0 to 13.3 at T1), emotional regulation score (ALS from 29 at T0 to 10.8 at T1), insomnia score (ISI from 18.5 at T0 to T1 of 9.2 at T1), and harmful use of alcohol and drugs score (ADOSPA from 2.3 at T0 to 0.3 at T1) was observed after EMDR therapy, as well as an increase in quality of life (CBCL 4–16 score from 57.9 at T0 to 77.4 at T1). Conclusions: The results of this study are encouraging and suggest that EMDR may be effective in the symptom management reducing post-traumatic symptoms and certain comorbid disorders frequently seen in adolescents who have experienced childhood abuse. Further research is needed on adolescent populations suffering from cPTSD (e.g., randomized controlled trials with control groups and other therapies or evaluating the action of the different phases of the study). [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) is a psychiatric condition producing considerable distress, dysfunction, and impairment in affected individuals. While various forms of psychotherapy are commonly utilized in PTSD treatment, the known neurological pathologies associated with PTSD are insufficiently addressed by these conventional approaches. Heart rate variability biofeedback (HRV-BFB) is a promising tool for correcting autonomic dysfunction in PTSD, with subsequent changes in clinically significant outcome measures. This paper outlines a systematic approach for the development, distribution, and implementation of a prescription at-home HRV-BFB digital therapeutic. We provide recommendations for evidence-generation strategies and propose appropriate regulatory pathways within existing frameworks. Widespread access to HRV-BFB could potentially reduce the distress, disability, and healthcare burden associated with PTSD. Promoting HRV-BFB as a primary intervention could also serve to reduce the stigma associated with “mental” illness and increase health literacy regarding the neuroimmune impacts of psychosocial factors. These processes might in turn improve treatment-seeking, adherence, and supported self-management of these conditions.

Anxiety disorders are the most commonly diagnosed mental disorders worldwide, and their prevalence continues to rise, leading to significant social and economic burdens. Recent interest has focused on CBD as a potential treatment. This systematic review assesses the current evidence on the efficacy of CBD in treating anxiety and related disorders, including post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and autism spectrum disorder (ASD). Unlike open-label trials prone to placebo bias, this study reviews randomized, double-blind, placebo-controlled trials. A review of literature was conducted using the Google Scholar database to gather information on "cannabidiol," specifically focusing on its relationship with "anxiety," "social anxiety disorder", "post-traumatic stress disorder” and ,,human trials." Positive outcomes were observed with 300 mg CBD doses, reducing anxiety in SAD patients, tremor in Parkinson’s disease, and anxiety in ASD and opioid-dependent individuals. Minimal improvements were noted in PTSD patients with sexual trauma. Further research is needed to clarify CBD’s therapeutic potential in diverse clinical contexts.

The article discusses the potential advantages of using phenomenological psychopathology methods to improve the diagnosis of post-traumatic stress disorder (PTSD) and anxiety-depressive disorders, especially in the context of the ongoing war in Ukraine. It highlights the limitations of relying solely on the diagnostic criteria set out in International statistical classification of diseases and related health problems, 10th revision (ICD-10), arguing that they may not reflect the subjective, lived experience of mental disorders. The authors note a significant increase in the number of diagnosed mental and behavioural disorders in Ukraine since the Russian invasion. The number of cases of PTSD has quadrupled compared to pre-war levels. Common triggers include fear, anxiety, witnessing violence, personal harm, loss of loved ones, isolation, and displacement. The study used analytical, comparative, and interdisciplinary methods to explore how the approaches of phenomenological philosophy and phenomenological psychopathology can complement traditional psychiatric interviewing. Phenomenological psychopathology is an interdisciplinary field that aims to study changes in dimensions such as lived time, space, body, and self that manifest in mental illness. The main methods include semi-structured phenomenological interviews that allow patients to describe their subjective experiences. The authors argue that the combination of phenomenological methods with standard psychiatric diagnostic methods in Ukraine will allow for a more complete and accurate diagnosis of PTSD, anxiety, depression, and other conditions exacerbated by the war. This interdisciplinary, patient-centred approach promises to improve the quality of mental health care as the country recovers. However, they acknowledge that the application of these methods in Ukraine is currently fragmented. The authors suggest that the methods of phenomenological psychopathology are a valuable but underutilised tool for addressing the challenges facing the mental health system in Ukraine.

IntroductionMillions of people living in volcanic environments are at risk of experiencing volcanic eruptions, a natural disaster. This systematic review aimed to collect empirical evidence of the effects of volcanic eruptions on the mental health of the exposed populations.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted systematic searches on Scopus, PubMed, PsycINFO, Medline, and Web of Science (WoS) databases.ResultsA total of 17,044 articles were screened. Of these, 24 articles met the inclusion criteria and data were extracted. Twenty-one articles investigated psychological disorders, two articles studied emotions and their relationships with certain environmental factors, and one article explored cognitive functions in the exposed populations. These studies showed that highly exposed populations were more vulnerable to develop long-lasting psychological disorders than less exposed populations.ConclusionThe negative influence of experiencing volcanic activity on mental health was confirmed. Clearly, there is a need for more research to improve the mental health of the populations highly exposed to volcanic eruptions. Recommendations for future research are also included.

Abstract Background During recent years, Europe has faced the arrival of migrants whereof a considerable group of youth present mental health problems, such as symptoms of post-traumatic stress disorder (PTSD). Schools offer a safe environment for mental health interventions to these groups, yet there is limited research on the impact of school-based interventions addressing mental health problems in newcomer youths, especially in the Swedish context. This cluster randomized controlled trial (RCT) aimed to explore the effectiveness of the Teaching Recovery Techniques (TRT) intervention among newcomer students with PTSD symptoms in Swedish secondary schools. Methods Nine schools were randomly assigned to TRT or a wait list control group prior to the baseline assessment. Follow-up data were collected immediately following the intervention and three months post-intervention. In total, 531 students were approached, of which 61 gave consent and were eligible to be included in the study: 55 in TRT and 6 in the control condition. Given the low number of participants in the control condition, we merely analyzed students who had received TRT. Results We report on feasibility of recruitment, data collection, intervention delivery and intervention effectiveness. In terms of intervention effectiveness, within subjects ANOVAs revealed significant reductions in PTSD symptoms and general mental health problems from baseline to the three months-follow-up (p

Background: Post-traumatic stress disorder (PTSD) is a well-known psychiatric disorder that can occur after a major traumatic event and adversely impact the individual’s mental health. PTSD is a multifaceted mental health problem that requires long periods of treatment and expensive treatment protocols. Despite significant advances in treatment, there is little evidence of the economic burden and social support associated with PTSD. Hence, this study examines empirical research on the economic burden and social support associated with patients with PTSD. Methods: In this study, we used the preferred reporting items for systematic reviews and meta-analyses guided scoping review protocol to assess the research on the economic burdens and social support associated with PTSD patients. Accordingly, we selected 14 primary research studies examining the economic burden and 17 primary studies examining social support for PTSD patients. Results: PTSD patients incur a high economic burden worldwide with huge direct cost variability. Meanwhile, social support is an impactful approach to curbing the impacts of PTSD on patients. This study demonstrated the substantial role of social support in reducing PTSD symptoms and as a significant moderator in the treatment of PTSD patients. Conclusion: PTSD is a mental health problem associated with a highly variable economic burden on patients and healthcare systems across the globe. In addition, social support facilitates the speedy recovery of PTSD patients. Because of the high economic burden associated with PTSD, the World Health Organization (WHO) should formulate a policy that improves resource allocation specifically for vulnerable individuals with PTSD.

Background: New research in the field of psychological trauma has emphasized (a) the heterogeneity of psychological reactions after traumatic events and (b) the existence of distinct symptom trajectories. Aims: In this study, existing data on post-traumatic stress disorder (PTSD) symptoms in 66 parent-child dyads were re-examined in the light of this literature in order to establish whether a similar pattern of symptom trajectories also applies to this population. Study Design: A prospective observational cohort study. Participants' PTSD symptoms were assessed 3 and 12 months after discharge from a paediatric intensive care unit (PICU), using a short form of the Davidson Trauma Scale with parents and the Child Revised Impact of Events Scale with children aged 7-17 years. Results: Results confirmed that the majority of children (58%) and parents (46%) exhibited a 'Resilient' PTSD trajectory over the year, in the sense that their scores remained in the non-clinical range at both timepoints. Children displaying a 'Resilient' trajectory were more likely to have a parent who also displayed a 'Resilient' trajectory (p = .018). However, there was also evidence of a 'Recovery' trajectory in a significant minority in this sample and over 1 in 4 children and parents exhibited a 'Chronic' or 'Delayed' symptom trajectory. Conclusions: Although average PTSD scores reduced over time in this sample and 'Resilient' trajectories were common, a significant proportion of children and parents exhibited 'Chronic' and 'Delayed' symptom trajectories. Relevance to Clinical Practice: These results suggest that, although the majority do well, a significant number of children and family members may develop chronic or delayed symptoms of PTSD in the year following PICU discharge. The monitoring of individual family members' symptoms beyond 3 months post-discharge may help to determine those who might most benefit from further support. [ABSTRACT FROM AUTHOR]

Children can develop post-traumatic stress disorder (PTSD) and mental health symptoms after traumatic events. This meta-analysis evaluated the influence of moderators of cognitive behavioural trauma treatment (CBTT) with caregiver involvement in traumatized children. A total of 28 studies were included, with 23 independent samples and 332 effect sizes, representing the data of 1931 children (M age = 11.10 years, SD = 2.36). Results showed a significant medium overall effect (d = 0.55, t = 2.478, p = 0.014), indicating CBTT with caregiver involvement was effective in treating PTSD (d = 0.70), with somewhat smaller effect sizes for internalizing, externalizing, social, cognitive and total problems (0.35 < d > 0.48). The positive treatment effect was robust; we found somewhat smaller effect sizes at follow-up (d = 0.49) compared to post-test (d = 0.57) assessments. Furthermore, several sample (i.e. child's age, gender, and trauma event), programme (i.e. the duration of treatment, number of sessions), study (i.e. control condition, type of instrument, informant, type of sample), and publication (i.e. publication year and impact factor) characteristics moderated the treatment outcomes of the child. In sum, the results of our meta-analysis might help to improve the effectiveness of cognitive behavioural trauma treatment for youth with PTSD, and guide the development of innovative trauma interventions that involve caregivers. Implications for theory and practice are discussed. [ABSTRACT FROM AUTHOR]

Background: Post-traumatic stress disorder (PTSD) is a well-known psychiatric disorder that can occur after a major traumatic event and adversely impact the individual’s mental health. PTSD is a multifaceted mental health problem that requires long periods of treatment and expensive treatment protocols. Despite significant advances in treatment, there is little evidence of the economic burden and social support associated with PTSD. Hence, this study examines empirical research on the economic burden and social support associated with patients with PTSD. Methods: In this study, we used the preferred reporting items for systematic reviews and meta-analyses guided scoping review protocol to assess the research on the economic burdens and social support associated with PTSD patients. Accordingly, we selected 14 primary research studies examining the economic burden and 17 primary studies examining social support for PTSD patients. Results: PTSD patients incur a high economic burden worldwide with huge direct cost variability. Meanwhile, social support is an impactful approach to curbing the impacts of PTSD on patients. This study demonstrated the substantial role of social support in reducing PTSD symptoms and as a significant moderator in the treatment of PTSD patients. Conclusion: PTSD is a mental health problem associated with a highly variable economic burden on patients and healthcare systems across the globe. In addition, social support facilitates the speedy recovery of PTSD patients. Because of the high economic burden associated with PTSD, the World Health Organization (WHO) should formulate a policy that improves resource allocation specifically for vulnerable individuals with PTSD. [ABSTRACT FROM AUTHOR]

Objective: The devastating Kahramanmaras earthquake doublet struck with a magnitude of Mw 7.8 and Mw 7.7, occurring 9 hours apart on February 6, 2023. Earthquakes can cause significant psychological impacts. This study aimed to investigate the prevalence and determinants of probable post-traumatic stress disorder (PTSD) among university students eight months following the 2023 earthquake doublet in Kahramanmaras, Turkiye. Method: Convenience sampling was used to recruit participants. The study included 445 university students who completed a detailed questionnaire about the 2023 Turkiye-Syria earthquakes, along with the PTSD checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, PCL-5). Researchers prepared the questionnaire to evaluate pre-earthquake psychiatric history, behavioral reactions during and after the earthquake, experiences of being trapped under rubble, physical injury status, extent of property damage, and loss of loved ones through face-to-face interviews. Results: According to the PCL-5 scores, 61.6% of the participants exhibited probable earthquake-related PTSD. Factors associated with a higher prevalence of probable earthquake-related PTSD included being female, having severe house damage, pre-existing psychiatric conditions, and a history of traumatic events. Only 26.5% of the participants were in a safer location outside buildings during the second earthquake. Conclusion: A total of 274 subjects (61.6%) were diagnosed with probable earthquake-related PTSD eight months after the 2023 Kahramanmaras earthquake. The determinants linked to a probable PTSD diagnosis were severe house damage, preexisting psychiatric conditions, a history of traumatic events, and being female. These findings enhance our understanding of probable earthquake-related PTSD, its associated risk factors, and underscore the importance of taking preventive measures to mitigate the psychological impacts of earthquakes. [ABSTRACT FROM AUTHOR]

Since the first reported outbreak in China, the Coronavirus disease 2019 (COVID‐19) has raised serious concerns globally. The COVID‐19 pandemic has caused a severe psychological impact on healthcare workers (HCWs), and especially nurses, who are the most numerous and exposed frontline group. This systematic review and meta‐analysis aims to summarise extant literature on the effects of the COVID‐19 pandemic on the psychological health of nurses, particularly concerning the prevalence and risk factors for post‐traumatic stress disorder (PTSD). A systematic search was conducted on PubMed, Embase and PsycInfo from March 2020 to July 2023. Articles were included/excluded on predetermined eligibility criteria. A random‐effect meta‐analysis was performed using proportions to determine the pooled prevalence for PTSD among nurses. Subgroup analyses were also performed, and heterogeneity across studies was analysed using meta‐regression. Relatively high prevalence rates of PTSD were reported among nurse populations during the COVID‐19 pandemic in twenty‐six different countries, globally. Risk factors associated with PTSD include having prior mental health co‐morbidities, being a female, having high exposure/contact with COVID‐19 patients, having insufficient protective conditions and having intensive workloads. The overall pooled prevalence was 29.1% (95% C.I. = 23.5%, 35.5%) using a random‐effects model in 55 studies. The regression test of funnel plot asymmetry indicated a significant level of publication bias among studies. The COVID‐19 pandemic is associated with significant levels of PTSD among frontline nurses globally. A high level of heterogeneity was observed across studies. Psychological, social and administrative interventions should be implemented to mitigate heavy psychological distress in nurses. [ABSTRACT FROM AUTHOR]

There is a significant co-occurrence of opioid use disorder (OUD) and post-traumatic stress disorder (PTSD) in clinical populations. However, the neurobiological mechanisms linking chronic opioid use, withdrawal, and the development of PTSD are poorly understood. Our previous research has shown that proinflammatory cytokines, expressed primarily by astrocytes in the dorsal hippocampus (DH), play a role in the development of heroin withdrawal-enhanced fear learning (HW-EFL), an animal model of PTSD-OUD comorbidity. Given the role of astrocytes in memory, fear learning, and opioid use, our experiments aimed to investigate their involvement in HW-EFL. Experiment 1 examined the effect of withdrawal from chronic heroin administration on GFAP surface area and volume, and identified increased surface area and volume of GFAP immunoreactivity in the dentate gyrus (DG) following 24-hour heroin withdrawal. Experiment 2 examined astrocyte morphology and synaptic interactions at the 24-hour withdrawal timepoint using an astroglial membrane-bound GFP (AAV5-GfaABC1D-lck-GFP). Although we did not detect significant changes in surface area and volume of GfaABC1D-Lck-GFP labelled astrocytes, we did observe a significant increase in the colocalization of astrocyte membranes with PSD-95 (postsynaptic density protein 95) in the DG. Experiment 3 tested if stimulating astroglial Gi signaling in the DH alters HW-EFL, and our results demonstrate this manipulation attenuates HW-EFL. Collectively, these findings contribute to our current understanding of the effects of heroin withdrawal on astrocytes and support the involvement of astrocytes in the comorbid relationship between opioid use and anxiety disorders. [ABSTRACT FROM AUTHOR]

BackgroundPost-Traumatic Stress Disorder (PTSD) is a severe and pervasive mental disorder, and patients experience numerous distressing symptoms and impairments that significantly impact their lives. In addition to being a mental disorder, PTSD is strongly associated with a wide range of metabolic abnormalities that affect the entire body. Existing treatment options of psychotherapy and medications are often ineffective. Exploring other potential treatments is necessitated. The ketogenic diet has shown potential as a metabolic therapy in certain neurological and mental disorders and is a promising intervention in the treatment of PTSD.AimThis study aimed to examine if a 4-week ketogenic diet intervention supplemented with exogenous ketones (KD-KS) was feasible in adult patients with PTSD, to what extent it was possible to recruit patients, attain and maintain ketosis (plasma concentration of β-hydroxybutyrate (BHB) ≥ 0.5 mmol/L), the occurrence of serious adverse reactions and adverse reactions to KD-KS, and acceptance of treatment. Our exploratory aims were changes in PTSD symptoms and health-related quality of life (QoL) from baseline to 4 weeks.MethodsPatients 18 ≤ 65 years old, diagnosed with PTSD, and receiving outpatient treatment for PTSD at Southern Oslo District Psychiatric Centre (DPC), Oslo University Hospital, Oslo, Norway, were included. The intervention consisted of a ketogenic diet supplemented with β-hydroxybutyrate salt to obtain ketosis. PTSD symptoms were measured with the PTSD Checklist for DSM-5 (PCL-5) and QoL was measured with the RAND 36-Item Health Survey 1.0.ResultsDuring a 21-week inclusion period, three of four eligible patients (75% [95% CI: 30 to 95%]) were included. Two patients (67% [95% CI: 21 to 94%]) completed the 4-week intervention and one patient (33% [95% CI: 6 to 79%]) completed 2 weeks of intervention before discontinuing. Ketosis was achieved on day 1 in one patient, and on day 2 in two patients, and was maintained in 87% of the intervention. There were no serious adverse reactions. Adverse reactions were reported in a total of 70% of intervention days, the most frequent being headache followed by fatigue. The participant-perceived degree of adverse reactions was low to moderate. The treatment was accepted by patients on all intervention days. PCL-5 decreased by 20 points (70 to 50) in patient 1 and by 10 points (50 to 40) in patient 2, from baseline to 4 weeks, which is a reliable and clinically meaningful improvement. QoL improved in six of eight RAND-36 subscales in patient 1 and three of eight in patient 2. Patient 3 did not complete assessments after week 2.ConclusionTo the best of our knowledge, this feasibility study is the first study examining a ketogenic diet intervention in patients with PTSD. Three of four predefined feasibility criteria were achieved. Ketosis was attained fast and maintained, patients were compliant and there were clinically meaningful improvements in PTSD symptoms and QoL. Despite the small sample size, the knowledge obtained in this study is important for the planning of future studies with ketogenic diet interventions in this patient group. It is a first step for potential dietary and metabolic therapies in PTSD. Further feasibility and pilot studies with larger sample sizes are needed to determine feasibility and safety before planning future randomised controlled trials investigating an effect.Clinical trial registrationhttps://ClinicalTrials.gov, identifier NCT05415982.

Virtual Reality Exposure Therapy (VRET) has emerged as a groundbreaking tool in the treatment of Post-Traumatic Stress Disorder (PTSD) and anxiety disorders, offering a controlled, immersive environment that facilitates desensitization and fear extinction. The review process adhered strictly to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. This literature review explores the mechanisms by which VRET enhances therapeutic outcomes, comparing its efficacy to traditional exposure therapies. Through an examination of clinical applications, particularly in PTSD and various anxiety disorders, the review highlights both the advantages of VRET—such as increased patient engagement and treatment customization—and its challenges, including technological limitations and ethical considerations. Future directions for VRET are also discussed, emphasizing its potential to revolutionize mental health care by integrating advancements in technology and personalized treatment approaches.

Recent studies have documented that post-traumatic stress disorder (PTSD) symptoms are robustly associated with depressive symptoms and may mediate the relationship between trauma exposure and depressive symptoms. However, no study has explored the differential mediating effects of four specific PTSD symptom clusters. This study made the first attempt to examine the mediating effects of different PTSD symptom clusters on the linkage between trauma exposure and depressive symptoms. We analyzed data from two large samples of Chinese middle school students (N = 693 and 957) who had experienced the 2013 Ya'an earthquake. Participants completed standardized measures of trauma exposure, PTSD symptoms, and depressive symptoms. The prevalence of probable PTSD was 3.4% and 3.6%, respectively, in the two samples. Mediation analyses revealed that negative alterations in cognitions and mood and alterations in arousal and reactivity were statistically significant mediators in the relationship between trauma exposure during the earthquake and depressive symptoms. The results are very consistent in both samples. The findings suggest that symptom-specific tailored management of these two specific PTSD symptom clusters might have the potential to change the trajectory of developing depressive symptoms among trauma-exposed populations.

Backgrounds: Memory and emotion are especially vulnerable to psychiatric disorders such as post-traumatic stress disorder (PTSD), which is linked to disruptions in serotonin (5-HT) metabolism. Over 90% of the 5-HT precursor tryptophan (Trp) is metabolized via the Trp-kynurenine (KYN) metabolic pathway, which generates a variety of bioactive molecules. Dysregulation of KYN metabolism, particularly low levels of kynurenic acid (KYNA), appears to be linked to neuropsychiatric disorders. The majority of KYNA is produced by the aadat (kat2) gene-encoded mitochondrial kynurenine aminotransferase (KAT) isotype 2. Little is known about the consequences of deleting the KYN enzyme gene. Methods: In CRISPR/Cas9-induced aadat knockout (kat2-/-) mice, we examined the effects on emotion, memory, motor function, Trp and its metabolite levels, enzyme activities in the plasma and urine of 8-week-old males compared to wild-type mice. Results: Transgenic mice showed more depressive-like behaviors in the forced swim test, but not in the tail suspension, anxiety, or memory tests. They also had fewer center field and corner entries, shorter walking distances, and fewer jumping counts in the open field test. Plasma metabolite levels are generally consistent with those of urine: antioxidant KYNs, 5-hydroxyindoleacetic acid, and indole-3-acetic acid levels were lower; enzyme activities in KATs, kynureninase, and monoamine oxidase/aldehyde dehydrogenase were lower, but kynurenine 3-monooxygenase was higher; and oxidative stress and excitotoxicity indices were higher. Transgenic mice displayed depression-like behavior in a learned helplessness model, emotional indifference, and motor deficits, coupled with a decrease in KYNA, a shift of Trp metabolism toward the KYN-3-hydroxykynurenine pathway, and a partial decrease in the gut microbial Trp-indole pathway metabolite. Conclusions: This is the first evidence that deleting the aadat gene induces depression-like behaviors uniquely linked to experiences of despair, which appear to be associated with excitatory neurotoxic and oxidative stresses. This may lead to the development of a double-hit preclinical model in despair-based depression, a better understanding of these complex conditions, and more effective therapeutic strategies by elucidating the relationship between Trp metabolism and PTSD pathogenesis.

Background: Determining the prevalence of PTSD and contributing variables among (EMS) specialists was the goal of the current investigation. Furthermore, limited evidence exists regarding the application of PCL-5 for EMT practitioners, and the incidence of PTSD among different age groups and genders in Saudi Arabia. Methods: This cross-sectional descriptive study includes 211 prehospital care providers of the Saudi Red Crescent Authority stations in Riyadh. The randomization was done using Google Forms into subgroups according to participants' gender, years of experience, occupations, and average working hours. The presence and severity of PTSD symptoms were evaluated using the 20-item PTSD Checklist for DSM-5 (PCL-5) self-report questionnaire. Data were analyzed using Pearson Chi-Square, Mann-Whitney and Kruskal-Wallis tests. The reliability statistics were calculated using Cronbach's Alpha for the 20-survey questionnaire. Results: The comparison of PCL-5 total scores indicated more PTSD symptomatology among females (1.61 + 0.799) as compared to male workers (1.13 + 0.642). The total score of PTSD demonstrated no statistically significant (P=0.79) differences between our age group classifications. In terms of the participants' city (Riyadh), the total PTSD score was less than the cutoff point which is 31. PTSD total score may not be affected by working experience as indicated by the non-significant difference in prevalence among EMT practitioners having <5 years, 5-10 years and above 10 years of working experience (P=0.215 with X2 = 3.076). PTSD incidence is affected by the type of occupation as statistically significant differences between groups (P=0.001) were recorded depending on the position and responsibilities of EMS practitioners. PTSD is also affected by average working hours per week, and there were statistically significant differences between groups (P=0.001). Conclusion: The total score of PTSD in the case of emergency service practitioners was found to be 33.7% among all the research participants, which may be regarded as a high prevalence when compared to the general population. Our investigations would contribute to a better understanding of the underlying factors of mental stress in EMS specialists in Saudi Arabia and to the development of adequate mental health practices. [ABSTRACT FROM AUTHOR]