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Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
Fear learning is a core component of conceptual models of how adverse experiences may influence psychopathology. Specifically, existing theories posit that childhood experiences involving childhood trauma are associated with altered fear learning processes, while experiences involving deprivation are not. Several studies have found altered fear acquisition in youth exposed to trauma, but not deprivation, although the specific patterns have varied across studies. The present study utilizes a longitudinal sample of children with variability in adversity experiences to examine associations among childhood trauma, fear learning, and psychopathology in youth.
Methods
The sample includes 170 youths aged 10–13 years (M = 11.56, s.d. = 0.47, 48.24% female). Children completed a fear conditioning task while skin conductance responses (SCR) were obtained, which included both acquisition and extinction. Childhood trauma and deprivation severity were measured using both parent and youth report. Symptoms of anxiety, externalizing problems, and post-traumatic stress disorder (PTSD) were assessed at baseline and again two-years later.
Results
Greater trauma-related experiences were associated with greater SCR to the threat cue (CS+) relative to the safety cue (CS−) in early fear acquisition, controlling for deprivation, age, and sex. Deprivation was unrelated to fear learning. Greater SCR to the threat cue during early acquisition was associated with increased PTSD symptoms over time controlling for baseline symptoms and mediated the relationship between trauma and prospective changes in PTSD symptoms.
Conclusions
Childhood trauma is associated with altered fear learning in youth, which may be one mechanism linking exposure to violence with the emergence of PTSD symptoms in adolescence.
Phenol and its derivatives are regarded as ‘priority pollutants’ and p-nitrophenol (p-NP), in particular, is of great interest due to its toxicity and frequent presence in waste waters and fresh waters. Straightforward, inexpensive methods to identify p-NP in water, however, is lacking. In the present study, an electrochemical technique using clay-modified electrodes to measure p-NP was investigated as a potentially promising method to fill that gap. A glassy carbon electrode (GCE) was modified with a thin layer of Na-enriched bentonite and a series of benzyltrimethylammonium (BTMA+)-bentonites (BTMA+-B) in order to confirm these materials as p-NP electrosensitive. A series of organobentonites was synthesized using different BTMA+/bentonite ratios. The materials obtained were characterized using X-ray diffraction, Fourier-transform infrared spectroscopy, and a low-temperature nitrogen adsorptiondesorption method. A monolayer arrangement of BTMA+ within the interlamellar region of beidellite-rich smectite was confirmed. Deterioration of the textural properties was observed with increase of BTMA+ loading. The electro-oxidation of p-NP in an acidic medium on BTMA+-B-modified GCE was investigated. The cyclic voltammetry method with a three-electrode cell was used. The reference electrode was Ag/AgCl in 3 M KCl and a Pt foil was the counter electrode. For each electrochemical measurement, a different BTMA+ loading in BTMA+-B was used as the material for GCE coating and applied as the working electrode. The electrochemical activity of BTMA+-B-based electrodes increased with BTMA+ loading. The results confirmed that the organophylic character of the BTMA+-B-modified surface was the main influence on the electrochemical activity of the BTMA+-B-based GCE; the influence of textural properties was almost negligible. The increased electrode activity toward p-NP was achieved by the adsorption of p-NP on the electrode surface, the process that commonly precedes the electro-oxidation. The present study showed that synthesized materials could potentially be used in an electrochemical test for the presence of p-NP in water solutions.
In contrast to women, men do no experience a sudden cessation of gonadal function comparable to menopause. However, there is a progressive decline in hypothalamic-pituitary-gonadal function in aging men: testosterone level decline, and there is a loss of circadian rhythm of testosterone secretion.
By age 75 years, mean plasma testosterone levels have decreased 35% compared with young adults, and more than 25% of men of this age are clinically hypogonadal. Age related hypogonadism, which has been termed»andropause«, is thought to be responsible for variety of symptoms experienced by elderly men, including reduced muscle and bone mass, sexual dysfunction, depression, fatigue and irritability.
Objectives
However, it has been difficult to establish correlations between these symptoms and plasma testosterone levels. Clinical trials of testosterone replacement have documented some symptoms relief (improved muscle strength and bone mineral density), yet studies to date on the specific relation between depression and testosterone level have been methodologically flawed.
Methods
Data are presented from systematic clinical and epidemiological studies with bearing on this relation:
1. population-based assessments of the relation between testosterone level, genetic factors and depression in elderly men,
2. placebo-controlled clinical trials of testosterone replacement in men with major depressive disorder.
Results
Results suggest that age-related hypothalamo-pituitary-gonadal hypofunction may have particular etiologic importance in late-onset male dysthimia.
Conclusions
However, there is still the dilemma whether late-onset depression in older men is predominantly biological (in which testosterone decline certainly plays an important role), psychosocial, or stress-diathesis origin.
Race with cars is currently one of the most popular sports.
Objectives
The aims of this study are establishing the profile of persons with posttraumatic stress disorder by using psychopathological dimensions – clinical scales (MMPI). Psychiatric measures (HAMD, HAMA, API) exploited to detect differences between acute and delayed type of PTSD on the level of depression, anxiety, and readiness for panic.
Methods
The research included 30 drivers: 20 have reacted with acute and 10 with delayed onset of PTSD. Diagnosis criteria were DSM-V.
Results
The scores on subscales at MMPI personality profile for acute and delayed type of PTSD, are much higher D (T=80.15, t=3.10, p<0.05) and Hy (T=79.25, t=3.02, p<0.05), in relate to normal (T=70). There was high level of appearing the structural correlates D (t=4.22, p<0.01) and HS (t=3.43, p<0.01) in delayed PTSD in relate to acute.
Conclusions
There is a higher level of depression (HAMD: t=4.03, p<0.01) and of anxiety (HAMA: t=3.05, p<0.05). There is no statistical difference between acute and delayed PTSD, considering the panic. Whether running risk remains controversial.
Key words: PTSD, cars drivers, and psychological profile
Several hypotheses may explain the association between substance use, posttraumatic stress disorder (PTSD), and depression. However, few studies have utilized a large multisite dataset to understand this complex relationship. Our study assessed the relationship between alcohol and cannabis use trajectories and PTSD and depression symptoms across 3 months in recently trauma-exposed civilians.
Methods
In total, 1618 (1037 female) participants provided self-report data on past 30-day alcohol and cannabis use and PTSD and depression symptoms during their emergency department (baseline) visit. We reassessed participant's substance use and clinical symptoms 2, 8, and 12 weeks posttrauma. Latent class mixture modeling determined alcohol and cannabis use trajectories in the sample. Changes in PTSD and depression symptoms were assessed across alcohol and cannabis use trajectories via a mixed-model repeated-measures analysis of variance.
Results
Three trajectory classes (low, high, increasing use) provided the best model fit for alcohol and cannabis use. The low alcohol use class exhibited lower PTSD symptoms at baseline than the high use class; the low cannabis use class exhibited lower PTSD and depression symptoms at baseline than the high and increasing use classes; these symptoms greatly increased at week 8 and declined at week 12. Participants who already use alcohol and cannabis exhibited greater PTSD and depression symptoms at baseline that increased at week 8 with a decrease in symptoms at week 12.
Conclusions
Our findings suggest that alcohol and cannabis use trajectories are associated with the intensity of posttrauma psychopathology. These findings could potentially inform the timing of therapeutic strategies.
DIALOG+ is a digital psychosocial intervention aimed at making routine meetings between patients and clinicians therapeutically effective. This study aimed to evaluate the cost-effectiveness of implementing DIALOG+ treatment for patients with psychotic disorders in five low- and middle-income countries in Southeast Europe alongside a cluster randomised trial.
Methods
Resource use and quality of life data were collected alongside the multi-country cluster randomised trial of 468 participants with psychotic disorders. Due to COVID-19 interruptions of the trial’s original 12-month intervention period, adjusted costs and quality-adjusted life years (QALYs) were estimated at the participant level using a mixed-effects model over the first 6 months only. We estimated the incremental cost-effectiveness ratio (ICER) with uncertainty presented using a cost-effectiveness plane and a cost-effectiveness acceptability curve. Seven sensitivity analyses were conducted to check the robustness of the findings.
Results
The average cost of delivering DIALOG+ was €91.11 per participant. DIALOG+ was associated with an incremental health gain of 0.0032 QALYs (95% CI –0.0015, 0.0079), incremental costs of €84.17 (95% CI –8.18, 176.52), and an estimated ICER of €26,347.61. The probability of DIALOG+ being cost-effective against three times the weighted gross domestic product (GDP) per capita for the five participating countries was 18.9%.
Conclusion
Evidence from the cost-effectiveness analyses in this study suggested that DIALOG+ involved relatively low costs. However, it is not likely to be cost-effective in the five participating countries compared with standard care against a willingness-to-pay threshold of three times the weighted GDP per capita per QALY gained.
In Southeast Europe (SEE) standard treatment of patients with psychosis is largely based on pharmacotherapy with psychosocial interventions rarely available. DIALOG+ is a digital psychosocial intervention designed to make routine care therapeutically effective. This trial simultaneously examined effectiveness of DIALOG+ versus standard care on clinical and social outcomes (Aim 1) and explored intervention fidelity (Aim 2).
Methods
A hybrid type II effectiveness–implementation, cluster-randomized trial was conducted in five SEE countries: Bosnia and Herzegovina, Kosovo*, Montenegro, North Macedonia, and Serbia. The intervention was offered to patients six times across 12 months instead of routine care. The outcomes were subjective quality of life (primary), clinical symptoms, satisfaction with services, and economic costs. Intervention fidelity was operationalized as adherence to the protocol in terms of frequency, duration, content, and coverage. Data were analyzed using multilevel regression.
Results
A total of 81 clinicians and 468 patients with psychosis were randomized to DIALOG+ or standard care. The intervention was delivered with high fidelity. The average number of delivered sessions was 5.5 (SD = 2.3) across 12 months. Patients in the intervention arm had better quality of life (MANSA) at 6 months (p = 0.03). No difference was found for other outcomes at 6 months. Due to disruptions caused by the COVID-19 pandemic, 12-month data were not interpretable.
Conclusions
DIALOG+ improved subjective quality of life of individuals with psychosis at 6 months (after four sessions), albeit with small effect size. The intervention has the potential to contribute to holistic care of patients with psychosis.
Racial and ethnic groups in the USA differ in the prevalence of posttraumatic stress disorder (PTSD). Recent research however has not observed consistent racial/ethnic differences in posttraumatic stress in the early aftermath of trauma, suggesting that such differences in chronic PTSD rates may be related to differences in recovery over time.
Methods
As part of the multisite, longitudinal AURORA study, we investigated racial/ethnic differences in PTSD and related outcomes within 3 months after trauma. Participants (n = 930) were recruited from emergency departments across the USA and provided periodic (2 weeks, 8 weeks, and 3 months after trauma) self-report assessments of PTSD, depression, dissociation, anxiety, and resilience. Linear models were completed to investigate racial/ethnic differences in posttraumatic dysfunction with subsequent follow-up models assessing potential effects of prior life stressors.
Results
Racial/ethnic groups did not differ in symptoms over time; however, Black participants showed reduced posttraumatic depression and anxiety symptoms overall compared to Hispanic participants and White participants. Racial/ethnic differences were not attenuated after accounting for differences in sociodemographic factors. However, racial/ethnic differences in depression and anxiety were no longer significant after accounting for greater prior trauma exposure and childhood emotional abuse in White participants.
Conclusions
The present findings suggest prior differences in previous trauma exposure partially mediate the observed racial/ethnic differences in posttraumatic depression and anxiety symptoms following a recent trauma. Our findings further demonstrate that racial/ethnic groups show similar rates of symptom recovery over time. Future work utilizing longer time-scale data is needed to elucidate potential racial/ethnic differences in long-term symptom trajectories.
Acute and chronic exposure to cadmium (Cd), due to its increased use and application in the industry, can result in the development of atherosclerosis, the occurrence of cardiomyopathy, cerebrovascular stroke, as well as carcinogenesis in some organs. The target for cadmium action is thought to be the vascular endothelium.
Objectives
The aim of this study is to investigate the occurrence of oxidative stress on blood vessel endothelium induced by subacute administration of cadmium, as well as the protective power of alpha-lipoic acid (α-LA) supplementation on the Wistar strain albino rat model system.
Methods
After anesthesia of rats in the vivarium of the Scientific Research Center for Biomedicine, Faculty of Medicine in Niš, blood was collected by cardiac puncture and sent to the Clinic of Nephrology, Clinical Center in Niš, Serbia for determination of hematological parameters.
Results
According to the results of this study, it can be seen that the number of granulocytes is reduced due to cadmium intoxication, which is probably induced by the migration of neutrophils into tissues. The number of lymphocytes was increased due to subacute cadmium intoxication compared to the control group of animals. The positive efficacy of α-LA supplements in combating the adverse effects of cadmium on blood vessels is also confirmed.
Conclusions
Cadmium administration is thought to cause a systemic inflammatory reaction due to the formation of free radicals in the blood vessel endothelium. Administration of α-LA supplement confirms that it can be used as an antioxidant in the clinical management of many diseases and also in cadmium intoxication.
In 1978, Bracewell suggested the technique of nulling interferometry to directly image exoplanets which would enable characterisation of their surfaces, atmospheres, weather, and possibly determine their capacity to host life. The contrast needed to discriminate starlight reflected by a terrestrial-type planet from the glare of its host star lies at or beyond a forbidding $10^{-10}$ for an exo-Earth in the habitable zone around a Sun-like star at near-infrared wavelengths, necessitating instrumentation with extremely precise control of the light. Guided Light Interferometric Nulling Technology (GLINT) is a testbed for new photonic devices conceived to overcome the challenges posed by nulling interferometry. At its heart, GLINT employs a single-mode nulling photonic chip fabricated by direct-write technology to coherently combine starlight from an arbitrarily large telescope at 1 550 nm. It operates in combination with an actuated segmented mirror in a closed-loop control system, to produce and sustain a deep null throughout observations. The GLINT South prototype interfaces the 3.9-m Anglo-Australian Telescope and was tested on a sample of bright Mira variable stars. Successful and continuous starlight injection into the photonic chip was achieved. A statistical model of the data was constructed, enabling a data reduction algorithm to retrieve contrast ratios of about $10^{-3}$. As a byproduct of this analysis, stellar angular diameters that were below the telescope diffraction limit ($\sim$100 mas) were recovered with 1$\sigma$ accuracy and shown to be in agreement with literature values despite working in the seeing-limited regime. GLINT South serves as a demonstration of the capability of direct-write photonic technology for achieving coherent, stable nulling of starlight, which will encourage further technological developments towards the goal of directly imaging exoplanets with future large ground based and space telescopes.
The purpose of the current study was to examine the validity of an FFQ utilised in the Food Retail: Evaluating Strategies for a Healthy Austin (FRESH Austin) study, designed to evaluate changes in the consumption of fruits and vegetables (FV) in diverse low-income communities in Austin, TX.
Design:
The FRESH Austin FFQ was validated against three 24-h dietary recalls (24hDR). All dietary assessments were administered (in-person or by telephone) by trained investigators.
Setting:
Recruitment was conducted at sites within the geographic areas targeted in the FRESH Austin recruitment. People at a community health clinic, a local health centre and a YMCA within the intervention area were approached by trained and certified data collectors, and invited to participate.
Participants:
Among fifty-six participants, 83 % were female, 46 % were non-White, 24 % had income < $25 K/year and 30 % spoke only/mostly Spanish at home.
Results:
The FFQ and average of three 24hDR produce similar estimates of average total servings/d across FV (6·68 and 6·40 servings/d, respectively). Correlations produced measures from 0·01 for ‘Potatoes’ and 0·59 for ‘Other Vegetables’. Mean absolute percentage errors values were small for all FV, suggesting the variance of the error estimates was also small. Bland–Altman plots indicate acceptable levels of agreement between the two methods.
Conclusion:
These outcomes indicate that the FRESH FFQ is a valid instrument for assessing FV consumption. The validation of the FRESH Austin FFQ provides important insights for evaluating community-based efforts to increase FV consumption in diverse populations.
Disulfiram is an aversive medication that works by making the drinking of alcohol an unpleasant experience (FDA approved since 1951) and most study of understanding alcohol abuse and dependence are based on it. Also, the combined Cognitive Behavioral Therapy (CBT) and disulfiram assurance treatment was substantially effective in patients with alcohol disorders.
Methods
We conducted 150 male patients range of age 20-60 and treated in Special Hospital on Addictions for 3 months period of time (inpatient setting).The recommended dose of disulfiram was 250 mg. All patients were diagnosis of alcohol dependence according the ICD-X, excluded psychosis and no one was unable to take disulfiram for medical reason. We used medical history of illness, psychiatric interview and semi structured CBT protocol for alcohol disorder and CBT sessions (2 sessions per week). Control group were 80 patients on disulfiram assurance therapy (alone).
Results
CBT plus disulfiram assurance (N=150): 93(62%) maintaining sobriety and absence of drinking for 3 months; 44 (29,33%) maintaining sobriety for 2 months and 13 (8,66%) absence of drinking only 1 - 1,5 month.Disulfiram assurance therapy alone (control group) (N=80): 41 (51,25%) maintaining sobriety of drinking for 3 months; 22 (27,5%) less than 3 months; 10 (12,5%) for 1,5 - 2 months and 7 patients (8,75%) drop-out after a week without no relevant or medical reasons.
Conclusions
In this paper was shown the high level of effectiveness for the CBT combined with disulfiram assurance therapy according the maintaining sobriety and absence of drinking.
Many studies describing print media representations of mental illnesses have showed that these depictions are frequently negative and contribute to consequent stigmatization of people with mental illness. The main objective of this international study was to identify predictors of stigmatizing and nonstigmatizing articles on mental illness in Czech Republic, Croatia and Slovakia.
Methods
The study sample comprised all articles pertaining to the topic of mental illness (N=450) chosen from 6 most widely read newspapers and magazines identified during five weeklong periods in 2007. The presence of stigmatization and destigmatization statements was coded and articles were grouped in positive, neutral, mixed and negative clusters. Negative/positive ratio (NPR) was used to assess the predictor value of different features of the article regarding stigmatization.
Results
61.8% of articles contained some stigmatizing statements towards persons with mental illness. The highest NPR was found in articles published in tabloids (6.8), on the front page (3.7) and in the articles where psychotic disorder was mentioned (7.4) and mentally ill person figured as a source of information (1.8). Lowest NPR was found in magazines (0.6), articles in later sections (1.7) that mentioned eating disorders (0.3) and scientific surveys (0.1).
Conclusions
There is a high level of stigmatizing statements in the studied articles. As the strongest predictors of stigmatizing content we have identified articles that are published in tabloids and articles with reference to psychosis. Contrary to this, eating disorders had the least stigmatizing depiction as well as articles containing scientific data.
During and after the Civil War in former Yugoslavia many various social changes and migrations occured. One of their consequences is the increase of Gypsi-Roma population in Republic of Serbia. At the same time, the incidence of admissions and readmissions of Gypsi-Roma population into the psychiatric hospitals increased, in comparasion both with their participation in overall population and the incidence of admission before the war. Since the war led to economic exhaustion, especialy in social assistance resources, the vulnerability of this social group grew more dramatic. Difficulties in psychiatric treatment also have their origin in the particularites of this population. One of the most frequent demands of the representatives of this minority is the exclusively hospital treatment, on their own or on their families request, not always followed with clinical signs of relapse. This was verified despite the efforts of psychiatric reform and tendencies to reduce the psychiatric hospital treatments. Difficulties in diagnosis and consistent treatment were notified, therefore often psychopharmacotherapeutic resistance.
Variety of symptoms depend on ethnicity, and it is not consistant with diagnostic criteria due to possible pathoplastic moderators. Relaps and non compliance are more likely to occur. Somatic dissorders and illness are often reported and diagnostic by psychiatrist. Difficulties in treatment are sometimes based on the line between their social needs and abuse of psychiatry, since the patients and their families are more likely to show rental claims to illness. These request a complexed, multidisciplinary approach.
One million people worldwide commit suicide each year; the number of attempters is 20 times larger. The diathesis to suicidal behavior is inherited independently from mental disorders and is most often associated with depression. The importance of serotonergic genes in the genesis of suicidal behavior and depression is assumed. The link between depression and suicidal behavior is hopelessness.
Objectives
Analyzing the link of certain serotonergic alleles and genotypes with suicidal behavior and depression, as well as with hopelessness.
Aims
To analyze the association of chosen serotonergic alleles and genotypes (5HTT LPR, LPR SNP, VNTR2; THP1 A218C, 5HTR1A C1019G; 5HTR2A T102C, C1354 T) with suicidal behavior, depression and hopelessness.
Methods
The study included 30 depressed suicide attempters, 30 depressed patients without attempt and 30 healthy controls. Polymerase Chain Reaction method was used to analyze serotonergic gene polymorphisms. Participants were tested with Beck Depression Inventory, Suicidal Intent Scale, Becks Hopelessness Scale.
Results
Two analyzed polymorphisms are associated with depression, but not with suicidal behavior (5HTTintron 2 alele 10 and A218 of the TPH1 gene). Hopelessness is more prominent in depressed suicide attempters.
Conclusions
The results support the role of two serotonergic genes in the genesis of depression. Hopelessness is an important predictor of suicidal behavior. Further investigation of the role of serotonergic genes in various subtypes of suicidal behavior is suggested.
Gender-based perspective is not systematically included across trauma studies and deeper insight into women's response to trauma is required. We explored how the type of trauma (military vs. civilian) is related to clinical characteristics of post-traumatic stress disorder (PTSD) female patients.
Out of 55 PTSD patients included in the study, 34 were military trauma victims (combat experience, witnessing family members being killed) and 21 experienced civilian trauma (rape, robbery, traffic accident). All patients were hospitalized at the Zagreb University Hospital. Data were gathered retrospectively from the medical charts.
Regardless to the type of trauma, examination of clinical characteristics indicate high rate of comorbid psychiatric disorders among PTSD patients with major depressive disorder being the most prominent one; others are personality disorder, anorexia nervosa and somatoform disorder. We found no significant inter-group differences in PTSD symptoms according to the DSM-IV criteria. Most pronounced PTSD symptoms in both groups were hyperarousal and social avoidance symptoms. Late first contact with psychiatrist was found to be a risk factor for PTSD diagnosis among the military group. Those patients were more likely to present first with somatic symptoms such as arterial hypertension, rheumatic pain and gastritis.
Study results suggest that both military and civilian traumas left polymorphous psychological consequences on the mental health of the victims. There is a need for sensitive and coordinated care for traumatized people in order to recognize psychological symptoms and provide optimal psychiatric interventions.