Over half of former ICU patients in the UK report symptoms of psychological disorders

Patients in the UK who have survived critical illnesses requiring care in an intensive care unit (ICU) frequently report symptoms of anxiety, PTSD and/or depression, according to a study published in open access journal Critical Care. Those reporting symptoms of depression after critical illness appear to be at a greater risk of death.

Researchers at the University of Oxford investigated psychological disorders in a cohort of 4,943 of former ICU patients. They found that 46% of patients reported symptoms of anxiety, 40% reported symptoms of depression and 22% reported symptoms of PTSD, while 18% of patients in the study reported symptoms of all three psychological conditions.

Dr Peter Watkinson, the corresponding author said: “Psychological problems after being treated for a critical illness in the ICU are very common and often complex when they occur. When symptoms of one psychological disorder are present, there is a 65% chance they will co-occur with symptoms of another psychological disorder.”

Full story at Science Daily

Diversity Training Programs Nurture Research Career

“It had never occurred to me to do a Ph.D. It’s nothing I’d ever thought of. I didn’t know anyone who’s done a science Ph.D.,” noted Frances Johnson just weeks before matriculating in a neuroscience doctoral program at the University of Pittsburgh. She was just completing a summer stint as a trainee in a neuroscience lab at the National Institute of Mental Health (NIMH) Intramural Research Program on the NIH campus in Bethesda, MD.

A U.S. Army veteran and math major at Western Connecticut State University –  who at times paid the bills working as a substitute teacher – Johnson says her interest in understanding the brain was sparked by curiosity about the origins of a friend’s post-traumatic stress disorder (PTSD) symptoms.

“What caused something like that?” she asked herself. “I think everybody has this kind of curiosity. We have people in our lives, we have family members – especially around mental health.”

Full story at NIMH

PTSD symptoms improve when patient chooses form of treatment

A multiyear clinical trial comparing medication and mental health counseling in the treatment of post-traumatic stress disorder shows that patients who chose their form of treatment — whether drugs or therapy — improved more than those who were simply prescribed one or the other regardless of the patient’s preference.

The study, led by the University of Washington and Case Western Reserve University, was conducted at outpatient clinics in Seattle and Cleveland. It found that both a medication — Sertraline, marketed as Zoloft — and a specific form a therapy known as prolonged exposure were effective in reducing PTSD symptoms during the course of treatment, with improvements maintained at least two years later. But patients who received their choice between the two possible treatments showed greater reduction in symptoms, were more apt to stick to their treatment program and even lost their PTSD diagnosis over time.

The study, published Oct. 19 in the American Journal of Psychiatry, is the first large-scale trial of hundreds of PTSD patients, including veterans and survivors of sexual assault, to measure whether patient preference in the course of treatment impacts the effectiveness of a type of cognitive behavioral therapy and use of selective serotonin reuptake inhibitors, a type of antidepressant often prescribed for PTSD.

Full story at Science Daily

A Shorter—but Effective—Treatment for PTSD

First-line treatments for post-traumatic stress disorder (PTSD) often require many treatment sessions and delivery by extensively trained therapists. Now, research supported by the National Institute of Mental Health (NIMH) has shown that a shorter therapy may be just as effective as lengthier first-line treatments. The study appeared in the March 2018 issue of JAMA Psychiatry.

First-line treatments for PTSD consist of psychotherapies that focus on exposure and/or cognitive restructuring. One such therapy is cognitive processing therapy (CPT), which is widely acknowledged as an effective treatment for PTSD. Patients being treated with CPT take part in 12 weekly therapy sessions that are delivered by a highly-trained practitioner. During these sessions, patients learn to recognize and challenge dysfunctional thoughts about their traumatic event, themselves, others, and the world. In addition, patients are given homework to complete between sessions.

Full story at NIMH

A Shorter—but Effective—Treatment for PTSD

First-line treatments for post-traumatic stress disorder (PTSD) often require many treatment sessions and delivery by extensively trained therapists. Now, research supported by the National Institute of Mental Health (NIMH) has shown that a shorter therapy may be just as effective as lengthier first-line treatments. The study appeared in the March 2018 issue of JAMA Psychiatry.

First-line treatments for PTSD consist of psychotherapies that focus on exposure and/or cognitive restructuring. One such therapy is cognitive processing therapy (CPT), which is widely acknowledged as an effective treatment for PTSD. Patients being treated with CPT take part in 12 weekly therapy sessions that are delivered by a highly-trained practitioner. During these sessions, patients learn to recognize and challenge dysfunctional thoughts about their traumatic event, themselves, others, and the world. In addition, patients are given homework to complete between sessions.

Full story at NIMH

Brain abnormality indicates general risk for mental illness

A new study by researchers at Duke University reports an abnormality in visual regions of the brain that is associated with a person’s general risk for mental illness. The findings, published in Biological Psychiatry, indicate a signature abnormality shared between common forms of mental illness, which could help clinicians assess a patient’s general risk for developing a mental illness. The signature abnormality was present in participants involved in the study who already had a higher risk of mental illness. This was characterized by a reduced efficiency between visual areas and brain networks important for integrating sensory information and suppressing distracting information.

Researchers have long thought that some aspects of the biology of the risk for psychiatric disorders were specific to particular disorders, and by studying specific groups of patients, may have mistaken general risk factors as specific risk factors. Newer research suggests that a person’s risk for developing mental illness is not specific to one form of disorder, but is instead shared across many different disorders. “In other words, there may be a single risk factor that predicts whether an individual develops any form of psychiatric disorder, be it depression, post-traumatic stress disorder, addiction, or even schizophrenia,” said first author Maxwell Elliott, a doctoral student in the laboratory of Ahmad Hariri, PhD.

Full story at Science Daily

Certain PTSD therapies prove effective long after patients stop treatment

Both civilians and military veterans with post-traumatic stress disorder (PTSD) reap long-term benefits from psychotherapies used for short-term treatment, according to a new study from Case Western Reserve University.

The findings suggest effective and lasting approaches for symptoms of PTSD-a debilitating and typically chronic disorder that rarely diminishes spontaneously and is associated with significant distress, impairment and considerable economic costs.

For U.S.-based military veterans alone, lost productivity, health-care and other costs are estimated to be in the billions of dollars, according to recent peer-reviewed research.

Full story at Science Daily

Nightmares are common but underreported in US military personnel

A new study shows that a high percentage of military personnel with sleep disturbances met criteria for nightmare disorder, but few of them reported nightmares as a reason for sleep evaluation. Those with nightmare disorder had an increased risk of other sleep and mental health disorders.

Results show that 31 percent of military participants had clinically significant nightmares, and trauma-related nightmares occurred in 60 percent of them. Participants who met criteria for nightmare disorder were five times more likely to have post-traumatic stress disorder (PTSD), four times more likely to have depression, three times more likely to have anxiety, and two times more likely to have insomnia. Despite their common presence, nightmares were reported as a sleep-related concern by only 3.9 percent of military personnel.

“This research provides a basis for furthering the study and knowledge of nightmares in survivors of traumatic experiences,” said principal investigator Dr. Jennifer Creamer, medical director of the Sleep Medicine Center at Martin Army Medical Center in Fort Benning, Georgia. “Treatment of nightmares can lead to improvement in sleep, quality of life, and other disorders such as suicidality.”

Full story at Science Daily

Psychologist examines methods of classifying mental disorders

Mental illnesses, such as major depression, bipolar disorder and post-traumatic stress disorder, affect nearly 1 in 5 adults in the United States, according to the National Alliance on Mental Illness. Many aspects of these illnesses remain something of a mystery, despite the progress made in understanding them by researchers studying these disorders in the last half century.

Even so, clinicians and researchers, together with patients and their families, have made significant strides identifying and treating mental illnesses. Two major diagnostic manuals — the Diagnostic and Statistical Manual of Mental Disorders (DSM), used primarily in the U.S., and the International Classification of Diseases (ICD), used internationally — provide clinicians, researchers and patients a structured approach to diagnosing mental health. Further, the federal National Institute of Mental Health also uses a new framework for researching mental illness, called the Research Domain Criteria, or R-DoC.

Full story at Science Daily

Many cancer survivors are living with PTSD

A recent study showed approximately one-fifth of patients with cancer experienced post-traumatic stress disorder (PTSD) several months after diagnosis, and many of these patients continued to live with PTSD years later. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings highlight the need for early identification, careful monitoring, and treatment of PTSD in cancer survivors.

Although PTSD is primarily known to develop in individuals following a traumatic event such as a serious accident or natural disaster, it can also occur in patients diagnosed with cancer. Because PTSD in cancer has not been explored thoroughly, Caryn Mei Hsien Chan, PhD, of the National University of Malaysia, and her colleagues studied 469 adults with various cancer types within one month of diagnosis at a single oncology referral center. Patients underwent additional testing after six months and again after four years.

Clinical evaluations revealed a PTSD incidence of 21.7% at 6-months follow-up, with rates dropping to 6.1% at 4-years follow-up. Although overall rates of PTSD decreased with time, roughly one-third of patients initially diagnosed with PTSD were found to have persistent or worsening symptoms four years later.

Full story at Science Daily