Psychological symptoms and quality of life after repeated exposure to earthquake: A cohort study in Italy.
ABSTRACT: In 2005, a random sample of 200 people were assessed in Camerino, Italy, eight years after an earthquake. Psychological symptom levels were low and only one person had current Post-Traumatic Stress Disorder (PTSD). In 2016 a new earthquake occurred in Camerino. The study aims to assess the impact of the second exposure in the same cohort. A longitudinal study was conducted, 130 participants were re-interviewed between July and December 2017. Psychological symptoms were self-rated on the Brief Symptom Inventory (BSI) and the Global Severity Index (GSI) was analysed. Post-traumatic stress symptoms were self-rated on the Impact of Event Scale-Revised (IES-R). Subjective quality of life (SQOL) was assessed on the Manchester Short Assessment of Quality of Life (MANSA). Mean scores of GSI and IES-R were significantly higher than in 2005 (p<0.01 and p<0.001), whilst SQOL remained almost unchanged (p = 0.163). In 2017, 16.9% of the sample had reached the PTSD threshold whilst in 2005 only the 0.5% had reached it. Despite low symptom levels several years after an earthquake, people can show psychological distress after a new exposure, whilst average quality of life levels are not affected.
Project description:Introduction: Nepal suffered from major earthquakes in April 2015 resulting in great damage to the society. The objective of the current study is to describe the earthquake exposure, the impact on family's daily life and the symptoms of post-traumatic stress disorder (PTSD) and their association in Nepalese mothers 20 months following the earthquakes. Methods: In a clinical trial in Bhaktapur, Nepal, 558 mothers responded to an inventory on earthquake exposure and the Impact of Event Scale - Revised (IES-R) 20 months after the earthquakes. In multiple linear regression models, we estimated the associations between the earthquake exposure and the impact on the families' life and the IES-R score. Results: Over 60% reported that the earthquakes had a great deal of negative impact on their family's life. In 4.7%, close family members died, and in 10.5%, family members were injured. 24% had IES-R scores indicating PTSD symptoms within clinical concern or a possible diagnosis. Lower levels of education were associated with higher scores on the total IES-R. Mothers who report that the earthquakes had a great deal of negative impact had higher total IES-R scores [9.8, 95% CI (5.9, 13.6)] compared to mothers that reported no such negative impact. Mothers with family members who were killed had higher IES-R scores [3.6, 95% CI (1.6, 5.5)] than those with no family members who died. Mothers assisting in rescue efforts had lower IES-R scores [2.8, 95% CI (0.8, 4.8)] than those not assisting. Conclusion: Our study demonstrates high levels of exposure to traumatic events, large negative impact on the everyday life of the families, and a high level of PTSD symptoms. There was a consistent and graded association between the exposure variables and PTSD symptoms. The large impact of the earthquakes on these Nepalese mothers underscore the importance of awareness of mental disorders following major natural catastrophes for marginalized families.
Project description:<h4>Background</h4>COVID-19 has become a public health emergency based on its clinical characteristics. Previous studies demonstrated that the onset of a sudden and immediately life-threatening illness could lead to extraordinary amounts of psychological pressure on nurses who play an important role in the illness. Whether COVID-19 pandemic has greater impacts on the psychological status and somatic symptoms from nurses who stand in the frontline of this crisis remain unclear.<h4>Methods</h4>We evaluated post-traumatic stress disorder (PTSD), anxiety and somatic symptoms in the frontline nurses (n = 438) who served in Wuhan, China, during COVID-19 crisis. Nurses who did not worked in the frontline of COVID-19 served as controls (n = 452). The investigation was processed by online questionnaires including: impact of event scale-revised (IES-R) , self-rating anxiety scale (SAS), and somatic symptoms.<h4>Results</h4>Prevalence of moderate and severe PTSD was significantly increased in the frontline nurses compared to non-frontline nurses. Prevalence of mild anxiety was significantly increased in frontline nurses compared to non-frontline nurses. There were more frontline nurses suffering from severe insomnia and losing weight compared to non-frontline nurses. Severity of PTSD (IES-R score), but not severity of anxiety (SAS score) was similarly positively correlated to incidence of insomnia and weight loss in both frontline and non-frontline nurses to a similar extent.<h4>Limitations</h4>The results only represented psychological statues and somatic symptom on one time point thus the development of psychological stress and somatic symptom during pandemic of COVID-19 in the frontline nurses were missing.<h4>Conclusions</h4>COVID-19 negatively impacted on psychological and somatic status in frontline nurses. PTSD may be the most reliability and validity criteria for evaluating psychological and somatic status for frontline nurses of COVID-19.
Project description:OBJECTIVE: To determine to what extent patients who have survived abdominal sepsis suffer from symptoms of posttraumatic stress disorder (PTSD) and depression, and to identify potential risk factors for PTSD symptoms. DESIGN AND SETTING: PTSD and depression symptoms were measured using the Impact of Events Scale-Revised (IES-R), the Post-Traumatic Symptom Scale 10 (PTSS-10) and the Beck Depression Inventory II (BDI-II). PATIENTS AND PARTICIPANTS: A total of 135 peritonitis patients were eligible for this study, of whom 107 (80%) patients completed the questionnaire. The median APACHE-II score was 14 (range 12-16), and 89% were admitted to the ICU. MEASUREMENTS AND RESULTS: The proportion of patients with "moderate" PTSD symptom scores was 28% (95% CI 20-37), whilst 10% (95% CI 6-17) of patients had "high" PTSD symptom scores. Only 5% (95% CI 2-12) of the patients expressed severe depression symptoms. Factors associated with increased PTSD symptoms in a multivariate ordinal regression model were younger age (0.74 per 10 years older, p=0.082), length of ICU stay (OR=1.4 per doubling of duration, p=0.003) and having some (OR=4.9, p=0.06) or many (OR=55.5, p<0.001) traumatic memories of the ICU or hospital stay. CONCLUSION: As many as 38% of patients after abdominal sepsis report elevated levels of PTSD symptoms on at least one of the questionnaires. Our nomogram may assist in identifying patients at increased risk for developing symptoms of PTSD.
Project description:Analysis of transcript abundance estimates as a function of child soldier status, PTSD symptoms, and psychological resilience. Gene expression profiling was conducted on dried blood spot (DBS) samples collected from community dwelling adolescents and young adults in Nepal. Approximatley half of the sample were former child soldiers in the Nepal People's War and the other half were demographically similiar civilian non-combatants. In addition to basic demographic characteristics (age, sex, ethnic minority status, social caste status, education level), participants were also assessed on syptoms of post-traumatic stress (PTS, assessed by a culturally adapted version of The Child PTSD Symptom Scale; Kohrt BA, et al. (2011) Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal. BMC Psychiatry 11(1):e127, with higher values indicating greater PTSD symptoms) and psychological resilience (assessed by a culturally adapted version of the Resilience Scale; Wagnild GM & Young HM (1993) Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, with higher values indicating greater resilience). Dichotomous variables were coded 0=no/absent and 1=yes/present. Valid gene expression data are available for 254 samples.
Project description:Posttraumatic stress disorder (PTSD) patients experience impaired response inhibition. Little is known about the relationship between response inhibition abnormalities and distinct PTSD symptom clusters. This study investigated the relationship between response inhibition processing and a five-factor model of posttraumatic stress symptomatology in adolescents. The event-related potentials of 54 unmedicated adolescent earthquake survivors (age 15-18 years) were recorded as they completed a Go/NoGo task. The PTSD Checklist-Specific Stressor Version (PCL-S) was used to assess PTSD symptoms. Regression analyses were conducted to examine the associations between the five symptom-cluster model and response inhibition processing. The results revealed that the avoidance symptom cluster score, but not the numbing or other clusters' scores, was positively associated with NoGo-P3 latency. These results suggest that a specific PTSD symptom cluster--avoidance--has a distinct association with the slowed speed of the late step of response inhibition processing, i.e., decision or success of response inhibition in adolescent earthquake survivors.
Project description:<h4>Objective</h4>Since the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, there are reports on the increased prevalence of physical symptoms observed in the general population. We investigated the association between psychological outcomes and physical symptoms among healthcare workers.<h4>Methods</h4>Healthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. Healthcare workers included doctors, nurses, allied healthcare workers, administrators, clerical staff and maintenance workers. This questionnaire collected information on demographics, medical history, symptom prevalence in the past month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. The prevalence of physical symptoms displayed by healthcare workers and the associations between physical symptoms and psychological outcomes of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were evaluated.<h4>Results</h4>Out of the 906 healthcare workers who participated in the survey, 48 (5.3%) screened positive for moderate to very-severe depression, 79 (8.7%) for moderate to extremely-severe anxiety, 20 (2.2%) for moderate to extremely-severe stress, and 34 (3.8%) for moderate to severe levels of psychological distress. The commonest reported symptom was headache (32.3%), with a large number of participants (33.4%) reporting more than four symptoms. Participants who had experienced symptoms in the preceding month were more likely to be older, have pre-existing comorbidities and a positive screen for depression, anxiety, stress, and PTSD. After adjusting for age, gender and comorbidities, it was found that depression (OR 2.79, 95% CI 1.54-5.07, p = 0.001), anxiety (OR 2.18, 95% CI 1.36-3.48, p = 0.001), stress (OR 3.06, 95% CI 1.27-7.41, p = 0.13), and PTSD (OR 2.20, 95% CI 1.12-4.35, p = 0.023) remained significantly associated with the presence of physical symptoms experienced in the preceding month. Linear regression revealed that the presence of physical symptoms was associated with higher mean scores in the IES-R, DASS Anxiety, Stress and Depression subscales.<h4>Conclusions</h4>Our study demonstrates a significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak. We postulate that this association may be bi-directional, and that timely psychological interventions for healthcare workers with physical symptoms should be considered once an infection has been excluded.
Project description:Analysis of transcript abundance estimates as a function of child soldier status, PTSD symptoms, and psychological resilience. Overall design: Gene expression profiling was conducted on dried blood spot (DBS) samples collected from community dwelling adolescents and young adults in Nepal. Approximatley half of the sample were former child soldiers in the Nepal People's War and the other half were demographically similiar civilian non-combatants. In addition to basic demographic characteristics (age, sex, ethnic minority status, social caste status, education level), participants were also assessed on syptoms of post-traumatic stress (PTS, assessed by a culturally adapted version of The Child PTSD Symptom Scale; Kohrt BA, et al. (2011) Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal. BMC Psychiatry 11(1):e127, with higher values indicating greater PTSD symptoms) and psychological resilience (assessed by a culturally adapted version of the Resilience Scale; Wagnild GM & Young HM (1993) Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, with higher values indicating greater resilience). Dichotomous variables were coded 0=no/absent and 1=yes/present. Valid gene expression data are available for 254 samples.
Project description:<h4>Background</h4>Survivors of acute lung injury (ALI) and other critical illnesses often experience substantial posttraumatic stress disorder (PTSD) symptoms. However, most questionnaires have not been validated against a PTSD diagnostic reference standard in this patient population. Hence, in the current study of survivors of ALI, we evaluated the Impact of Events Scale-Revised (IES-R), a questionnaire measure of PTSD symptoms, against the Clinician-Administered PTSD Scale (CAPS), the current state-of-the-art PTSD diagnostic reference standard, which also provides a quantitative assessment of PTSD symptoms.<h4>Methods</h4>We evaluated the IES-R questionnaire vs the CAPS diagnostic interview in 60 of 77 consecutively recruited survivors of ALI from two prospective cohort studies of patients 1 to 5 years after ALI.<h4>Results</h4>The IES-R total score (range: 0.0-3.2) and the CAPS total severity score (range: 0-70) were strongly related (Pearson r=0.80, Spearman ρ=0.69). Using CAPS data, eight of the 60 patients (13%) had PTSD at the time of assessment, and an additional eight patients had partial PTSD (total prevalence, 27%). In a receiver operating characteristics curve analysis with CAPS PTSD or partial PTSD as criterion variables, the area under the curve ranged from 95% (95% CI, 88%-100%) to 97% (95% CI, 92%-100%). At an IES-R threshold of 1.6, with the same criterion variables, sensitivities ranged from 80% to 100%, specificities 85% to 91%, positive predictive values 50% to 75%, negative predictive values 93% to 100%, positive likelihood ratios 6.5 to 9.0, negative likelihood ratios 0.0 to 0.2, and efficiencies 87% to 90%.<h4>Conclusions</h4>The IES-R appears to be an excellent brief PTSD symptom measure and screening tool in ALI survivors.
Project description:PURPOSE:We aimed to characterize anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms over 5-year follow-up after acute respiratory distress syndrome (ARDS) and determine risk factors for prolonged psychiatric morbidity. METHODS:This prospective cohort study enrolled patients from 13 medical and surgical intensive care units in four hospitals, with follow-up at 3, 6, 12, 24, 36, 48, and 60 months post-ARDS. Trained research staff administered the Hospital Anxiety and Depression Scale (HADS) (scores ? 8 on anxiety and depression subscales indicating substantial symptoms) and the Impact of Event Scale-Revised (IES-R, scores ? 1.6 indicating substantial PTSD symptoms) at each follow-up visit. RESULTS:Of 196 consenting survivors, 186 (95%) completed HADS and IES-R assessments; 96 (52%) had any continuous or recurring (prolonged) symptoms, and 71 (38%), 59 (32%), and 43 (23%) had prolonged anxiety, depression, and PTSD symptoms, respectively (median total durations 33-39 months, 71-100% of observed follow-up time). Prolonged psychiatric symptoms tended to co-occur across domains; the most common morbidity pattern involved substantial symptoms in all three domains. Worse pre-ARDS mental health, including prior depression and psychological distress in the period immediately preceding ARDS, was strongly associated with prolonged post-ARDS psychiatric morbidity across symptom domains. CONCLUSIONS:Clinically significant and long-lasting symptoms of anxiety, depression, and PTSD are common in the first 5 years after ARDS. In-hospital screening of psychiatric history, including recent anxiety and depression symptoms, may be useful for long-term mental health treatment planning after ARDS.
Project description:<h4>Purpose</h4>Evidence suggests that the oxytocin receptor (OXTR) gene may be involved in the psychopathology of posttraumatic stress disorder (PTSD). This study aimed to investigate the effects of OXTR rs53576 genotype on PTSD symptoms introduced in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5).<h4>Methods</h4>This study was a cross-sectional study conducted among 1140 adults who had personally experienced the Wenchuan earthquake. PTSD symptoms were measured with the PTSD checklist for DSM-5. A custom-by-design 2 × 48-Plex SNPscan<sup>TM</sup> Kit were used to determine the OXTR rs53576. Multiple regression models were used to analyze the independent and interactive effects of OXTR rs53576 genotype and earthquake exposure on the severity of total PTSD symptoms and different dimensions of PTSD symptoms.<h4>Results</h4>The results revealed that the rs53576 genotype could significantly predict PTSD symptoms (β = 0.055, p = 0.045). Further analysis showed that the rs53576 genotype was only significantly associated with dysphoric arousal symptoms of PTSD (β = 0.080, p = 0.005). The rs53576 genotype × earthquake exposure interaction had no significant effect on different symptom clusters (p > 0.05).<h4>Conclusion</h4>This study showed that the rs53576 genotype was only associated with the dysphoric arousal symptoms but not with other symptom clusters of PTSD. These findings support the role of the OXTR on the psychopathology of PTSD and help us to understand the genetic basis of PTSD.