Prévalence et facteurs prédicteurs des troubles post-traumatiques chez les accidentés de la voie publique / Prevalence and predictors of post-traumatic stress disorder in road traffic accidents

Introduction: les troubles post-traumatiques survenant à la suite d'un accident de la route ont un impact tant sanitaire qu'économique. Méthodes: notre étude prospective, vise à déterminer la prévalence de ces troubles, et de dégager leurs facteurs de risque auprès de sujets victimes d'accidents de la route et hospitalisés au service de chirurgie orthopédique et de traumatologie du Centre Hospitalo-Universitaire de Sfax-Tunisie. Résultats: soixante-dix sujets ont été inclus dans notre étude. La prévalence de l'état de stress aigu était de 37,1% et il a été associé au sexe féminin, au niveau scolaire bas, à la présence d'antécédents médicochirurgicaux, à la passivité au cours de l'accident, à la sévérité des lésions, et à la présence d'une symptomatologie anxieuse et dépressive. Le trouble stress post traumatique était constaté chez 40% des sujets et il a été associé au milieu de résidence urbain, à la passivité au cours de l'accident, et à la symptomatologie anxieuse et dépressive. Des scores faibles des stratégies de coping fonctionnelles et des scores élevés des stratégies de coping dysfonctionnelles ont été significativement associés à ces deux troubles. Le niveau scolaire bas, la résidence en milieu urbain, un niveau élevé d'anxiété et de dépression et la stratégie de coping de déni apparaissent comme des facteurs de risque indépendants de l'état de stress aigu et du trouble stress post traumatique. Conclusion: il s'avère ainsi important de déterminer un profil de personnes plus exposées aux troubles post-traumatique afin de permettre un dépistage précoce par les médecins avec lesquels les accidentés pourraient avoir des contacts dans les suites de leurs accidents.

ntroduction: Post-traumatic stress disorder following a road accident has both a health and an economic impact. Methods: we conducted a prospective study to determine the prevalence of this disorder, and to identify risk factors in subjects victims of road accidents and hospitalized in the Department of Orthopedic Surgery and Traumatology of the University Hospital Center of Sfax-Tunisia. Results: a total of sixty-ten subjects were included in this study. The prevalence of acute stress was 37.1% and was associated with female sex, low educational level, previous medical and surgical history, passivity during the accident, severity of injuries and the presence of anxious and depressive symptoms. Post-traumatic stress disorder was observed in 40% of subjects and was associated with urban residential environment, passivity during the accident and anxious and depressive symptoms. Low scores for functional coping strategies and high scores for dysfunctional coping strategies were significantly associated with both disorders. Low educational level, urban residential environment, high levels of anxiety and depression, and denial coping strategy appear to be independent risk factors for acute stress and post-traumatic stress disorder. Conclusion: It is therefore important to determine the profile of people at greater risk of post-traumatic stress disorder, to enable early diagnosis in victims of road accidents.

The effects of minocycline on neuroinflammation in rats with post-traumatic stress disorder / 神经解剖学杂志

Objective:To investigate the effect of minocycline on neuroinflammation of rats with post-traumatic stress disorder(PTSD).Methods:The rat model of PTSD was prepared by a single prolonged stress(SPS)method,and the rats were treated with minocycline(PTSD+Mino group)or normal saline(PTSD group)by gavage.The behavioral changes of rats were detected by light-dark box test.The expression of ionized calcium-binding adapter molecule 1(Iba-1)in hippocampus was detected by immunohistochemical staining.The contents of IL-1β and TNF-α in hippocampus were detected by ELISA,and the expression levels of IL-1β and TNF-α mRNA in hippocampus were detected by real-time RT-PCR(qRT-PCR).Results:After 3 days of SPS stimulation,the anxiety-like behavior of rats was obvious,the expression of Iba-1 in hippocampus was increased,and the contents of IL-1β and TNF-α in hippocampus were in-creased.Minocycline treatment significantly reduced anxiety-like behavior and decreased the expression of Iba-1 in the hippocampus of PTSD rats.Meanwhile,minocycline treatment also decreased the levels of IL-1β and TNF-α mRNA and protein in the hippocampus.Conclusion:Minocycline can improve the anxiety-like behavior of PTSD rats by inhibiting the activation of microglia.

Trajectories and influencing factors of post-traumatic stress disorder in women with multiple in vitro fertilization embryo transfer failures / 中国实用护理杂志

Objective:To explore the potential categories of post-traumatic stress disorder (PTSD) trajectories in women with multiple in vitro fertilization-embryo transfer (IVF-ET) failures, and to analyze the effects of different demographic characteristics and psychological factors on the potential categories of PTSD trajectories.Methods:This was a prospective empirical research, from May 2021 to October 2022, women with IVF-ET failure ≥ 2 times in the reproductive department of Shanghai First People′s Hospital from May 2021 to October 2022 were selected as the research objects. Post-traumatic stress disorder civilian version scale was used for 4 follow-ups at 3 d (T1), 10 d (T2), 20 d (T3) after the last transplantation failure and 3 d before the next transplantation cycle (T4). Telephone follow-up and online follow-up were combined to obtain the PTSD level at 4 time points. Potential categories of PTSD score trajectories at four time points were identified using a latent category growth model, and analyze influencing factors using unordered multi classification logistic analysis.Results:Totally 196 IVF-ET women were admitted, aged (29.42 ± 4.13) years. Three PTSD trajectories were fitted in this study, including 82 cases (42%) in non-PTSD group, 61 cases (31%) in mild PTSD group and 53 cases (27%) in elevated PTSD group. Logistic regression analysis showed that age, education level, fertility pressure and marital adjustment level were the predictors of PTSD trajectory in women with multiple IVF-ET failures. Compared with the non-PTSD group, women aged ≥35 years, with lower education level and marital adjustment level were more likely to enter the elevated PTSD group ( OR=4.570, 8.540, 0.949, all P<0.05). Women aged 35 years and with greater reproductive pressure were more likely to enter the mild PTSD group ( OR=3.871, 1.063, both P<0.05). Conclusions:There is group heterogeneity in the trajectories of PTSD in women with multiple IVF-ET failures in the next transplantation cycle. Old age, low education level, high fertility pressure and poor marital adjustment can predict the trajectories of PTSD. Fertility stress and marriage adjustment are changeable variables. Medical staff can relieve women′s fertility pressure through health education and mindfulness intervention, promote a good state of marriage adjustment, and minimize the adverse effects of PTSD on the next cycle of conception.

A scoping review of application of ICU diary in critically ill patients / 中国实用护理杂志

Objective:To conduct a scope review on the application of ICU diaries in critically ill patients, laying the foundation for further exploration and construction of ICU diary patterns and frameworks that were in line with the national conditions and tailored to different regions and cultural backgrounds.Methods:The Joanna Briggs Institute Reviewer′s Manual was used as the methodological framework, and a computer search was conducted in nine domestic and international databases, including China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, Cochrane Library, PubMed, and Embase, etc. The search period was from the inception of the databases until March 13, 2023. The included literature was screened, summarized, and analyzed.Results:A total of 19 articles were included. ICU diaries were commonly recorded using a combination of text and visuals, with the involvement of both healthcare professionals and family members. Most patients received ICU diaries approximately one month after their transfer from the ICU. Out of the 15 studies, ICU diaries were found to be effective, while 4 studies indicated no significant improvement in patients′ psychological issues. However, ICU diaries were still considered acceptable by patients and their families.Conclusions:The application of ICU diaries has shown positive significance in critically ill patients, but further research and exploration are needed to investigate its impact on issues such as post-traumatic stress disorder, anxiety, depression, and quality of life. In the future, a combination of multiple forms and high-quality research designs with large samples, long periods, and structured approaches should be employed to explore its application effects and long-term outcomes on psychological problems.

Correlation between resilience,post-traumatic stress disorder and quality of life of front-line medical staff in public health emergencies / 沈阳医学院学报

Objective:To explore the correlation between post-traumatic stress disorder(PTSD),resilience and quality of life of front-line medical staff in public health emergencies.Methods:From Nov to Dec 2020,the medical staff of 4 COVID-19 designated hospitals in Wuhan were investigated with the general demographic questionnaire,10-item Connor-Davidson Resilience Scale,PTSD Checklist for DSM-5 and Simplify Qualify of Life Scale.Spearman correlation analysis and hierarchical regression analysis were used to investigate the correlation between PTSD,resilience and quality of life.Results:A total of 545 questionnaires were collected in this survey and the valid effective rate was 97.8% (533/545).The score of psychological resilience,PTSD and quality of life of medical staff were 26(20,30),17(8,25),and 20(18,23),respectively.And 13.1% (70/533)of medical staff had obvious PTSD symptoms.There were significant differences in the score of quality of life among medical staff with different genders,occupations and PTSD levels.Spearman correlation analysis results showed that the score of PTSD was negatively correlated with quality of life and psychological resilience(r=-0.488 and-0.464,P＜0.01).The score of psychological resilience was positively correlated with the score of quality of life(r =0.578,P＜0.01).Psychological resilience and PTSD were important predictors of quality of life,with an explanatory capacity of 37.0% .Conclusions:PTSD is a risk factor for quality of life,and psychological resilience is a protective factor for quality of life.In public health emergencies,improving psychological resilience,preventing and treating PTSD can improve the quality of life of medical staff.

Analysis of influencing factors of post-traumatic stress disorder in hospitalized patients with placenta previa / 沈阳医学院学报

Objective:To investigate the influencing factors of post-traumatic stress disorder(PTSD)in hospitalized patients with placenta previa.Methods:A total of 110 hospitalized patients with placenta previa admitted to our hospital from Oct 2019 to Jan 2023 were selected,and the occurrence of PTSD during hospitalization was evaluated by using Post-Traumatic Stress Disorder Checklist-Civilian Version(PCL-C),and relevant data were collected.Multivariable logistic regression analysis was used to analyze the influencing factors of PTSD in these patients.Results:Among 110 patients,41 cases developed PTSD(37.27% ).Univariable analysis showed that the type of pregnant women(primigravida),optimistic tendency,family support,psychological resilience and personality traits were associated with PTSD in hospitalized patients with placenta previa(P＜0.05).Other information such as age,gestational age,parity,unplanned pregnancy and education level were not associated with PTSD(P＞0.05).Multivariable logistic regression analysis showed that primiparas and introversion were risk factors for PTSD(OR＞1,P＜0.05),and higher optimism tendency,higher degree of family support and higher psychological resilience were protective factors for PTSD in hospitalized patients with placenta previa(OR＜1,P＜0.05).Conclusions:The incidence of PTSD is higher in hospitalized patients with placenta previa.The risk factors of PTSD are primiparas,low level of optimistic tendency,low degree of family support,low psychological resilience and introversion.

Research progress in reconsolidation-based interventions for aversive memories / 中华行为医学与脑科学杂志

Aversive memories are the core pathology of many psychiatric disorders (such as posttraumatic stress disorder and depression), often impeding clinical treatment, which requires validated interventions. Animal researches and preclinical human studies have shown that memories are vulnerable after retrieval due to a memory process known as the memory reconsolidation mechanism, and that interventions during this process can potentially rewrite or update memories. The discovery of the reconsolidation mechanism has sparked a wave of research interest in its potential to rewrite aversive memories. This article presents a brief research history and advances in reconsolidation-based interventions, including pharmacological, non-invasive brain stimulation and behavioral interventions, as well as the biological mechanisms of reconsolidation. It is noted that pharmacological, behavioral and non-invasive brain stimulation interventions are all potential approaches for reconsolidation intervention, with propranolol, extinction/exposure therapy and transcranial magnetic stimulation being relatively effective. It is important to consider the differences between laboratory and clinical studies in future clinical translational research, and to overcome the " boundary conditions" of reconsolidation-based intervention in clinical applications, such as duration of memory retrieval, age of memory, individual differences, and so on, which may affect its efficacy.

Effects of icariin on BDNF/TkB signaling pathway and synaptic plasticity regulation on fear memory improvement in rats with post-traumatic stress disorder / 中国医科大学学报

Objective To investigate the effects and mechanisms of icariin on changes in fear memory in post-traumatic stress disorder(PTSD)rats.Methods Thirty male SD rats were used to construct a rat model of single prolonged stress(SPS).The model rats were randomly divided into the SPS,icariin,and icariin + K252a(tyrosine kinase receptor B inhibitor)groups(n= 10 each;another 10 normal rats were used as the control group).The icariin and icariin + K252a groups were administered 20 mg/kg icariin by gavage once per day after SPS,while the control and SPS groups were administered the same dose of normal saline.K252a cells were injected into the lateral ventricles.After 2 weeks,anxiety,depression,and fear memory disorder in rats in each group were detected by the mine experiment,ele-vated cross maze experiment,and conditional fear test.The binding activity of icariin to brain-derived neurotrophic factor(BDNF)and the BDNF and TrkB expressions in the rat amygdala were detected by immunohistochemistry.The relative expressions of BDNF and TrkB pro-teins were detected by Western blotting.The expressions of postsynaptic density protein 95(PSD95)and synaptophysin(SYN)in the rat amygdala were detected using immunofluorescence.Results Icariin showed strong binding to BDNF.Compared with the control group,the times of entering the central area and the percentage of movement distance in the central area in the SPS group and the icariin+K252a group were significantly reduced.The open arm entry(OE)and arm opening time(OT)were significantly reduced,the freezing time and defecation times were significantly increased,and the expressions of the BDNF,TrkB,PSD95,and SYN proteins were significantly reduced(P<0.05).Compared with the SPS group,the icariin group rats had significantly increased times of entering the central area and percentages of movement distance in the central area,significantly increased OE and OT,significantly reduced the time of immobilization and defecation,and significantly increased the expressions of BDNF,TrkB,PSD95,and SYN proteins(P<0.05).Conclusion Icariin effectively alleviated the fear memory impairment induced by SPS in rats.This protective effect is related to BDNF/TrkB signaling pathway activation and upregulated PSD95 and SYN expression.

Trauma e literalidade: a razão psicodinâmica no espírito da traumatização neurocientífica / Trauma and literality: psychodynamic reason in the spirit of neuroscientific traumatization

Resumo Desde o seu nascimento na medicina cirúrgica do século XVII, a pesquisa do trauma admitiu interpretações múltiplas e associadas ora às lesões visíveis de órgãos e tecidos, ora à influência de agentes psíquicos patogênicos sobre a memória, a consciência e a personalidade. Com o aprofundamento do papel dos sistemas classificatórios desde DSM-III, o fenômeno do trauma será incorporado ao prisma psiquiátrico através do Transtorno de Estresse Pós-Traumático e destinado, finalmente, à circunscrição da pesquisa neurocientífica. A partir de revisão narrativa, este artigo abordará uma das premissas epistemológicas fundamentais para essa transição, que informa como o trauma psicológico ganhou autonomia sobre as descrições anatômicas para ser, cerca de um século depois, por ela reanexado enquanto fenômeno essencialmente corporal e aderido à gramática das neurociências.

Abstract Since its origin in the surgical medicine of the 17th century, trauma research has had multiple interpretations and has been associated either with visible injuries to organs and tissues, or with the influence of pathogenic psychic agents on memory, consciousness and personality. With the intensification of the role of classification systems since DSM-III, the phenomenon of trauma came to be incorporated into the psychiatric realm through Post-Traumatic Stress Disorder and destined finally to the constraints of neuroscientific research. Based on a narrative review, this article will address one of the fundamental epistemological premises for this transition, which informs how psychological trauma gained autonomy over anatomical descriptions to be reclassified, around a century later, as an essentially bodily phenomenon and incorporated into the jargon of neurosciences.

Effectiveness of narrative exposure therapy for post-traumatic stress disorder in children and adolescents： a Meta-analysis / 四川精神卫生

BackgroundNarrative exposure therapy （NET）， an integration of narrative therapy and exposure therapy， has been shown to be effective in relieving the symptoms of post-traumatic stress disorder （PTSD）， which can help patients gain a deeper understanding of their trauma and is also considered to be quite safe. PTSD is highly prevalent in children and adolescents， while the effectiveness of NET intervention varies among the subjects. ObjectiveTo systematically evaluate the effectiveness of NET for PTSD in children and adolescents， so as to provide references for the clinical application of NET. MethodsOn August 1， 2022， the Cochrane Library， PubMed， Web of Science， CINAHL， China National Knowledge Infrastructure （CNKI）， SinoMed， VIP and Wanfang database were searched from their inception to June 2022. Search was conducted with the use of a combination of medical subject heading and free text terms， and randomized controlled trials relevant to NET for PTSD in children and adolescents were collected. Then the quality of the controlled trials was evaluated according to the Cochrane Collaboration's tool for assessing risk of bias （2011）， and Meta-analysis was performed using RevMan 5.4 software. ResultsNine randomized controlled trials involving 394 children and adolescents with PTSD were included. Meta-analysis showed that NET and relaxation therapy reported comparable symptom relief in PTSD patients within 1 to 3 months after intervention （SMD=0.22， 95% CI： -0.84~1.28） and at 6 months after intervention （SMD=0.21， 95% CI： -0.75~1.17）， while NET provided greater PTSD symptom relief than routine therapy both within 1 to 3 months after intervention （SMD=-0.66， 95% CI： -1.04~-0.27） and at 6 months after intervention （SMD=-0.77， 95% CI： -1.36~-0.19）， with statistically significant differences. Regarding the alleviation of depressive symptoms， the effect was similar between NET and routine therapy within 1 to 3 months after intervention （SMD=-0.39， 95% CI： -0.98~0.21） and at 6 months after intervention （SMD=-0.74， 95% CI： -2.23~0.75）. No statistical difference was demonstrated between NET and routine therapy in relieving psychological distress （SMD=-0.54， 95% CI： -2.14~1.07） and suppressing hyperorexia （SMD=-0.17， 95% CI： -0.54~0.19） 1 to 3 months after intervention. ConclusionNET yields a better outcome and a medium- and long-term effectiveness in alleviating symptoms of PTSD in children and adolescents compared with routine therapy， while it does not offer any significant advantages in improving depression symptoms， psychological distress and hyperorexia.

Experience with Chikujountanto (Untanto) for Trauma- and Stressor- Related Disorders / 日本東洋医学雑誌

I report five cases in which chikujountanto and untanto were effective for trauma and stressor-related disorders. Post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) are both psychiatric disorders that occur as a reaction to severe stress, and are distinguished by the duration of the disorder. Chikujountanto is indicated for those who have cough and insomnia after late yang stage pattern in case of cold, and for chronic diseases such as depression and sleep disorders, and is applied to various psychiatric disorders. In this paper, I cite the grounds for applying chikujountanto to PTSD from the classics, examine the similarities and differences with other Kampo medicines reported to be used for PTSD from the characteristics of the constituent crude drug centered on Huang lian. I also infer the relationship between the therapeutic mechanism of Kampo and neuroinflammation. Regardless of the severity of the trauma, rapid administration of this drug is expected to hasten the healing process.

Is post-traumatic stress disorder related to the severity of physical trauma?

SUMMARY OBJECTIVE: Trauma can cause physical morbidity and even result in death. Besides, it can lead to serious mental problems as well. The most well-known mental health problem is post-traumatic stress disorder. Through this study, it was primarily aimed to find out whether the severity of physical trauma is effective on post-traumatic stress disorder and other risk factors if any. METHODS: The reports of the patients who were transferred to the Turkish Council of Forensic Medicine Third Speciality Board between January 01, 2019, and December 31, 2020, for post-traumatic invalidity or disability evaluation and whose psychiatric examinations were performed were retrospectively analyzed in the electronic environment. RESULTS: It was found that 34 (26.4%) of the patients had a diagnosis of post-traumatic stress disorder (under treatment for at least 6 months), while 76 (58.9%) of them did not have a psychiatric disease and 19 (14.7%) of them had mental disorders not associated with trauma (i.e., affective disorder, anxiety disorder, etc.). No significant correlation was found between trauma scores and post-traumatic stress disorder (p>0.05). CONCLUSION: Based on the results of our study, post-traumatic stress disorder and the severity of physical trauma are not significantly correlated. Being of female gender, sustaining a non-accidental injury, and witnessing a fatal event stand out as significant risk factors.

Treating post-traumatic stress disorder in survivors of community and domestic violence using narrative exposure therapy: a case series in two public health centers in Rio de Janeiro/Brazil / Terapia de exposição narrativa para o tratamento do transtorno de estresse pós-traumático com pessoas que passaram por violência doméstica e comunitária: estudo de série de casos em dois centros de saúde no Rio de Janeiro, Brasil

Abstract Prevalence of violence in Brazil is high, which contributes to an increasing number of trauma-related disorders, especially post-traumatic stress disorder (PTSD). This study aims to present a case series of PTSD patients treated with narrative exposure therapy (NET) in two public health centers in Rio de Janeiro (Brazil). Health professionals were trained in a two-week workshop to deliver NET. Exposure to violence and other potentially traumatic events, as well as PTSD were assessed by interviewers before treatment and six months later in follow-up interviews conducted by blind assessors. Multiple traumatic events, including different types of childhood and sexual abuse, intimate partner violence and community violence were reported. Five patients were exposed to community violence, and one to domestic violence, during or after NET treatment. Treatment delivery was integrated into the routine of health centers. Eight patients completed NET and presented a substantial reduction in PTSD severity at six-month follow-up. NET is a feasible and effective treatment for PTSD patients exposed to ongoing violence, and can be integrated into established public health services.

Resumo A prevalência de exposição à violência é alta no Brasil, contribuindo para o aumento do número de transtornos relacionados a traumas, especialmente o transtorno de estresse pós-traumático (TEPT). Este estudo tem por objetivo apresentar uma série de casos de pacientes com TEPT que passaram pela terapia de exposição narrativa (NET) em dois centros de saúde do Rio de Janeiro. Os profissionais de saúde receberam duas semanas de treinamento NET. A exposição à violência e a outros eventos potencialmente traumáticos, bem como o TEPT, foram avaliados por entrevistadores antes do tratamento e seis meses depois em entrevistas de acompanhamento conduzidas por avaliadores sob condição cega. O tratamento foi integrado à rotina dos serviços. Oito pacientes completaram a NET e apresentaram redução substancial na severidade do TEPT. Todos reportaram exposição a eventos traumáticos múltiplos, incluindo diferentes tipos de abuso infantil, sexual, violência por parceiro íntimo e comunitária. Cinco pacientes foram expostos à violência comunitária e um à violência doméstica durante ou após o tratamento. Esta série de casos mostra que a NET é um tratamento eficaz para pacientes com TEPT expostos a violências contínuas e pode ser integrado nos serviços públicos de saúde.

Validation Spanish of the Post-Traumatic Stress Disorder Scale in the Postpartum - City BITS / Validación al castellano de la Escala de Trastorno de Estrés Postraumático en el Postparto - City BITS

Background: Postpartum post-traumatic stress disorder (PTSD) has a prevalence of 3-4% in women, rising to 15-19% in the presence of risks during pregnancy or childbirth, and reaching 39% in the case of neonatal death. Perinatal complications can trigger a real or perceived threat to maternal or neonatal life, which can evoke intense emotional reactions equivalent to a traumatic stressor according to PTSD criteria. Four symptom clusters have been identified: re-experiencing, avoidance, negative cognitions and mood, and hyperarousal symptoms. Despite its high comorbidity with depression and anxiety, postpartum PTSD remains underdiagnosed in maternal settings. The Postpartum Posttraumatic Stress Disorder Scale, originally developed in England, is in the process of translation and global validation. Objective: To validate the Spanish adaptation of the City Birth Trauma Scale. Methods: Quantitative, nonexperimental, cross-sectional, descriptive-correlational study in a sample of 677 Argentine women with children under 12 months of age. Results: Exploratory factor analysis revealed two dimensions that explained 49.56% of the total variance. Confirmatory factor analysis supported the two-factor structure. The scale showed high internal consistency (total α = .903), with α = .872 for 'birth-related symptoms' and α = .886 for 'general symptoms'. Construct validity of the City BiTS was demonstrated by moderate associations with the DASS-21 subscales and a negative correlation with the BIEPS-A. Conclusions: The Spanish adaptation of the City Birth Trauma Scale is confirmed as a reliable and valid instrument, consistent with original research findings and subsequent validations, articulating postpartum PTSD in two symptom categories: birth-related and general.

Introducci�n: El Trastorno de Estr�s Postraum�tico (TEPT) posparto tiene una prevalencia del 3�4% en mujeres, incrementando al 15-19% en presencia de riesgos durante la gestaci�n o parto, y alcanzando un 39% en caso de fallecimiento neonatal. Las complicaciones perinatales pueden desencadenar una amenaza real o interpretada sobre la vida materna o neonatal, lo cual puede suscitar intensas respuestas emocionales equivalentes a un estresor traum�tico seg�n los criterios de TEPT. Se identifican cuatro grupos sintom�ticos: reexperimentaci�n, evitaci�n, cogniciones y estado de �nimo negativos y s�ntomas de hiperactivaci�n. A pesar de su alta comorbilidad con depresi�n y ansiedad, el TEPT posparto permanece subdiagnosticado en contextos maternales. La Escala de Trastorno de Estr�s Postraum�tico en el Postparto, originalmente dise�ada en ingl�s en Inglaterra, est� en proceso de traducci�n y validaci�n global. Objetivo: Validar la adaptaci�n al castellano de The City Birth Trauma Scale. M�todo: Estudio cuantitativo, no experimental, transversal y descriptivo-correlacional en una muestra de 677 mujeres argentinas con hijos menores de 12 meses. Resultados: El an�lisis factorial exploratorio revel� dos dimensiones que explican el 49.56% de la varianza total. El an�lisis factorial confirmatorio respald� esta estructura bifactorial. La escala demostr� una alta consistencia interna (α total = 0.903), siendo α = 0.872 para "S�ntomas relacionados con el parto" y α = 0.886 para "S�ntomas generales". La validez de constructo de City BiTS se evidenci� a trav�s de asociaciones moderadas con las subescalas de DASS-21 y una correlaci�n negativa con BIEPS-A. Conclusi�n: La adaptaci�n al castellano de The City Birth Trauma Scale se confirma como un instrumento confiable y v�lido, alineado con hallazgos de la investigaci�n original y validaciones subsiguientes, articulando el TEPT posparto en dos categor�as sintom�ticas: las relacionadas al parto y las generales.

Psychopathological intersection between obsessive-compulsive disorder and post-traumatic stress disorder: scoping review of similarities and differences

Abstract Introduction Although post-traumatic stress disorder and obsessive-compulsive disorder have distinct diagnostic criteria, some psychopathological phenomena seem to be shared, which may lead to misdiagnosis and erroneous treatment decisions. This scoping review explores the psychopathological similarities and differences between these two disorders. Method The review complies with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and included articles published in Portuguese, English, or Spanish in the last 50 years indexed in the PubMed database. Case-reports were excluded. Results Fifty-three studies with different designs were included (30 [56.5%] were cross-sectional studies; eight [15.1%] were case-control studies; one [1.9%] was a cohort study; three [5.7%] were clinical trials; nine [17%] were reviews/systematic reviews; and two [3.8%] were meta-analyses). The main psychopathological aspects described by the studies included were flashbacks x obsessions; avoidant behavior (AB); depressive, anxious, and somatic symptoms; sexuality, sleep, and appetite; psychiatric comorbidities; and suicidality. The intersection between clinical features seems to occur in the extrinsic psychopathological dimension. Conclusion The disorders' core psychopathological symptoms (intrinsic characteristics) are distinctly different, since flashbacks and obsessions are consequences of different predominant defective mental functions: the former derives from defective memory, the latter from defective thought. Along the same lines, the ABs observed in the two disorders are products of different purposes and inner necessities.

A soberania do visível: como a memória traumática se torna estresse traumático / The sovereignty of the visible: how traumatic memory becomes traumatic stress / La soberanía de lo visible: cómo la memoria traumática se convierte en estrés traumático

Desde o lançamento da terceira versão do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-III), a psiquiatria biológica vem sistematicamente aplicando seu raciocínio classificatório a fenômenos sociais de múltiplas naturezas. Nessa perspectiva, ganha relevância o discurso do trauma, pelo qual acontecimentos de magnitude devastadora passaram a receber interpretações neurocomportamentais e foram, finalmente, reconhecidos menos por seus impactos culturais e subjetivos que pelas alterações fisiológicas que propiciam. Apoiado em revisão narrativa, este artigo procurará explorar a transição da racionalidade traumática entre o século XIX, quando o trauma fora concebido em associação ao conceito cognitivo de memória, e o século XX, quando finalmente esse fenômeno foi anexado à pesquisa neurocientífica do estresse. A pluralidade de modelos conceituais e paradigmas determinísticos pode contribuir para que a pesquisa do trauma produza protocolos de enfrentamento multifatoriais mais adequados à experiência humana do sofrimento pós-traumático.

Since the release of the third version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), biological psychiatry has been systematically applying its classification reasoning to social phenomena of many natures. From this perspective, the discourse of trauma gained relevance and events of devastating magnitude began to receive neurobehavioral interpretations until finally being recognized less for their cultural and subjective effects than for the physiological changes they cause. By a narrative review, this study aims to analyze the transition of traumatic rationality from the 19th century, when trauma was associated with the cognitive concept of memory, to the 20th century, when this phenomenon was finally attached to neuroscientific research on stress. The plurality of conceptual models and deterministic paradigms can contribute to the fact that trauma research produces multifactorial coping protocols more appropriate to the human experience of post-traumatic suffering.

Desde la publicación de la tercera versión del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-III), la psiquiatría biológica ha aplicado sistemáticamente su razonamiento clasificatorio a fenómenos sociales de múltiple naturaleza. Desde esta perspectiva cobra relevancia el discurso del trauma, a través del cual eventos muy devastadores pasaron a tener interpretaciones neuroconductuales y finalmente fueron reconocidos menos por sus impactos culturales y subjetivos que por los cambios fisiológicos que provocan. A partir de una revisión narrativa, este artículo busca explorar la transición del razonamiento traumático entre el siglo XIX, cuando el trauma se concibe en asociación con el concepto cognitivo de memoria, y el siglo XX, cuando este fenómeno se vincula a la investigación neurocientífica sobre estrés. La diversidad de modelos conceptuales y paradigmas deterministas puede contribuir a que la investigación del trauma produzca protocolos de afrontamiento multifactoriales más adecuados a la experiencia humana del sufrimiento postraumático.

Abnormal neuronal activation associated with fear memory extinction in the hippocampus of a PTSD mouse model / 神经解剖学杂志

Objective:To analyze the differences in neuronal activation during fear memory extinction in various sub-regions of the hippocampus in post-traumatic stress disorder(PTSD)mice.Methods:Two immediate early gene-pro-tein labeling strategies were employed to label neurons associated with fear extinction in PTSD mice.In the first group,Arc protein in hippocampal neurons was labeled and observed through immunofluorescence staining in wild-type mice.In the second group,Fos-CreERT2;Ai9 transgenic mice were injected with tamoxifen 23 hours prior to inducing fear memory extinction,and the relevant neurons were labeled with fluorescent proteins for observation.The number of labeled hippocampal neurons and the dendritic branch structure were analyzed to compare the activation levels of hipp-ocampal neurons and the plasticity of neuronal dendrites.Results:The two groups of Arc and Fos positive neurons were mainly distributed in the dorsal hippocampus,in which Arc protein chromogenic was enriched in CA3 and DG subre-gions,while CA1 and CA2 subregions were scattered,while Fos-positive neurons were enriched in the DG subregion of hippocampus and scattered in CA1,CA2 and CA3 subregions.Compared to the control group,there was no significant difference in the number of neurons expressing Arc protein in each subregion of the hippocampus in the PTSD group.The number of Fos-positive neurons in CA1,CA3 and DG subregions in the hippocampus of the PTSD group was signifi-cantly increased(P＜0.01).The dendritic branches of neurons in the hippocampal region were observed and analyzed in Fos-CreERT2;Ai9 mice from both groups,but no significant changes were found.Conclusion:Abnormal activation of neurons occurs in different subregions of the hippocampus during fear extinction in PTSD mice,although there are no significant plasticity changes in the dendritic branches of the activated neurons.

The effects of exercise on the expression of ferroptosis-related proteins in mice with post-traumatic stress disorder / 神经解剖学杂志

Objective:The study aimed to investigate the effects of exercise on the expression of ferroptosis-related proteins and the associated mechanisms in a post-traumatic stress disorder(PTSD)model induced by transient foot shock.Methods:Thirty-five male C57BL/6J mice(8 weeks old)were randomly divided into three groups:Control group,PTSD group,and Exe+PTSD group.PTSD model mice were established by foot-shock and PTSD behaviors were assessed using a fear conditioning box.Iron distribution areas were detected by Fe3+staining.Western Blot analysis were performed to determine the expression level of ferroptosis-related proteins in the mice.Results:Compared to the control group,the freezing time and Fe3+distribution areas in the cortex and hippocampus were significantly increased in the mice with PTSD(P＜0.05).The levels of ferroportin1(FPN1),glutathione peroxidase 4(GPX4),and brain-derived neurotrophic factor(BDNF)proteins were significantly decreased(P＜0.05),while the expression of high mobility group box 1(HMGB1)protein was significantly elevated(P＜0.05).Exercise significantly reduced freezing time and Fe3+accumulation in the cortex and hippocampus(P＜0.05),and it also up-regulated the expression of FPN1,GPX4,and BDNF proteins(P＜0.05),while down-regulating HMGB1 expression compared to the PTSD group(P＜0.05).Conclusion:This study demonstrates that PTSD induces the ferroptosis-related pathway in mice,and exercise can inhibit iron accumulation and reverse the expression of ferroptosis-related proteins induced by PTSD,there-by alleviating PTSD-like behavior in mice.

Research Progress on Neurobiological Mechanism of Acupuncture Intervention on Fear Memory of PTSD / 世界科学技术-中医药现代化

Acupuncture is effective in the treatment of post-traumatic stress disorder(PTSD),and can effectively improve patients'anxiety and fear.The mechanism of acupuncture intervention in PTSD has been widely concerned and made some progress.This paper combs and analyzes the relevant data on the neurobiological mechanism of acupuncture intervention on fear memory in PTSD in recent years,and finds that the mechanism of acupuncture intervention in PTSD is closely related to repairing structural damage in key brain regions of fear memory,regulating abnormal brain network connections,inhibiting stress-induced neuroinflammatory response,and regulating the expression of neuronal plasticity molecules and neural signal transduction molecules.This provides a data basis for further research and application of the biological mechanism of acupuncture intervention on PTSD.

Progress in physical therapy for post-traumatic stress disorder / 中国神经精神疾病杂志

Post-traumatic stress disorder(PTSD),as a mental disorder disease,can seriously damage the physical and mental health and social functioning of patients.Physical therapy is increasingly being used in research on the treatment of PTSD due to its ability to directly target specific brain regions and improve the core symptoms of PTSD.This review categorizes on physical therapy for PTSD into two categories:non-invasive physical therapy and invasive physical therapy.Non-invasive physical therapy methods included electroconvulsive therapy,transcranial direct current stimulation,transcranial magnetic stimulation,and the Flexyx neurotherapy system.Non-invasive physical therapy had the advantages of safety,convenience,and simple operation.However,their stimulation accuracy was limited.Invasive physical therapy methods included deep brain stimulation and stellate ganglion block.Invasive physical therapy had the advantages of precise stimulation,fewer adverse reactions.However,there were surgical risks,high operational difficulty,and high treatment costs.In addition,potential physical therapy methods included transcranial alternating current stimulation,magnetic seizure therapy,and vagus nerve stimulation,which were currently in the theoretical research stage.This study discussed the mechanism of action,therapeutic parameters,clinical efficacy,adverse effects and the latest forms of technology of the above physical therapy methods,so as to provide reference for the treatment of PTSD.