ABSTRACT
OBJECTIVE: War veterans are at high risk of developing posttraumatic stress disorder (PTSD), and the development of brief self-report instruments that enable screening for PTSD in this population is crucial. The PTSD Checklist-Military Version (PCL-M) is widely used for this purpose. This study sought to explore the diagnostic utility of the Portuguese version of the PCL-M. METHODS: The participants were 86 Portuguese Colonial War veterans (42 with a PTSD diagnosis and 44 without PTSD). Participants completed a self-report instrument designed to collect sociodemographic data, the PCL-M, and the Clinician-Administered PTSD Scale (CAPS). RESULTS: The area under the receiver operator characteristic (ROC) curve showed excellent discriminant ability between subjects with and without PTSD (AUC = 0.94). To achieve a positive PTSD diagnosis, an optimal cutoff point of 49 for the PCL-M total score and cutoff points for each of its 17 items are recommended. CONCLUSIONS: This work is a relevant contribution for research and clinical practice in the vast population of Portuguese Colonial War veterans. Use of the PCL-M as a screening tool for PTSD symptoms will allow easier, resource-aware targeting of subjects with a potential PTSD diagnosis, adding to the improvement of public health in Portugal.
Subject(s)
Checklist/standards , Combat Disorders/diagnosis , Language , Stress Disorders, Post-Traumatic/diagnosis , Veterans/psychology , Aged , Combat Disorders/psychology , Epidemiologic Methods , Humans , Male , Middle Aged , Psychometrics , Reference Values , Severity of Illness Index , Stress Disorders, Post-Traumatic/psychologyABSTRACT
BACKGROUND: Topiramate might be effective in the treatment of posttraumatic stress disorder (PTSD) because of its antikindling effect and its action in both inhibitory and excitatory neurotransmitters. Open-label studies and few controlled trials have suggested that this anticonvulsant may have therapeutic potential in PTSD. This 12-week randomized, double-blind, placebo-controlled clinical trial will compare the efficacy of topiramate with placebo and study the tolerability of topiramate in the treatment of PTSD. METHODS AND DESIGN: Seventy-two adult outpatients with DSM-IV-diagnosed PTSD will be recruited from the violence program of Federal University of São Paulo Hospital (UNIFESP). After informed consent, screening, and a one week period of wash out, subjects will be randomized to either placebo or topiramate for 12 weeks. The primary efficacy endpoint will be the change in the Clinician-administered PTSD scale (CAPS) total score from baseline to the final visit at 12 weeks. DISCUSSION: The development of treatments for PTSD is challenging due to the complexity of the symptoms and psychiatric comorbidities. The selective serotonin reuptake inhibitors (SSRIs) are the mainstream treatment for PTSD, but many patients do not have a satisfactory response to antidepressants. Although there are limited clinical studies available to assess the efficacy of topiramate for PTSD, the findings of prior trials suggest this anticonvulsant may be promising in the management of these patients. TRIAL REGISTRATION: NCT 00725920.
Subject(s)
Anticonvulsants/therapeutic use , Combat Disorders/drug therapy , Fructose/analogs & derivatives , Stress Disorders, Post-Traumatic/drug therapy , Adolescent , Adult , Combat Disorders/diagnosis , Combat Disorders/psychology , Double-Blind Method , Female , Fructose/therapeutic use , Humans , Male , Middle Aged , Personality Inventory , Placebos , Psychiatric Status Rating Scales/statistics & numerical data , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Topiramate , Treatment Outcome , WarfareABSTRACT
Our study evaluated the relationship between positive affect (PA) and negative affect (NA) traits on the development of posttraumatic stress symptoms (PTSS) among peacekeepers. A longitudinal study with 138 army personnel deployed to a peacekeeping mission in Haiti was conducted. An instrument for measuring PA and NA traits was used before deployment. PTSS, indexed by posttraumatic stress disorder Checklist--Military Version (PCL-M) and frequency of stressful situations were measured after return. Regression analysis showed that both NA and number of stressful situations contributed toward increasing PCL-M scores (Adjusted R = 0.25; p < 0.001). We also found that NA traits interact with intensively stressful situations enhancing the occurrence of PTSS (Adjusted R = 0.32; p < 0.001). These findings suggest that NA traits are an important predictor for PTSS among peacekeepers and also worsen the consequences of being exposed to stressful situations.
Subject(s)
Affective Symptoms/diagnosis , Combat Disorders/diagnosis , Military Personnel/psychology , Stress Disorders, Post-Traumatic/diagnosis , United Nations , Volunteers/psychology , Adult , Affective Symptoms/epidemiology , Affective Symptoms/psychology , Brazil , Character , Combat Disorders/epidemiology , Combat Disorders/psychology , Cross-Sectional Studies , Haiti , Humans , Longitudinal Studies , Male , Personality Inventory/statistics & numerical data , Prospective Studies , Psychometrics , Risk Factors , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Volunteers/statistics & numerical data , Young AdultABSTRACT
The occurrence of intrusive auditory perceptions has rarely been addressed in the study of posttraumatic stress disorder. This study examined the background of 59 individuals with combat-related posttraumatic stress disorder. Subjects with and without auditory hallucinations were compared on demographic military and symptom variables. The occurrence of hallucinations among veterans with posttraumatic stress disorder appears to be more frequent among subjects of Hispanic ethnicity. This may have been related to higher combat exposure or social stresses. The occurrence of hallucinations was unrelated to drug abuse and did not appear to be associated with any particular war.
Subject(s)
Auditory Perception , Combat Disorders/psychology , Cross-Cultural Comparison , Hallucinations/psychology , Hispanic or Latino/psychology , Veterans/psychology , Acculturation , Combat Disorders/diagnosis , Combat Disorders/ethnology , Hallucinations/diagnosis , Hallucinations/ethnology , Humans , Male , Mexico/ethnology , TexasABSTRACT
Camptocormia is a rare conversion syndrome found mainly in soldiers from World War I and II. No case has been reported since, but this paper reports the syndrome in a former soldier of the Nicaraguan army. It is characterised by severe frontal flexion of the spinal cord and knees, with passive dropping of both arms, and sometimes behavioural abnormalities.