RESUMEN
The COVID-19 pandemic is placing enormous stress on U.S. health care workers. Prior studies of infectious disease outbreaks and other catastrophic events have shown the damaging mental health impacts caused by these events. Implications for the policy and treatment of health care workers facing the COVID-19 crisis are discussed in this commentary. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Asunto(s)
Infecciones por Coronavirus , Personal de Salud/psicología , Pandemias , Neumonía Viral , Distrés Psicológico , Trauma Psicológico , Suicidio , Adulto , COVID-19 , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Humanos , Neumonía Viral/terapia , Neumonía Viral/transmisión , Trauma Psicológico/etiología , Estados UnidosRESUMEN
Systematic evaluation and redesign of a substance use disorder treatment program resulted in elimination of wait times, same-day treatment, and increased pharmacotherapy for patients with alcohol and opioid use disorders.
RESUMEN
The purpose of this trial was to test whether right prefrontal cortex 1â¯Hz versus 10â¯Hz rTMS provides a significantly greater improvement in PTSD symptoms and/or function. Veterans 18 to 50 years of age suffering from PTSD were randomized to right prefrontal 1â¯Hz rTMS [2400 pulses/session] versus right prefrontal 10â¯Hz rTMS [2400 pulses/session]. The treatments were performed 5 days a week for 6 weeks with a 3-week taper using the NeuroStar system. There were one month and three months post treatment follow-up evaluations. Forty-four participants were enrolled with 17 being randomized to 1â¯Hz rTMS and 18 to 10â¯Hz rTMS. Both groups had significant improvement in PTSD and depression scores from baseline to the end of acute treatment. The 10â¯Hz group but not the 1â¯Hz group demonstrated significant improvement in function. Although both groups demonstrated significant improvement in PTSD and depression symptoms, a significant advantage for either the 1â¯Hz or 10â¯Hz frequency group on any of the scales acquired was not demonstrated. Further work is required with larger samples sizes to test whether low or high frequency is superior or if individual differences would indicate the more effective frequency.
Asunto(s)
Trastornos por Estrés Postraumático/terapia , Estimulación Magnética Transcraneal/métodos , Veteranos/psicología , Adolescente , Adulto , Depresión/psicología , Depresión/terapia , Trastorno Depresivo/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Corteza Prefrontal/fisiopatología , Trastornos por Estrés Postraumático/psicología , Resultado del Tratamiento , Adulto JovenRESUMEN
With the large number of Veterans experiencing posttraumatic stress disorder (PTSD) and chronic pain, the purpose of this article is to review the prevalence of PTSD and chronic pain, the theoretical models that explain the maintenance of both conditions, and the challenges faced by providers and families who care for these patients. The Department of Veterans Affairs (VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress with special attention to chronic pain is presented. Limited scientific evidence supports specific care and treatment of PTSD and chronic pain, and this challenges providers to investigate and research potential treatment options. Integrated care models designed for working with these patients are reviewed, including a focus on the techniques and strategies to address not only PTSD and chronic pain, but other conditions, including substance dependence and depression. A specific focus on headaches, back pain, and neuropathic pain follows, including treatment recommendations such as pharmacological, psychotherapeutic, and complementary approaches, given the high rates of these pain complaints for Veterans in PTSD clinical programs. Integrated care is presented as a viable solution and approach that challenges clinicians and researchers to develop innovative, scientifically based therapeutics and treatments to enhance the recovery and quality of life for Veterans with PTSD and chronic pain.