Pain in the aftermath of trauma is a risk factor for post-traumatic stress disorder

2007 ◽  
Vol 38 (4) ◽  
pp. 533-542 ◽  
Author(s):  
S. B. Norman ◽  
M. B. Stein ◽  
J. E. Dimsdale ◽  
D. B. Hoyt

BackgroundIdentifying risk factors for the development of post-traumatic stress disorder (PTSD) is important for understanding and ultimately preventing the disorder. This study assessed pain shortly after traumatic injury (i.e. peritraumatic pain) as a risk factor for PTSD.MethodParticipants (n=115) were patients admitted to a Level 1 Surgical Trauma Center. Admission to this service reflected a severe physical injury requiring specialized, emergent trauma care. Participants completed a pain questionnaire within 48 h of traumatic injury and a PTSD diagnostic module 4 and 8 months later.ResultsPeritraumatic pain was associated with an increased risk of PTSD, even after controlling for a number of other significant risk factors other than acute stress disorder symptoms. An increase of 0.5 s.d. from the mean in a 0–10 pain rating scale 24–48 h after injury was associated with an increased odds of PTSD at 4 months by more than fivefold, and at 8 months by almost sevenfold. A single item regarding amount of pain at the time of hospital admission correctly classified 65% of participants.ConclusionsIf these findings are replicated in other samples, high levels of peritraumatic pain could be used to identify individuals at elevated risk for PTSD following traumatic injury.

2021 ◽  
Author(s):  
David S. Krantz ◽  
Lisa M. Shank ◽  
Jeffrey L. Goodie

Evidence indicates that post-traumatic stress disorder (PTSD) is a significant risk factor for the development and progression of cardiovascular disease (CVD). Most explanations for PTSD-CVD associations conceptualize PTSD as a stress-related mental health disorder that elicits physiological, behavioral, and psychological responses that are causal factors in the development of cardiovascular disorders. This article reviews evidence for the broader physical health consequences of PTSD, and presents a conceptual model based on research suggesting that PTSD is a systemic disorder. Specifically, research findings indicate that diagnostic criteria are just the “tip of the iceberg” of a broader systemic disorder with elements that are cardiovascular risk factors. These systemic physiological and behavioral elements therefore should not be regarded as accompanying but unrelated diseases or comorbidities, but as inherent components of PTSD that directly impact the development of CVD. The systemic disorder approach has implications for the conceptualization of PTSD as a cardiovascular risk factor, needed research on PTSD and CVD, and clinical efforts to reduce PTSD-associated cardiovascular risk. It is suggested that treatments that aim to reduce cardiovascular disease risk need to address both the PTSD diagnostic components and its associated cardiovascular risk factors. Further research is needed to test the applicability and implications of the systemic disorder perspective.


2021 ◽  
Author(s):  
David S. Krantz ◽  
Lisa M. Shank ◽  
Jeffrey L. Goodie

Evidence indicates that post-traumatic stress disorder (PTSD) is a significant risk factor for the development and progression of cardiovascular disease (CVD). Most explanations for PTSD-CVD associations conceptualize PTSD as a stress-related mental health disorder that elicits physiological, behavioral, and psychological responses that are causal factors in the development of cardiovascular disorders. This article reviews evidence for the broader physical health consequences of PTSD, and presents a conceptual model based on research suggesting that PTSD is a systemic disorder. Specifically, research findings indicate that diagnostic criteria are just the “tip of the iceberg” of a broader systemic disorder with elements that are cardiovascular risk factors. These systemic physiological and behavioral elements therefore should not be regarded as accompanying but unrelated diseases or comorbidities, but as inherent components of PTSD that directly impact the development of CVD. The systemic disorder approach has implications for the conceptualization of PTSD as a cardiovascular risk factor, needed research on PTSD and CVD, and clinical efforts to reduce PTSD-associated cardiovascular risk. It is suggested that treatments that aim to reduce cardiovascular disease risk need to address both the PTSD diagnostic components and its associated cardiovascular risk factors. Further research is needed to test the applicability and implications of the systemic disorder perspective.


2021 ◽  
Vol 15 (5) ◽  
pp. 155798832110349
Author(s):  
Bradley S. Gundlach ◽  
Irena Tsui

The primary aim of this study was to determine whether psychosocial factors, such as post-traumatic stress disorder (PTSD) and anxiety, are independently associated with the development of central serous chorioretinopathy (CSCR), a predominantly male eye disorder. A secondary aim was to verify previously determined risk factors in a veteran population. All CSCR subjects seen in one year at a veteran eye clinic were included. Chart review was performed to identify general health information as well as eye history. Univariate and multivariate analysis was performed to identify factors that were independently associated with the development of CSCR. Fifty-one cases of CSCR were identified and an additional 51 age-matched controls with healthy eyes were used for analysis. Multivariate analysis revealed that history of PTSD was strongly associated with the development of CSCR (OR = 9.43, p = .002), even more so than previously reported risk factors. Anxiety was significant at the univariate level (OR = 6.48, p = .001) but lost significance at the multivariate level. At the multivariate level, several existing risk factors were confirmed including sleep apnea (OR = 5.76, p = .004), heart disease (OR = 7.06, p = .004), smoking (OR = 5.52, p = .003) and steroid use (OR = 4.55, p = .005). PTSD was strongly associated with the development of CSCR in the veteran population studied and may represent an important modifiable risk factor.


2019 ◽  
Vol 7 (9) ◽  
pp. 1452-1455 ◽  
Author(s):  
Gede Wirya Kusuma Duarsa ◽  
Dinar Ayu Pratiwi ◽  
Pande Wisnu Tirtayasa ◽  
Wayan Yudiana ◽  
Kadek Budi Santosa ◽  
...  

BACKGROUND: Children with hypospadias, being born with congenital abnormalities, having repeated genital examination, hospitalization, and undewent genital surgery, experienced psychological stress that may negatively affect their psychosocial life. Choosing the proper time of surgery as recommended is important, since it may have a positive impact on the psychosocial adaptation. AIM: This study aims to find the risk factors causing psychosocial disorders in post-repair surgery on hypospadias children. METHODS: This is a case control study, from 203 hypospadias patients underwent urethroplasty from 2009 to 2018. Subjets were screened for psychosocial disorders by Pediatric Symptoms Questionnaire 17 (PSC-17) questionnaire to find those with psychosocial disorders, score 15 or more (case group) and those without psychosocial disorders (control group), score 0-14. We traced back the data retrospectively from both group (history of utrethrocutaneous fistula and meatal stenosis, age upon urethroplasty) and collecting new ones (cosmetic outcome, emotional stress after genital examination, and the existence of PTSD). Fisher’s exact test was performed to see the Odds ratio (OR) for each variable. RESULTS: Some children with hypospadias show impaired on psychocosial. Functional and cosmetic outcome not significantly different as potensial risk factor psychosocial disorders, genital examination doesn’t trigger psychological stress and also none children show PTSD symtomp after surgery. Comparison time of age urethroplasty did not differ significantly between two group CONCLUSIONS: Twenty-nine children post urthroplasty show psychosocial disorders. Functional and cosmetic urethroplasty outcomes, emotional stress after genital examination, post-traumatic stress disorder were not risk factors of pshycosocial disorder of hypospadias patients. Ages at time of surgery did not differ significantly between two group and this is contradict to the previous recommendations.


2006 ◽  
Vol 37 (2) ◽  
pp. 181-192 ◽  
Author(s):  
KARESTAN C. KOENEN ◽  
TERRIE E. MOFFITT ◽  
RICHIE POULTON ◽  
JUDITH MARTIN ◽  
AVSHALOM CASPI

Background. Childhood factors have been associated with increased risk of developing post-traumatic stress disorder (PTSD). Previous studies assessed only a limited number of childhood factors retrospectively. We examined the association between childhood neurodevelopmental, temperamental, behavioral and family environmental characteristics assessed before age 11 years and the development of PTSD up to age 32 years in a birth cohort.Method. Members of a 1972–73 New Zealand birth cohort (n=1037) who were assessed at ages 26 and 32 years for PTSD as defined by DSM-IV.Results. We identified two sets of childhood risk factors. The first set of risk factors was associated both with increased risk of trauma exposure and with PTSD assessed at age 26. These included childhood externalizing characteristics and family environmental stressors, specifically maternal distress and loss of a parent. The second set of risk factors affected risk for PTSD only and included low IQ and chronic environmental adversity. The effect of cumulative childhood factors on risk of PTSD at age 26 was substantial; over 58% of cohort members in the highest risk quartile for three developmental factors had PTSD as compared to only 25% of those not at high risk on any factors. Low IQ at age 5, antisocial behavior, and poverty before age 11 continued to predict PTSD related to traumatic events that occurred between the ages of 26 and 32.Conclusions. Developmental capacities and conditions of early childhood may increase both risk of trauma exposure and the risk that individuals will respond adversely to traumatic exposures. Rather than being solely a response to trauma, PTSD may have developmental origins.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maude Bernasconi ◽  
Béatrice Eggel-Hort ◽  
Antje Horsch ◽  
Yvan Vial ◽  
Alban Denys ◽  
...  

AbstractThis study intend to compare the long-term psychological impact (depression, post-traumatic stress disorder) on both partners between patients that underwent uterine artery embolization (UAE) for post-partum hemorrhage (PPH) and uneventful deliveries. Women who experienced severe PPH treated by UAE in our institution between 2003 and 2013 were identified in our obstetrical database. These cases were matched to controls with uneventful deliveries. Matching criteria were maternal age, parity, ethnicity, year of delivery, birthweight, gestational age and mode of delivery. Patients and their partners completed validated questionnaires measuring post-traumatic stress (TSQ), as well as depression symptoms (MINI). A total of 63 cases of PPH and 189 matched controls (1:3) participated in a study exploring gynecological and obstetrical outcomes. With a mean of 8 years post-index delivery, patients after PPH showed increased risk of depression (p = 0.015) and post-traumatic stress disorder (22.2% versus 4.8%, p < 0.005) compared to controls. PPH remains strongly associated with post-traumatic stress disorder, even after adjustment for depression (adjusted odds ratio 5.1; 95% confidence intervals 1.5–17.5). Similarly, partners of patients with PPH showed a propensity to depression (p = 0.029) and post-traumatic stress disorder (11.5% versus 1.5%, p = 0.019). In conclusion, both women and their partners are at increased risk of long-term psychological adverse outcomes after PPH. Couples may benefit from psychological support.


2020 ◽  
pp. bmjmilitary-2020-001622 ◽  
Author(s):  
Dominic Murphy ◽  
C Williamson ◽  
J Baumann ◽  
W Busuttil ◽  
N T Fear

IntroductionData are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic.MethodsData were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions—Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity.ResultsIt was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties.ConclusionsOur findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.


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