scholarly journals Hospitalized Medical Patients with Posttraumatic Stress Disorder (PTSD): Review of the Literature and a Roadmap for Improved Care

2020 ◽  
Vol 16 (1) ◽  
pp. 38-43
Author(s):  
Kathlyn E Fletcher ◽  
Scott Steinbach ◽  
Flower Lewis ◽  
Molly Hendricks ◽  
Brian Kwan
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Medical Condition ◽  
Hospital Medicine ◽  
The United States ◽  
Medical Patients ◽  
Care Providers ◽  
Trauma Informed Care ◽  
Trauma Informed

Posttraumatic Stress Disorder (PTSD) is common in the United States, with a prevalence of nearly 8% in the general population and between 10%-30% in veterans. Despite how common PTSD is, inpatient providers may not be familiar with its manifestations or feel comfortable taking care of patients who may exhibit symptoms related to it. In our combined experience as VA-based hospital medicine care providers, we have cared for thousands of patients hospitalized for a primary medical condition who also have PTSD as a comorbidity. We have noticed in our practices that we only focus our attention on PTSD if a related problem arises during a patient’s hospitalization (eg, confrontations with the care team or high levels of anxiety). We contend that a more proactive approach could lead to better care, but little evidence about best practices exists to inform the interdisciplinary team how to optimally care for hospitalized medical patients with PTSD. In this narrative review, we present a synthesis of existing literature, describe how trauma-informed care could be used to guide the approach to patients with PTSD, and generate ideas for changes that inpatient providers could implement now, such as engaging patients to prevent PTSD exacerbations and promoting better sleep in the hospital.

“Mental Health” in the NICU: Time to Catch Up and Provide Trauma-Informed Care for Families and Pros

2017 ◽  
Vol 36 (5) ◽  
pp. 318-320 ◽  
Author(s):  
Deborah Discenza
Keyword(s):  
Mental Health ◽  
Posttraumatic Stress Disorder ◽  
Postpartum Depression ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Developmental Outcomes ◽  
Outer Edge ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
Catch Up

AbstractMental health in the NICU has often been on the outer edge of neonatal care because of the focus being on the baby’s health. Yet, with postpartum depression and posttraumatic stress disorder (PTSD) skyrocketing in the NICU and being proven to affect developmental outcomes, it is time to change that. Evidence is provided in this interview with Cheryl Milford, EdS, a NICU psychologist.

scholarly journals Scaling Up: Multisite Open-Label Clinical Trials of MDMA-Assisted Therapy for Severe Posttraumatic Stress Disorder

2021 ◽  
pp. 002216782110236
Author(s):  
Julie B. Wang ◽  
Jessica Lin ◽  
Leah Bedrosian ◽  
Allison Coker ◽  
Ilsa Jerome ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Clinical Trials ◽  
Posttraumatic Stress ◽  
Clinical Supervision ◽  
Stress Disorder ◽  
The United States ◽  
Health Condition ◽  
Open Label ◽  
Adverse Health Outcomes ◽  
Ptsd Symptom Severity

Background: Posttraumatic stress disorder (PTSD) is a debilitating mental health condition associated with serious adverse health outcomes and functional impairment. Previous MDMA–assisted therapy (MDMA-AT) studies have shown promising results in single site studies. Two open-label studies tested this modality in multisite clinical trials to assess the feasibility of scaling this manualized therapy across 14 North American sites. Method: Cotherapist dyads were trained in the manualized MDMA-AT protocol and administered three experimental sessions 3 to 5 weeks apart among participants with severe PTSD. Cotherapist dyads were provided clinical supervision and evaluated for protocol adherence by centralized raters. Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) assessed change in symptoms severity. Results: Adherence rating scores were high across cotherapist dyads ( M = 95.08%, SD = 3.70%) and sites ( M = 95.23%, SD = 2.20%). CAPS-5 scores decreased following 3 MDMA-AT sessions at 18 weeks post baseline (Δ M = −29.99, Δ SD = 13.45, p < .0001, n = 37, Cohen’s d = 2.2, confidence interval [1.97, 2.47]). MDMA was well tolerated. Conclusions: These findings corroborate previous results that MDMA-AT can achieve significant improvements in PTSD symptom severity and demonstrate scalability of manualized therapy across clinic sites in the United States and Canada.

Women’s Health: Treating Survivors of Sexual Assault

2019 ◽  
Author(s):  
Elizabeth Schindler ◽  
Allison Cowan
Keyword(s):  
Mental Health ◽  
Posttraumatic Stress Disorder ◽  
Sexual Assault ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
The United States ◽  
Treatment Recommendations ◽  
Rape Recovery ◽  
History Of ◽  
Rape Survivor

Almost half of all women and almost a quarter of all men in the United States have experienced sexual violence in their lifetime. Treating individuals who have survived sexual assault can pose challenges for psychiatric and medical treatment. The rates of posttraumatic stress disorder (PTSD) are higher with sexual assault, and people with sexual trauma often feel stigmatized and have difficulty presenting for care. This chapter reviews epidemiology and neurobiology of sexual assault as well as the physical and psychological sequelae of sexual assault. Here, the authors review and propose practical treatment recommendations to assist in the treatment of individuals with a history of sexual assault. This review 5 figures, 5 tables, and 53 references. Key Words: posttraumatic stress disorder, rape recovery, sexual assault, treatment recommendations, women’s mental health, rape survivor treatment, rape

Complex PTSD – a better description for borderline personality disorder?

2017 ◽  
Vol 25 (4) ◽  
pp. 333-335 ◽  
Author(s):  
Jayashri Kulkarni
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Diagnostic Category ◽  
Borderline Personality ◽  
Complex Posttraumatic Stress Disorder ◽  
Dsm 5 ◽  
Trauma Informed

Objective: To consider the use of the diagnostic category ‘complex posttraumatic stress disorder’ (c-PTSD) as detailed in the forthcoming ICD-11 classification system as a less stigmatising, more clinically useful term, instead of the current DSM-5 defined condition of ‘borderline personality disorder’ (BPD). Conclusions: Trauma, in its broadest definition, plays a key role in the development of both c-PTSD and BPD. Given this current lack of differentiation between these conditions, and the high stigma faced by people with BPD, it seems reasonable to consider using the diagnostic term ‘complex posttraumatic stress disorder’ to decrease stigma and provide a trauma-informed approach for BPD patients.

Perceived health, adversity, and posttraumatic stress disorder in Syrian and Iraqi refugees

2020 ◽  
pp. 002076402097827
Author(s):  
Arash Javanbakht ◽  
Lana Ruvolo Grasser ◽  
Soyeong Kim ◽  
Cynthia L Arfken ◽  
Nicole Nugent
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Psychological Health ◽  
Armed Conflict ◽  
Stress Disorder ◽  
Psychiatric Symptoms ◽  
Perceived Health ◽  
The United States ◽  
Anxiety And Depression ◽  
Iraqi Refugees

Background: Exposure to armed conflict and fleeing country of origin for refugees has been associated with poorer psychological health. Methods: Within the first month following their arrival in the United States, 152 Syrian and Iraqi refugees were screened in a primary care setting for posttraumatic stress disorder (PTSD), anxiety, and depression and rated their perceived health, and perceived level of adversity of violence, armed conflict/flight. The moderating effects of psychiatric symptoms on the relation between perceived adversity and perceived health were assessed. Results: Three models based on diagnosis (PTSD, anxiety, and depression) were tested. While significant effects were found on perceived adversity negatively influencing perceived health across diagnoses, slightly different patterns emerged based on diagnosis. Discussion: Findings suggest that refugees’ perception regarding adversity of violence, armed conflict, and flight may contribute to perceived health, with a moderating role of clinically significant symptoms of PTSD, anxiety, and depression.

scholarly journals Onset of Posttraumatic Stress Disorder and Major Depression Among Refugees and Voluntary Migrants to the United States

2012 ◽  
Vol 25 (6) ◽  
pp. 705-712 ◽  
Author(s):  
Andrew Rasmussen ◽  
Mia Crager ◽  
Ray E. Baser ◽  
Tracy Chu ◽  
Francesca Gany
Keyword(s):  
United States ◽  
Posttraumatic Stress Disorder ◽  
Major Depression ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
The United States

PTSD Symptoms and Dementia in Older Veterans Who are Living in Long-Term Care

2021 ◽  
pp. 104973232110613
Author(s):  
Kim Ritchie ◽  
Heidi Cramm ◽  
Alice Aiken ◽  
Catherine Donnelly ◽  
Catherine Goldie
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Health Care Providers ◽  
Long Term Care ◽  
Stress Disorder ◽  
Care Providers ◽  
Chart Audit ◽  
Term Care ◽  
Posttraumatic Stress Disorder Symptoms

Co-occurring posttraumatic stress disorder symptoms and dementia can result in increased symptoms, such as suspicion, aggression, and nightmares in Veterans that can be difficult to manage in long-term care environments. The objective of the study was to explore how the co-occurrence of posttraumatic stress disorder symptoms and dementia are understood in Canadian Veterans who are living in long-term care. A descriptive multiple case study was conducted in two Veteran long-term care facilities in Canada. Data collection consisted of semi-structured interviews with Veterans, their family caregivers, and health care providers, non-participant observation, and a chart audit. Three major themes emerged relating to symptom expression and care approach: a) symptoms are the same but different; b) differences in the complexity of care; and c) added dimensions involved in care. The results of this study contribute foundational information about co-occurring posttraumatic and dementia symptoms that can inform policy, care approaches, and potential interventions.

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