• Title/Summary/Keyword: Post-traumatic Stress Disorder

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Living Experiences of Indian Adult Cancer Survivors - a Brief Report

  • Mohanti, Bidhu Kalyan;Kaur, Jaspreet
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.507-512
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    • 2015
  • Background: This pilot study looked into the physical, social, psychological and economic issues of Indian adult cancer survivors. Materials and Methods: Assumed cancer free patients, after cancer directed therapy (CDT), were assessed on the basis of a questionnaire developed by the investigators. The mental status of the survivors was elicited by modified MINI international neuro-psychiatric interview. This cross sectional assessment was conducted as a direct interaction with each patient for 30 to 45 minutes at a cancer hospital in 2012. Results: Thirty one adult cancer survivors participated in this study. Median age was 53 years with a median follow up duration of 21.8 months (Range 2.3-194.1 months). The majority (68%) did not receive financial support for treatment. Median interval after CDT to start of activity of daily living was 1.5 months (range: 0-24 months). Fatigue and loss of appetite were reported by 52% and 29% respectively. The cancer diagnosis and its treatment adversely impacted the financial condition in 42% of patients. Nineteen percent each showed social anxiety and post-traumatic stress disorder and another 13% patients reported depression. Conclusions: This prospective assessment highlights survivorship issues and the need to address those issues particularly in the context of developing countries where resources and manpower are limited.

Psychological and Physical Health in Family Caregivers of Intensive Care Unit Survivors: Current Knowledge and Future Research Strategies

  • Choi, JiYeon;Donahoe, Michael P.;Hoffman, Leslie A.
    • Journal of Korean Academy of Nursing
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    • v.46 no.2
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    • pp.159-167
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    • 2016
  • Purpose: This article provides an overview of current knowledge on the impact of caregiving on the psychological and physical health of family caregivers of intensive care unit (ICU) survivors and suggestions for future research. Methods: Review of selected papers published in English between January 2000 and October 2015 reporting psychological and physical health outcomes in family caregivers of ICU survivors. Results: In family caregivers of ICU survivors followed up to five years after patients' discharge from an ICU, psychological symptoms, manifested as depression, anxiety and post-traumatic stress disorder, were highly prevalent. Poor self-care, sleep disturbances and fatigue were identified as common physical health problems in family caregivers. Studies to date are mainly descriptive; few interventions have targeted family caregivers. Further, studies that elicit unique needs of families from diverse cultures are lacking. Conclusion: Studies to date have described the impact of caregiving on the psychological and physical health in family caregivers of ICU survivors. Few studies have tested interventions to support unique needs in this population. Therefore, evidence for best strategies is lacking. Future research is needed to identify ICU caregivers at greatest risk for distress, time points to target interventions with maximal efficacy, needs of those from diverse cultures and test interventions to mitigate family caregivers' burden.

Ear Acupuncture Treatment for Disaster-Related Trauma: Introduction of the National Acupuncture Detoxification Association (NADA) Protocol (재난트라우마에 대한 이침의 활용 - NADA 프로토콜의 소개)

  • Kim, Da-Woon;Kim, Sang-Ho
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.3
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    • pp.157-168
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    • 2020
  • The number of disasters caused by natural or human-made events such as earthquakes, tsunamis, floods, typhoons, industrial disasters, and the recent outbreak of COVID-19 has increased and the damage caused by such disasters is increasing every year. Disasters can cause physical destruction and also have unexpected psychological impacts, such as post-traumatic stress disorder (PTSD). Ear acupuncture is a treatment modality that can be helpful for both physical and mental health problems. Since ear acupuncture is a cost-effective, flexible, and safe treatment tool, it has the potential to provide medical assistance in disasters. The National Acupuncture Detoxification Association (NADA) auricular acupuncture protocol, originally developed for addiction treatment, has been used for mental illness and behavioral symptoms in both community health settings and in a variety of disaster, terror, and refugee settings. In this review, we introduced the NADA protocol, including its history, features, training, clinical evidence, and cases in disaster settings, suggesting that the NADA protocol could be utilized as a disaster medical support model in Korean medicine.

A Case of Clinical Application of Music Therapy in Patient with PTSD (외상후스트레스장애 환자에 대한 음악요법의 적용 일례)

  • Kwon, Soon-Jae;Yang, Jong-Chul;Park, Tae-Won;Chung, Young-Chul;Chung, Sang-Keun
    • Anxiety and mood
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    • v.8 no.1
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    • pp.50-54
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    • 2012
  • Music therapy had been widely used in the area of psychiatry. However recently, participation of psychiatrist has been decreased, due to recent trends of emphasizing biological psychiatry and rapid effectiveness of pharmacotherapy. A 46 years old male PTSD patient was admitted to psychiatric ward. He has suffered from PTSD symptoms, such as intrusive distressing recollection of his past traffic accident, social avoidance, insomnia and depression. Music therapy, which is conducted by a psychiatrist and a music therapist, was applied. This case suggests the positive role of music therapy in treatment of PTSD and emphasizes the importance of participation of psychiatrist, as an organizer during music therapy.

Awareness during general anesthesia despite simultaneous bispectral index and end-tidal anesthetic gas concentration monitoring

  • Lee, Jungwon;Park, Chorong;Kim, Saeyoung
    • Journal of Yeungnam Medical Science
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    • v.36 no.1
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    • pp.50-53
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    • 2019
  • Awareness during general anesthesia occurs in approximately 0.1-0.2% of cases; nevertheless, particular attention is required because it can lead to critical complications including insomnia, depression, anxiety, and post-traumatic stress disorder. To prevent these complications, bispectral index (BIS) and end-tidal anesthetic gas (ETAG) concentration monitoring are commonly used to examine patient consciousness during surgery. In the present case, an 80-year-old man was scheduled for total gastrectomy. Anesthesia was maintained using desflurane 4.0-5.0% vol, oxygen, and nitrous oxide. The authors simultaneously monitored BIS, which was maintained between 37 and 43, and ETAG, which was maintained between 0.9 and 1.2 minimum alveolar concentration (MAC). After the operation, however, the authors were surprised to learn that the patient complained of awareness during anesthesia. Although BIS and ETAG concentration monitoring are useful in preventing awareness during anesthesia, they cannot be completely trusted. Even though BIS was maintained at approximately 40 and ETAG at 0.7-1.3 MAC, awareness during anesthesia occurred.

A study on school health education curriculum in Japan (일본의 학교보건교육 교과과정 고찰)

  • Oh, Eun-Hwan
    • The Journal of Korean Society for School & Community Health Education
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    • v.22 no.2
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    • pp.65-73
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    • 2021
  • Objectives: In Japan, there are many disasters such as earthquakes and tsunamis, and because of the high temperature and humid climate, health education for food poisoning may be particularly important. In addition, sexual problems caused by precociousness of adolescents, smoking and drinking are already serious socially important problems, and addiction problems are also emerging. Methods: Various publications from Japanese governments, interest groups such as government officers, health center workers, and people from health educators. For the information of Korean health education conditions, a current health educator and people from middle and high schools. Results: In 2012, based on the "Investigation Report on the Mind Care of Children in Emergency Disasters" from the Ministry of Education, Culture, Sports, Science and Technology, the Post-traumatic stress disorder (PTSD) situation of children in East Japan affected areas was discovered, and health education became important. In 2014, the "School Health and Safety Act Enforcement Rule" was amended, and health checkups are emphasized as part of school health. Conclusions: School health education in Japan differs from other health care systems in many ways with the system of Korea in the context of non-existence of official health education curriculum. Therefore, the purpose of this study is to develope how the curriculum of school health education in Korea.

Validation of the Korean Version of the Trauma Symptom Checklist-40 among Psychiatric Outpatients (정신건강의학과 외래환자 대상 한국판 외상 증상 체크리스트(Trauma Symptom Checklist-40)의 타당도 연구)

  • Park, Jin;Kim, Daeho;Kim, Eunkyung;Kim, Seokhyun;Yun, Mirim
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.35-43
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    • 2018
  • Objectives : Effects of multiple trauma are complex and extend beyond core PTSD symptoms. However, few psychological instruments for trauma assessment address this issue of symptom complexity. The Trauma Symptom Checklist-40 (TSC-40) is a self-report scale that assesses wide range of symptoms associated with childhood or adult traumatic experience. The purpose of the present study was to evaluate the validity of the Korean Version of the TSC-40 in a sample of psychiatric outpatients. Methods : Data of 367 treatment-seeking patients with DSM-IV diagnoses were obtained from an outpatient department of psychiatric unit at a university hospital. The diagnoses were anxiety disorder, posttraumatic stress disorder, depressive disorder, adjustment disorder and others. Included in the psychometric data were the TSC-40, the Life events checklist, the Impact of Event Scale-Revised, the Zung's Self-report Depression Scale, and the Zung's Self-report Anxiety Scale. Cronbach's ${\alpha}$ for internal consistency were calculated. Convergent and concurrent validity was approached with correlation between the TSC-40 and other scales (PTSD, anxiety and depression). Results : Exploratory factor analysis of the Korean Version of TSC-40 extracted seven-factor structure accounted for 59.55% of total variance that was contextually similar to a six-factor structure and five-factor structure of the original English version. The Korean Version of TSC-40 demonstrated a high level of internal consistency. (Cronbach's ${\alpha}=0.94$) and good concurrent and convergent validity with another PTSD scale and anxiety and depression scales. Conclusions : Excellent construct validity of The Korean Version of TSC-40 was proved in this study. And subtle difference in the factor structure may reflect the cultural issues and the sample characteristics such as heterogeneous clinical population (including non-trauma related disorders) and outpatient status. Overall, this study demonstrated that the Korean version of TSC-40 is psychometrically sound and can be used for Korean clinical population.

Management of anxiety using eye movement desensitization and reprocessing therapy in children undergoing extraction: a randomized controlled pilot study

  • Namita Kalra;Apoorva Rathore;Rishi Tyagi;Amit Khatri;Deepak Khandelwal;Padma Yangdol
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.6
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    • pp.347-355
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    • 2023
  • Background: Eye movement desensitization and reprocessing (EMDR) therapy has been reported to be very efficacious for treating post-traumatic stress disorder (PTSD) and other anxiety-related conditions. However, a review of the literature reveals the sparse use of this therapy in the field of pediatric dentistry. This study aimed to evaluate anxiety trends in pediatric dental patients during local anesthesia and extraction with and without EMDR therapy. Methods: Children in the age range of 8-12 years who required dental extractions were assigned randomly into two groups: an EMDR group (group 1) and a routine behavior management therapy group (group 2; receiving more traditional interventions such as tender love and care behavioral modeling, and distraction). Anxiety scores were recorded at four levels using the visual facial anxiety scale (VFAS) preoperatively, after therapy, after the administration of local anesthesia (LA), and after extraction. Results: Reduced anxiety was observed after the delivery of EMDR therapy, after LA administration, and post-extraction in the EMDR group compared to pre-operative anxiety scores of anxiety (P < 0.001; unpaired Student's t and Mann-Whitney U tests). In the control group, mild reductions in anxiety after routine behavior management therapy were observed, accompanied by spikes in anxiety levels after LA and extractions. Conclusion: EMDR therapy was found to be valuable for reducing anxiety among pediatric dental patients during tooth extraction procedures.

Effect of Sihogayonggolmoryeotang on SPS-induced PTSD in Rats (시호가룡골모려탕(柴胡加龍骨牡蠣湯)이 흰쥐에서 SPS로 유도된 PTSD에 미치는 효과)

  • Kim, Hwi-Yeol;Lee, Tae Hee
    • Herbal Formula Science
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    • v.27 no.2
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    • pp.121-136
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    • 2019
  • Objective : To investigate the effect of sihogayonggolmoryeotang (SY) on Single Prolonged Stress(SPS)-induced Post Traumatic Stress Disorder(PTSD). Method : To confirm the effects of SY on SPS-induced PTSD, Changes in body weight, sucrose intake open field test(OFT) and forced swimming test(FST)were observed. After behavioral tests, the plasma corticosterone(CORT) from the abdominal aorta, serotonin(5-HT) from prefrontal cortex, hippocampus, amygdala and striatum, norepinephrine(NE) and dopamine(DA) from hippocampus was measured by ELISA. mRNA expression of brain-derived neurotrophic factor(BDNF) and cAMP response element-binding protein(CREB) in hippocampus was measured by RT-PCR. Result : Weight change and sucrose intakes of rats in 14th day after the administration of SY were significantly increased in the SPS + SY450 group compared to the SPS group (p<0.05). Numbers of crossing in the central zone in the OFT were significantly increased in the SPS + SY450 group (p<0.05) compared with the SPS group. The immobility time of FST was significantly decreased in SPS + SY450 group compared with SPS group (p<0.05). The change of plasma CORT concentration was significantly decreased in SPS + SY450 group compared with that in SPS group (p<0.05). The change of 5-HT concentration was significantly increased in the SPS + SY450 group at hippocampus and amygdala compared with the SPS group (p<0.05). The concentration of DA was significantly increased in the SPS + SY450 group compared with the SPS group (p<0.05). The expression of BDNF and CREB were significantly increased in SPS + SY450 group compared with the SPS group (p<0.05). Conclusion : SY administration lowered the increase of CORT caused by PTSD and increases the 5-HT concentration and reversed the decreased expression of NE and DA and BDNF and CREB by PTSD. It is postulated that SY is effective in treating PTSD by restoring cognitive function, memory impairment, unstable emotional disturbances.

One year of treating patients with open fractures of the lower extremity in a new military trauma center in Korea: a case series

  • Ji Wool Ko;Giho Moon;Jin Geun Kwon;Kyoung Eun Kim;Hankaram Jeon;Kyungwon Lee
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.376-384
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    • 2023
  • Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.