Wednesday, March 2, 2011

Which PTSD Symptoms Are Most Troubling ?

Public release date: 1-Mar-2011

Full Article at: Which symptoms of PTSD do the most damage?
PTSD sufferers would give up an average of 13 years of life to be without the disorder -- but may not realize that some symptoms don't affect happiness

In the case of post-traumatic stress disorder, not all symptoms are created equal.

In an effort to better treat PTSD, a study published March 1 in the journal Psychiatric Services is the first to examine which problems associated with PTSD actually correspond to lower quality of life, as indicated by the patient's willingness to die sooner or to risk life-threatening treatment to relieve their symptoms.

PTSD is more costly than any other anxiety disorder. As many as 300,000 veterans returning from Iraq and Afghanistan currently have PTSD, with costs for their care estimated at $4 to $6.2 billion over the next two years.

"To our knowledge, this is the first study to ask actual patients with PTSD about their health preferences," said lead author Jason Doctor, associate professor of Pharmaceutical Economics and Policy at the USC School of Pharmacy. "These findings identify targets for treatment that may improve quality of life among people with PTSD."

The researchers found that, of four major symptoms associated with PTSD, not all were associated with a patient's immediate quality of life, even though those who sought treatment for PTSD expressed significant overall declines in mental health.

Distressing recollections of a traumatic event and avoidance of certain activities and thoughts – both commonly conceived of as dysfunctional behaviors – had little correlation to a patient's reported sense of well-being, according to the study.

However, symptoms tied to heightened arousal – such as trouble sleeping, irritability and vigilance – were associated with lower quality of life among PTSD patients. Anxiety and depression were also associated with lower quality of life.

"We conjecture that although avoidance is an important aspect of PTSD, its effect on quality of life may be limited because it is a coping strategy. Avoidance may be a dysfunction that improves, in the short term, subjective well-being," explained Doctor, who is on the research faculty of the Schaeffer Center for Health Policy and Economics at USC.

The researchers found that, on average, a patient with PTSD was willing to give up 13.6 years of his or her life to live unburdened by the symptoms of the disorder.

On average, those with PTSD were willing to accept a treatment with up to a 13 percent chance of immediate death in order to achieve total relief of PTSD symptoms.

Lori Zoellner of the University of Washington, Seattle, and Norah Feeny of Case Western Reserve University were co-authors of the study.

The researchers interviewed 184 persons seeking treatment for PTSD at two treatment sites in different regions of the United States. The research was funded by the National Institute of Mental Health.

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For a full-text copy of the paper or to arrange an interview, contact Suzanne Wu at suzanne.wu@usc.edu.
University of Southern California

Pituitary Hormone Demonstrates Sex-Specific Association with PTSD

Full article at: Hormone Demonstrates Sex-Specific Association With PTSD

Deborah Brauser

March 2, 2011 — "An increase in pituitary adenylate cyclase–activating polypeptide (PACAP) blood levels in response to stress may indicate a vulnerability to posttraumatic stress disorder (PTSD) in women, new research suggests.

In a study of 64 civilian participants with significant exposure to violence and physical and sexual abuse, investigators found that women with high levels of PACAP had PTSD symptom scores that were 5 times greater than those in women with lower levels. This association was not found in the men.

In addition, a variation in the gene for the PACAP receptor (PAC1) was also linked to risk for PTSD development in women.

"These results give us a new window into the biology of PTSD," lead study author Kerry Ressler, MD, PhD, associate professor of psychiatry and behavioral sciences at Emory University School of Medicine in Atlanta, Georgia, and investigator at the Howard Hughes Medical Institute in Bethesda, Maryland, told Medscape Medical News.

"Both the PACAP peptide, or hormone, and a polymorphism in the receptor gene are associated with PTSD in women only, which was quite surprising to us. The findings suggest that men and women may arrive at PTSD by different biological pathways, possibly due to changes in the ability to respond to estrogen," said Dr. Ressler."

Update Dayton-VA Medical Center, 9 Exposed PatientsTest Positive for Hepatitis

Full Article at: Ohio VA hospital says 9 patients test positive for hepatitis after dentist investigation

DAYTON, Ohio — "Officials at a Veterans Administration hospital in southwest Ohio say nine patients have tested positive for hepatitis in preliminary screenings conducted because of a dentist who failed to change gloves and sterilize instruments properly between patients.

Dayton VA director Guy Richardson says 527 of the 535 people seen by the dentist have been contacted for free screenings. He tells the Dayton Daily News that of 375 tested so far, there were seven hepatitis C positives and two hepatitis B positives. No one has tested positive for HIV."