Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0848237 (acute stress)
 4,619 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We investigated the trauma narratives of 131 road traffic accident survivors prospectively, at 1 week, 6 weeks, and 3 months post-trauma. At 1 and 6 weeks, narratives of survivors with acute stress disorder (ASD) or post-traumatic stress disorder (PTSD) were less coherent and included more dissociation content. By 3 months, their narratives also contained more repetition, more non-consecutive chunks, and more sensory words. Traumatic brain injury was associated with a separate characteristic, confusion, at all three time points. Three aspects of narrative organisation at 1 week--repetition, non-consecutive chunks, and coherence--predicted PTSD severity at 3 months after controlling for initial symptoms. The results suggest both a strong concurrent and predictive relationship between narrative disorganisation and ASD/PTSD but that as people recover from ASD, their narratives do not necessarily become less disorganised.
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PMID:The organisation and content of trauma memories in survivors of road traffic accidents. 1656 41

This article reviews pharmacologic treatment options for posttraumatic stress disorder (PTSD), focusing on goals of pharmacotherapy and the clinical trial evidence for drug treatments available for PTSD. The selective serotonin reuptake inhibitors (SSRIs) are recommended as first-line therapy for PTSD; the roles of these and other drug classes including anticonvulsants, mood enhancers, atypical antipsychotic agents, benzodiazepines, alpha1-adrenergic antagonists, and beta-blockers in achieving improvement in PTSD symptom and outcome scores, achieving remission, and avoiding relapse are discussed. Treatment of PTSD in association with other comorbid conditions is addressed, and the role of pharmacotherapy in treating early PTSD and acute stress disorder is examined. Dosing strategies for the SSRIs sertraline and paroxetine are provided, and an algorithm for PTSD pharmacotherapy is discussed.
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PMID:Pharmacologic treatment of acute and chronic stress following trauma: 2006. 1660 13

Psychopharmacologic treatment in pediatric critical care requires a careful child or adolescent psychiatric evaluation, including a thorough review of the history of present illness or injury, any current or pre-existing psychiatric disorder, past history, and laboratory studies. Although there is limited evidence to guide psychopharmacologic practice in this setting, psychopharmacologic treatment is increasing in critical care, with known indications for treatment, benefits, and risks; initial dosing guidelines; and best practices. Treatment is guided by the knowledge bases in pediatric physiology, psycho-pharmacology, and treatment of critically ill adults. Pharmacologic considerations include pharmacokinetic and pharmcodynamic aspects of specific drugs and drug classes, in particular elimination half-life, developmental considerations, drug interactions, and adverse effects. Evaluation and management of pain is a key initial step, as pain may mimic psychiatric symptoms and its effective treatment can ameliorate them. Patient comfort and safety are primary objectives for children who are acutely ill and who will survive and for those who will not. Judicious use of psychopharmacolgic agents in pediatric critical care using the limited but growing evidence base and a clinical best practices collaborative approach can reduce anxiety,sadness, disorientation, and agitation; improve analgesia; and save lives of children who are suicidal or delirious. In addition to pain, other disorders or indications for psychopharmacologic treatment are affective disorders;PTSD; post-suicide attempt patients; disruptive behavior disorders (especially ADHD); and adjustment, developmental, and substance use disorders. Treating children who are critically ill with psychotropic drugs is an integral component of comprehensive pediatric critical care in relieving pain and delirium; reducing inattention or agitation or aggressive behavior;relieving acute stress, anxiety, or depression; and improving sleep and nutrition. In palliative care, psychopharmacology is integrated with psychologicapproaches to enhance children's comfort at the end of life. Defining how best to prevent the adverse consequences of suffering and stress in pediatric critical care is a goal for protocols and for new psychopharmacologic research [23,153].
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PMID:Psychopharmacology in pediatric critical care. 1679 42

Burnout and stress are common, related problems in service professionals, and post-traumatic stress disorder (PTSD) is a major concern among fire service workers. The purpose of this study was to evaluate the impact of PTSD and job-related stressors on burnout. A total of 243 fire service workers completed questionnaires, including the Impact of Event Scale-Revised (IES-R), Maslach Burnout Inventory (MBI), and Japan Brief Job Stress Questionnaire. Relationships were found between PTSD and burnout, and between job stressors and burnout. Social support reduced the impact on burnout. Stressors that impacted on burnout in fire service personnel were PTSD-related acute stress and general job-related chronic stress. Countermeasures, not only against job stress, but also against PTSD-related stress, are essential to prevent burnout. Social support and the development of human relationships in the work place are crucial in mitigating burnout.
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PMID:Impact of post-traumatic stress disorder and job-related stress on burnout: a study of fire service workers. 1679 46

Railroad and subway drivers can experience psychological trauma when trains strike or nearly miss other trains, motor vehicles, or persons or become instruments of death. Derailments, collisions, and suicides on the tracks can induce feelings of helplessness, horror, guilt, and anxiety in the drivers. Although some drivers experience acute stress disorder (ASD) or post-traumatic stress disorder (PTSD), their conditions are not always acknowledged within the occupational setting. The world literature suggests that PTSD has been an increasing focus of concern, giving rise to detailed intervention protocols. In the United States, the Federal Employers' Liability Act (FELA) governs the adjudication of work-related injuries among railroad employees. In practice, it is difficult for railroad drivers with PTSD to receive benefits if there was no "direct impact" linked to the employer's negligence. In this article, the authors review the literature on PTSD among railroad drivers, discuss relevant case law, and explain how the FELA militates against some employees with PTSD.
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PMID:PTSD in railroad drivers under the Federal employers' liability act. 1684

Posttraumatic stress disorder (PTSD) has a discernible starting point and typical course, hence the particular appropriateness of longitudinal research in this disorder. This review outlines the salient findings of longitudinal studies published between 1988 and 2004. Studies have evaluated risk factors and risk indicators of PTSD, the disorder's trajectory, comorbid disorders and the predictive role of acute stress disorder. More recent studies used advanced data analytic methods to explore the sequence of causation that leads to chronic PTSD. Advantages and limitations of longitudinal methods are discussed.
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PMID:Longitudinal studies of PTSD: overview of findings and methods. 1687 Nov 22

Disturbed regulation of both the hypothalamic-pituitary-adrenal (HPA) axis and sympathoadrenomedullary system in posttraumatic stress disorder (PTSD) suggests that immune function, which is modulated by these systems, may also be dysregulated. Two dermatologic, in vivo measures of immune function, delayed-type hypersensitivity (DTH) and skin barrier function recovery, were examined in female subjects with PTSD and compared to measures in healthy female comparison subjects. In addition, at the time of DTH test placement, circulating numbers of lymphocyte subtypes were assessed. In separate studies, the effects of acute psychological stress on DTH and skin barrier function recovery were examined in healthy volunteer subjects. Both DTH and barrier function recovery were enhanced in women with PTSD. These findings contrast with the effects of acute stress in healthy control subjects, which was associated with suppression of DTH responses and skin barrier function recovery. There was no difference between subjects with PTSD and healthy control subjects in proportions of circulating lymphocyte subsets or in expression of the lymphocyte markers CD62, CD25, and CD45RO/CD45RA. These results suggest that cell-mediated immune function is enhanced in individuals with PTSD, a condition that imposes chronic physiologic and mental stress on sufferers. These findings contrast with suppression of DTH and skin barrier function recovery in healthy volunteers in response to acute psychological stress.
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PMID:Immune function in PTSD. 1689 69

The psychosocial issues related to deployment and combat duty are complex. Deployment may result in psychiatric casualties that are either the result of inadequate coping with the stressors of deployment or acute stress reactions caused by the trauma of battle, that is, combat stress reactions. Combat duty is associated with traumatic events, deprivation, and exposure to war atrocities that may result in acute, delayed or chronic psychosocial issues during and afer returning from deployment. Although protective and mediating factors ar in place, 11% to 17% of combat veterans are at risk for mental disorders in 3 to 4 months after return from combat duty. Combat veterans include service members directly involved in combat as well as those providing support to combatants, that is, nurses. All combat veterans are at risk for experiencing the negative effects of deployment. Frequent deployments of active duty, reserve, and National Guard members have become commonplace. This translates into a disruption of live for anyone associated with the military, as well as an increased focus on the psychosocial impact of combat across the nation. Modern warfare has resulted in multiple changes in policy that govern military operations. Initiatives that focus on the stabilization of service members and their families may impact mental health outcomes of service members returning from combat duty. An initiative toward decreasing the stigma of receiving mental health care is warranted. Mental health issues must be addressed before and during deployment to ensure optimum individual and unit functioning. Early identification and treatment of mental health problems may decrease the psychosocial impact of combat and thus prevent progression to more chronic and severe psychopathology such as depression and PTSD.
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PMID:The psychosocial effects of combat: the frequently unseen injury. 1696 56

Anxiety and traumatic stress symptoms are common post-crash. This study documents generalised anxiety responses post-crash, and examines the association between Acute Stress Disorder and Post-Traumatic Stress Disorder (PTSD) with personality and coping styles. Sixty-two patients aged 18-60 admitted to hospital were interviewed prior to discharge, at 2-months and at 6-8 months post-crash. Anxiety symptoms were common, with 55% of participants experiencing moderate-severe levels prior to discharge, with this decreasing to 11% and 6.5% at 2-months and 6-8 months post-discharge. Females reported significantly higher levels of anxiety and acute distress. Neuroticism and generalised coping styles were associated with acute stress responses but not PTSD. These results have important theoretical and practical implications, and indicate that females are at risk of poorer acute anxiety outcomes following injury.
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PMID:Anxiety, acute- and post-traumatic stress symptoms following involvement in traffic crashes. 1696 44

In patients with frequent ICD discharges an acute stress disorder (ASD), and afterwards a post-traumatic stress disorder (PTSD) is commonly observed. We present a case of a 53-year-old patient with ASD and PTSD in whom RF ablation of VT was performed. After the successful procedure the symptoms of PTSD were significantly diminished. We conclude that in patients with PTSD after ICD discharges RF ablation should be performed as soon as possible.
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PMID:[Post-traumatic stress disorder in a patient with recurrent ICD shocks. The role of RF ablation]. 1698 Oct 66


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