Chronic Stress最新文献

{"title":"Psychological Impact of the COVID-19 Pandemic on Frontline Health Care Workers During the Pandemic Surge in New York City.","authors":"Jordyn H Feingold,&nbsp;Lauren Peccoralo,&nbsp;Chi C Chan,&nbsp;Carly A Kaplan,&nbsp;Halley Kaye-Kauderer,&nbsp;Dennis Charney,&nbsp;Jaclyn Verity,&nbsp;Alicia Hurtado,&nbsp;Larissa Burka,&nbsp;Shumayl A Syed,&nbsp;James W Murrough,&nbsp;Adriana Feder,&nbsp;Robert H Pietrzak,&nbsp;Jonathan Ripp","doi":"10.1177/2470547020977891","DOIUrl":"https://doi.org/10.1177/2470547020977891","url":null,"abstract":"<p><strong>Background: </strong>This study sought to assess the magnitude of and factors associated with mental health outcomes among frontline health care workers (FHCWs) providing care during the Spring 2020 COVID-19 pandemic surge in New York City.</p><p><strong>Methods: </strong>A cross-sectional, survey-based study over 4 weeks during the Spring 2020 pandemic surge was used to assess symptoms of COVID-19-related posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) in 2,579 FHCWs at the Mount Sinai Hospital. Participants were additionally asked about their occupational and personal exposures to COVID-19. Multivariable logistic regression and relative importance analyses were conducted to identify factors associated with these outcomes.</p><p><strong>Results: </strong>A total of 3,360 of 6,026 individuals completed the survey (55.8% participation), with 2,579 (76.8%) analyzed based on endorsing frontline responsibilities and providing information related to the three outcomes. 1,005 (39.0%) met criteria for symptoms of COVID-19-related PTSD, MDD, or GAD. 599 (23.3%) screened positively for PTSD symptoms, 683 (26.6%) for MDD symptoms, and 642 (25.0%) for GAD symptoms. Multivariable analyses revealed that past-year burnout was associated with the highest risk of developing symptoms for COVID-19-related PTSD (odds ratio [OR] = 2.10), MDD (OR = 2.83), and GAD (OR = 2.68). Higher perceived support from hospital leadership was associated with a lowest risk of all outcomes [PTSD (OR = 0.75), MDD (OR = 0.72), and GAD (OR = 0.76).</p><p><strong>Conclusion: </strong>In this large sample of FHCWs providing care during the 2020 NYC pandemic surge, 39% experienced symptoms of COVID-19-related PTSD, MDD, and/or GAD and pre-pandemic burnout as well as leadership support were identified as the most highly associated factors. These findings suggest that interventions aimed at reducing burnout and augmenting support from hospital leadership may be appropriate targets to mitigate the risk for developing further psychopathology in this population and others working in the midst of crisis.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"5 ","pages":"2470547020977891"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2470547020977891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25378341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Spirituality in the Management of Major Depression and Stress-Related Disorders.","authors":"Sajoy P Varghese,&nbsp;Ori David Florentin,&nbsp;Maju Mathew Koola","doi":"10.1177/2470547020971232","DOIUrl":"https://doi.org/10.1177/2470547020971232","url":null,"abstract":"Acknowledgement of the importance of religion and spirituality in medicine is increasing. Several studies have shown a predominantly inverse relationship between faith-based activities and psychiatric disorders. Chronic stress alters autonomic nervous system reactivity, and changes in the dopamine systems of people undergoing chronic stress have been well documented in the literature. In Figure 1, we hypothesize a model regarding the vicious cycle that exists between psychiatric disorders and chronic stress. Brain-derived neurotrophic factor (BDNF) is a brainnourishing molecule that plays an important role in synaptic plasticity, dendritic and neuronal fiber growth, and neuronal survival. People with mental health issues such as depression may improve their mood and behavior through faith-based activities, which are known to increase serum BDNF levels. The stress-related system, which includes the hypothalamic-pituitaryadrenocortical (HPA) axis and the hippocampus, and the reward system, which includes the ventral tegmental area and nucleus accumbens pathway, were found to be associated with altered BDNF expression following stress induction in animal models. Although the data are mixed, few studies have shown that chronic stress exposure decreases BDNF levels in brain regions implicated in mood and behavior such as the prefrontal cortex and hippocampus in rodents. Further, these findings are in agreement with results from postmortem brain studies from depressed suicide completers. The prefrontal cortex (PFC) assists us in completing our daily activities through thinking, reasoning, focusing, and controlling the emotions. Researchers conducted studies in a group that practices glossolalia (the phenomenon of speaking in an unknown language, especially in religious worship, practiced predominantly by Pentecostal and Charismatic Christians) as a form of deeply meaningful and intimate spiritual experience. Glossolalia is an unusual mental state in which individuals appear to be speaking an incomprehensible language during the most intimate praying moment. Functional magnetic resonance imaging (fMRI) scans showed that the frontal lobe, the part of the brain that controls language, was active when the participants prayed in English but fell mostly quiet when they prayed in glossolalia. Frontal lobe activity is known to increase when individuals focus on what they are saying, but this study found that when people speak in glossolalia, the words coming forth originate from a source other than the PFC. In addition, it was revealed that while blood flow to the PFC decreased, activity in the area that controls self-awareness (medial PFC/anterior cingulate cortex and medial parietal/posterior cingulate cortex) was active. On the contrary, it is of interest to note that an fMRI study of Carmelite nuns revealed that remembrance of spiritual, mystical experiences correlated with increased blood flow in the PFC and temporal, caudate, cingulate, and orbitofrontal","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"5 ","pages":"2470547020971232"},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2470547020971232","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38868888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pretreatment Brain Connectome Fingerprint Predicts Treatment Response in Major Depressive Disorder.","authors":"Siyan Fan,&nbsp;Samaneh Nemati,&nbsp;Teddy J Akiki,&nbsp;Jeremy Roscoe,&nbsp;Christopher L Averill,&nbsp;Samar Fouda,&nbsp;Lynnette A Averill,&nbsp;Chadi G Abdallah","doi":"10.1177/2470547020984726","DOIUrl":"https://doi.org/10.1177/2470547020984726","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) treatment is characterized by low remission rate and often involves weeks to months of treatment. Identification of pretreatment biomarkers of response may play a critical role in novel drug development, in enhanced prognostic predictions, and perhaps in providing more personalized medicine. Using a network restricted strength predictive modeling (NRS-PM) approach, the goal of the current study was to identify pretreatment functional connectome fingerprints (CFPs) that (1) predict symptom improvement regardless of treatment modality and (2) predict treatment specific improvement.</p><p><strong>Methods: </strong>Functional magnetic resonance imaging and behavioral data from unmedicated patients with MDD (n = 200) were investigated. Participants were randomized to daily treatment of sertraline or placebo for 8 weeks. NRS-PM with 1000 iterations of 10 cross-validation were implemented to identify brain connectivity signatures that predict percent improvement in depression severity at week-8.</p><p><strong>Results: </strong>The study identified a pretreatment CFP that significantly predicts symptom improvement independent of treatment modality but failed to identify a treatment specific CFP. Regardless of treatment modality, improved antidepressant response was predicted by high pretreatment connectivity between modules in the default mode network and the rest of the brain, but low external connectivity in the executive network. Moreover, high pretreatment internal nodal connectivity in the bilateral caudate predicted better response.</p><p><strong>Conclusions: </strong>The identified CFP may contribute to drug development and ultimately to enhanced prognostic predictions. However, the results do not assist with providing personalized medicine, as pretreatment functional connectivity failed to predict treatment specific response.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":" ","pages":"2470547020984726"},"PeriodicalIF":0.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2470547020984726","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38829612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketamine Normalizes the Structural Alterations of Inferior Frontal Gyrus in Depression.","authors":"Dan Dai,&nbsp;Cheryl M Lacadie,&nbsp;Sophie E Holmes,&nbsp;Ryan Cool,&nbsp;Alan Anticevic,&nbsp;Chris Averill,&nbsp;Chadi Abdallah,&nbsp;Irina Esterlis","doi":"10.1177/2470547020980681","DOIUrl":"https://doi.org/10.1177/2470547020980681","url":null,"abstract":"<p><strong>Background: </strong>Ketamine is a novel fast-acting antidepressant. Acute ketamine treatment can reverse microstructure deficits and normalize functional alterations in the brain, but little is known about the impacts of ketamine on brain volumes in individuals with depression.</p><p><strong>Methods: </strong>We used 3 T magnetic resonance imaging (MRI) and tensorbased morphological methods to investigate the regional volume differences for 29 healthy control (HC) subjects and 21 subjects with major depressive disorder (MDD), including 10 subjects with comorbid post-traumatic stress disorder (PTSD). All the subjects participated in MRI scanning before and 24 h post intravenous ketamine infusion. The effects of acute ketamine administration on HC, MDD, and MDD/PTSD groups were examined separately by whole-brain voxel-wise t-tests.</p><p><strong>Results: </strong>Our data showed smaller volume of inferior frontal gyrus (IFG, opercular part) in MDD and MDD/PTSD subjects compared to HC, and a significant correlation between opercular IFG volume and depressive severity in MDD subjects only. Ketamine administration normalized the structural alterations of opercular IFG in both MDD and MDD/PTSD groups, and significantly improved depressive and PTSD symptoms. Twenty-four hours after a single ketamine infusion, there were two clusters of voxels with volume changes in MDD subjects, including significantly increased volumes of opercular IFG. No significant structural alterations were found in the MDD/PTSD or HC groups.</p><p><strong>Conclusion: </strong>These findings provide direct evidence that acute ketamine administration can normalize structural alterations associated with depression and highlight the importance of IFG in the guidance of future therapeutic targets.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":" ","pages":"2470547020980681"},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2470547020980681","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38804766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Dose Ketamine Infusion for Comorbid Posttraumatic Stress Disorder and Chronic Pain: A Randomized Double-Blind Clinical Trial.","authors":"Alisher R Dadabayev,&nbsp;Sonalee A Joshi,&nbsp;Mariam H Reda,&nbsp;Tamar Lake,&nbsp;Mark S Hausman,&nbsp;Edward Domino,&nbsp;Israel Liberzon","doi":"10.1177/2470547020981670","DOIUrl":"https://doi.org/10.1177/2470547020981670","url":null,"abstract":"<p><strong>Objective: </strong>To date, treatment options (i.e. psychotherapy, antidepressant medications) for patients with posttraumatic stress disorder (PTSD), are relatively few, and considering their limited efficacy, novel therapies have gained interest among researchers and treatment providers alike. Among patients with chronic pain (CP) about one third experience comorbid PTSD, which further complicates their already challenging pharmacological regimens. Low dose ketamine infusion has shown promise in PTSD, and in treatment of CP, however they have not been studied in comorbid population and under rigorous control conditions.</p><p><strong>Methods: </strong>We compared the effects of a single dose of either ketamine (0.5 mg/kg) or ketorolac (15 mg) over a 40-minute of IV infusion in CP patients with and without PTSD, in double blind, randomized study. Measures were collected before, during, one day and seven days after the infusion. A planned sample size of 40 patients randomly assigned to treatment order was estimated to provide 80% power to detect a hypothesized treatment difference after the infusion.<b>Main Outcome and Measures:</b> The primary outcome measures were change in PTSD symptom severity assessed with the Impact of Event Scale-Revised (IES-R) and Visual Analogue Scale (VAS) for pain administered by a study clinician 24 hours post infusion. Secondary outcome measures included Impact of Event Scale-Revised (IES-R), VAS and Brief Pain Inventory (Short Form) for pain 1 week after the infusion.</p><p><strong>Results: </strong>Both treatments offered comparable improvement of PTSD and CP symptoms that persisted for 7 days after the infusion. Patients with comorbid PTSD and CP experienced less dissociative side effects compared to the CP group. Surprisingly, ketorolac infusion resulted in dissociative symptoms in CP patients only.</p><p><strong>Conclusions: </strong>This first prospective study comparing effects of subanesthetic ketamine versus ketorolac infusions for comorbid PTSD and CP, suggests that both ketamine and ketorolac might offer meaningful and durable response for both PTSD and CP symptoms.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":" ","pages":"2470547020981670"},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2470547020981670","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38804767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships Between Pain, Life Stress, Sociodemographics, and Cortisol: Contributions of Pain Intensity and Financial Satisfaction.","authors":"Angela M Mickle,&nbsp;Cynthia Garvan,&nbsp;Chelsea Service,&nbsp;Ralisa Pop,&nbsp;John Marks,&nbsp;Stanley Wu,&nbsp;Jeffrey C Edberg,&nbsp;Roland Staud,&nbsp;Roger B Fillingim,&nbsp;Emily J Bartley,&nbsp;Kimberly T Sibille","doi":"10.1177/2470547020975758","DOIUrl":"https://doi.org/10.1177/2470547020975758","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between psychosocial stress and chronic pain is bidirectional. An improved understanding regarding the relationships among chronic pain, life stress, and ethnicity/race will inform identification of factors contributing to health disparities in chronic pain and improve health outcomes. This study aims to assess relationships between measures of clinical pain, life stress, sociodemographics, and salivary cortisol levels.</p><p><strong>Methods: </strong>A cross-sectional analysis involving data from 105 non-Hispanic White (NHW) and non-Hispanic Black (NHB) participants aged 45-85 years old with or at risk for knee osteoarthritis. Data included sociodemographics, clinical pain, psychosocial stress, and salivary cortisol across five time points over an approximate 12-hour period. Non-parametric correlation analysis, sociodemographic group comparisons, and regression analyses were performed.</p><p><strong>Results: </strong>Clinical pain and psychosocial stress were associated with salivary cortisol levels, particularly morning waking and the evening to morning awakening slope. With the inclusion of recognized explanatory variables, the Graded Chronic Pain Scale characteristic pain intensity and financial satisfaction were identified as the primary pain and psychosocial measures associated with cortisol levels. Sociodemographic group differences were indicated such that NHB participants reported higher pain-related disability, higher levels of discrimination, lower financial and material satisfaction, and showed higher evening salivary cortisol levels compared to NHW participants. In combined pain and psychosocial stress analyses, greater financial satisfaction, lower pain intensity, and lower depression were associated with higher morning waking saliva cortisol levels while greater financial satisfaction was the only variable associated with greater evening to morning awakening slope.</p><p><strong>Conclusion: </strong>Our findings show relationships among clinical pain, psychosocial stress, sociodemographic factors, and salivary cortisol levels. Importantly, with inclusion of recognized explanatory variables, financial satisfaction remained the primary factor accounting for differences in morning waking cortisol and evening to morning awakening cortisol slope in an ethnic/racially diverse group of middle aged and older adults with or at risk for knee osteoarthritis.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":" ","pages":"2470547020975758"},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2470547020975758","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38786894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study on Playback Theatre as a Therapeutic Aid after Natural Disasters: Brain Connectivity Mechanisms of Effects on Anxiety.","authors":"Sarat Munjuluri,&nbsp;Peter K Bolin,&nbsp;Y T Amy Lin,&nbsp;Nina L Garcia,&nbsp;Leslie Gauna,&nbsp;Tien Nguyen,&nbsp;Ramiro Salas","doi":"10.1177/2470547020966561","DOIUrl":"https://doi.org/10.1177/2470547020966561","url":null,"abstract":"<p><strong>Background: </strong>Natural disasters can affect mental health and result in symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD). Playback Theatre (PT) is a form of improvisation where actors play-back personal stories told by audience members. Whether PT can be therapeutic in post-disaster settings is not known.</p><p><strong>Method: </strong>We used a series of PT performances and studied levels of depression, anxiety, and PTSD symptoms in a sample of 13 people affected by Hurricane Harvey that happened in Houston, TX, August 2017. Brain imaging, specifically resting state functional connectivity of the amygdala was also studied before and after the PT performances.</p><p><strong>Results: </strong>Both anxiety (<i>p</i> = .001, Cohen's d = -1.25) and PTSD (<i>p</i> = .002, Cohen's d = -1.0) symptoms significantly decreased after a series of 4 PT performances from January 2019 - February 2019. Depression reduction was not significant. We performed resting state functional connectivity (RSFC) MRI before and after the series of performances. We used the right and left amygdala as seeds for RSFC analysis and found that the connectivity between the left amygdala and the bilateral supramarginal gyri was increased after PT. The bilateral supramarginal connectivity with the default mode and the saliency networks increased too, which correlated with reduction in anxiety scores.</p><p><strong>Conclusions: </strong>PT may offer a form of intervention for anxiety caused by disasters. An increase in left amygdala/supramarginal gyri connectivity may be the underlying mechanism.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":" ","pages":"2470547020966561"},"PeriodicalIF":0.0,"publicationDate":"2020-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2470547020966561","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38620232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes-Related Distress and Associated Characteristics in Patients With Type 2 Diabetes in an Urban Primary Care Setting in Greece.","authors":"Kyriakos Kintzoglanakis,&nbsp;Paraskevi Vonta,&nbsp;Panagiota Copanitsanou","doi":"10.1177/2470547020961538","DOIUrl":"https://doi.org/10.1177/2470547020961538","url":null,"abstract":"<p><strong>Background: </strong>Diabetes-related distress (DRD) is a common psychological issue of people living with diabetes. International guidelines advise to take DRD into consideration in diabetes care but evidence for Greece is scarce. In the present study we aimed to estimate the frequency of DRD as assessed by Diabetes Distress Scale (DDS) and to examine its connections with clinical and sociodemographic characteristics among patients with type 2 diabetes mellitus (T2D) in urban primary care (PC) in Greece.</p><p><strong>Methods: </strong>This descriptive survey included adults with a diagnosis of T2D of at least six months under medication treatment attending a novel, public urban PC unit. Patients with other forms of diabetes, dementia, and psychosis were excluded. Patients were screened for DRD with DDS instrument and correlations were made between DRD and clinical and sociodemographic characteristics.</p><p><strong>Results: </strong>In 135 eligible participants the frequency of moderate to high levels of DRD (DDS ≥ 2) was 24.4% and of high levels of DRD (DDS ≥ 3) was 7.4%. Emotional burden (EB) subscale was significantly correlated with younger age, insulin use, duration of insulin use, and the number of insulin injections per day. Longer diabetes duration showed significant correlation with DDS total, EB, and regimen distress. Participants with lower income, sedentary lifestyle, micro-vascular complications, more episodes of hypoglycaemia, and higher levels of glycated haemoglobin (HbA1c) experienced significantly higher distress.</p><p><strong>Conclusion: </strong>DRD screening is important in urban PC and in more susceptible patients as those on more insulin injections per day, with longer diabetes duration, higher levels of HbA1c, lower income, sedentary lifestyle, and more episodes of hypoglycaemia.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":" ","pages":"2470547020961538"},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2470547020961538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38561745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hippocampal and Amygdalar Volume Changes in Major Depressive Disorder: A Targeted Review and Focus on Stress.","authors":"Mark Nolan,&nbsp;Elena Roman,&nbsp;Anurag Nasa,&nbsp;Kirk J Levins,&nbsp;Erik O'Hanlon,&nbsp;Veronica O'Keane,&nbsp;Darren Willian Roddy","doi":"10.1177/2470547020944553","DOIUrl":"https://doi.org/10.1177/2470547020944553","url":null,"abstract":"<p><p>Medial temporal lobe structures have long been implicated in the pathogenesis of major depressive disorder. Although findings of smaller hippocampal and amygdalar volumes are common, inconsistencies remain in the literature. In this targeted review, we examine recent and significant neuroimaging papers examining the volumes of these structures in major depressive disorder. A targeted PubMed/Google Scholar search was undertaken focusing on volumetric neuroimaging studies of the hippocampus and amygdala in major depressive disorder. Where possible, mean volumes and accompanying standard deviations were extracted allowing computation of Cohen's d_s effect sizes. Although not a meta-analysis, this allows a broad comparison of volume changes across studies. Thirty-nine studies in total were assessed. Hippocampal substructures and amygdale substructures were investigated in 11 and 2 studies, respectively. The hippocampus was more consistently smaller than the amygdala across studies, which is reflected in the larger cumulative difference in volume found with the Cohen's d_s calculations. The left and right hippocampi were, respectively, 92% and 91.3% of the volume found in controls, and the left and right amygdalae were, respectively, 94.8% and 92.6% of the volume of controls across all included studies. The role of stress in temporal lobe structure volume reduction in major depressive disorder is discussed.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":" ","pages":"2470547020944553"},"PeriodicalIF":0.0,"publicationDate":"2020-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2470547020944553","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38453374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychedelic Treatment for Trauma-Related Psychological and Cognitive Impairment Among US Special Operations Forces Veterans.","authors":"Alan K Davis, Lynnette A Averill, Nathan D Sepeda, Joseph P Barsuglia, Timothy Amoroso","doi":"10.1177/2470547020939564","DOIUrl":"10.1177/2470547020939564","url":null,"abstract":"<p><strong>Background: </strong>U.S. Special Operations Forces Veterans are at increased risk for a variety of mental health problems and cognitive impairment associated with military service. Current treatments are lacking in effectiveness and adherence. Therefore, this study examined psychedelic treatment with ibogaine and 5-methoxy-N,N-dimethyltryptamine for trauma-related psychological and cognitive impairment among U.S. Special Operations Forces Veterans.</p><p><strong>Method: </strong>We conducted a survey of Veterans who completed a specific psychedelic clinical program in Mexico between 2017 and 2019. Questions probed retrospective reports of mental health and cognitive functioning during the 30 days before and 30 days after treatment. A total of 65 people completed treatment during this time frame and were eligible for contact. Of these, 51 (78%) completed the survey and were included in data analyses (mean age = 40; male = 96%; married = 55%; Caucasian/White = 92%; Operation Enduring Freedom/Operation Iraqi Freedom Service = 96%).</p><p><strong>Results: </strong>Results indicated significant and very large reductions in retrospective report of suicidal ideation (p < .001; d = -1.9), cognitive impairment (p < .001; d = -2.8), and symptoms of posttraumatic stress disorder (p < .001; d = -3.6), depression (p < .001; d = -3.7), and anxiety (p < .001; d = -3.1). Results also showed a significant and large increase in retrospective report of psychological flexibility (p < .001; d = 2.9) from before-to-after the psychedelic treatment. Increases in the retrospective report of psychological flexibility were strongly associated with retrospective report of reductions in cognitive impairment, and symptoms of posttraumatic stress disorder, depression, and anxiety (rs range -0.61 to -0.75; p < .001). Additionally, most participants rated the psychedelic experiences as one of the top five personally meaningful (84%), spiritually significant (88%), and psychologically insightful (86%) experiences of their lives.<b>Limitations</b>: Several limitations should be considered including the retrospective, self-report, survey design of the study, and the lack of randomization and blinding, thus making these finding preliminary.</p><p><strong>Conclusion: </strong>U.S. Special Operations Forces Veterans may have unique treatment needs because of the sequela of problems associated with repeated trauma exposure and the nature of the exposure. Psychedelic-assisted therapy with these under-researched psychedelics may hold unique promise for this population. However, controlled studies are needed to determine whether this treatment is efficacious in relieving mental health and cognitive impairment among U.S. Special Operations Forces Veterans.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":" ","pages":"2470547020939564"},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/a8/10.1177_2470547020939564.PMC7359647.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38185839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}