MDMA-assisted therapy significantly reduces eating disorder symptoms in a randomized placebo-controlled trial of adults with severe PTSD DOI Creative Commons
Timothy D. Brewerton, Julie B. Wang, Adèle Lafrance

et al.

Journal of Psychiatric Research, Journal Year: 2022, Volume and Issue: 149, P. 128 - 135

Published: March 5, 2022

Eating disorders (EDs) and posttraumatic stress disorder (PTSD) are highly comorbid, yet there no proven integrative treatment modalities for ED-PTSD. In clinical trials, MDMA-assisted therapy (MDMA-AT) has shown marked success in the of PTSD may be promising Ninety individuals with severe received a double-blind, placebo-controlled pivotal trial MDMA-AT. addition to primary (Clinician-Administered Scale) secondary (Sheehan Disability outcome measures, Attitudes Test 26 (EAT-26) was administered pre-specified exploratory purposes at baseline study termination. The sample consisted 58 females (placebo = 31, MDMA 27) 31 males 12, 19) (n 89). Seven participants discontinued prior At baseline, 13 (15%) 89 had total EAT-26 scores range (≥20), 28 (31.5%) high-risk (≥11) despite absence active purging or low weight. completers 82), significant reduction group following MDMA-AT versus placebo (p .03). There were also reductions women high ≥11 ≥ 20 .0012 p .0478, respectively). ED psychopathology is common even EDs significantly reduced symptoms compared among PTSD. ED-PTSD appears requires further study.

Language: Английский

Smaller Hippocampal Volume in Posttraumatic Stress Disorder: A Multisite ENIGMA-PGC Study: Subcortical Volumetry Results From Posttraumatic Stress Disorder Consortia DOI Creative Commons
Mark W. Logue, Sanne J.H. van Rooij, Emily L. Dennis

et al.

Biological Psychiatry, Journal Year: 2017, Volume and Issue: 83(3), P. 244 - 253

Published: Sept. 20, 2017

Language: Английский

Citations

422
PTSD symptoms among health workers and public service providers during the COVID-19 outbreak DOI Creative Commons
Sverre Urnes Johnson, Omid V. Ebrahimi, Asle Hoffart

et al.

PLoS ONE, Journal Year: 2020, Volume and Issue: 15(10), P. e0241032 - e0241032

Published: Oct. 21, 2020

In the frontline of pandemic stand healthcare workers and public service providers, occupations which have proven to be associated with increased mental health problems during crises. This cross-sectional, survey-based study collected data from 1773 providers throughout Norway between March 31, 2020 April 7, 2020, encompasses a timeframe where all non-pharmacological interventions (NPIs) were held constant. Post-traumatic stress disorder (PTSD), anxiety depression assessed by Norwegian version PTSD checklist (PCL-5), General Anxiety Disorder –7, Patient Health Questionnaire-9 (PHQ-9), respectively. specific predictors items. Multiple regression analysis was used for predictor analysis. A total 28.9% sample had clinical or subclinical symptoms PTSD, 21.2% 20.5% above established cut-offs depression. Those working directly in contrast indirectly COVID-19 patients significantly higher symptoms. Worries about job economy, negative metacognitions, burnout, emotional support symptoms, after controlling demographic variables psychological are experiencing high levels pandemic. compared those indirectly. Appropriate action monitor reduce anxiety, among these groups individuals crucial societal roles should taken immediately.

Language: Английский

Citations

246
Post-traumatic Stress Disorder by Gender and Veteran Status DOI
Keren Lehavot,

Jodie G. Katon,

Jessica Chen

et al.

American Journal of Preventive Medicine, Journal Year: 2017, Volume and Issue: 54(1), P. e1 - e9

Published: Dec. 14, 2017

Language: Английский

Citations

231
MDMA-assisted therapy for moderate to severe PTSD: a randomized, placebo-controlled phase 3 trial DOI Creative Commons
Jennifer Mitchell,

Marcela Ot’alora G.,

Bessel van der Kolk

et al.

Nature Medicine, Journal Year: 2023, Volume and Issue: 29(10), P. 2473 - 2480

Published: Sept. 14, 2023

This multi-site, randomized, double-blind, confirmatory phase 3 study evaluated the efficacy and safety of 3,4-methylenedioxymethamphetamine-assisted therapy (MDMA-AT) versus placebo with identical in participants moderate to severe post-traumatic stress disorder (PTSD). Changes Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) total severity score (primary endpoint) Sheehan Disability (SDS) functional impairment (key secondary were assessed by blinded independent assessors. Participants randomized MDMA-AT (n = 53) or 51). Overall, 26.9% (28/104) had PTSD, 73.1% (76/104) PTSD. ethnoracially diverse: 28 104 (26.9%) identified as Hispanic/Latino, 35 (33.7%) other than White. Least squares (LS) mean change CAPS-5 (95% confidence interval (CI)) was -23.7 (-26.94, -20.44) -14.8 (-18.28, -11.28) (P < 0.001, d 0.7). LS SDS CI) -3.3 (-4.03, -2.60) -2.1 (-2.89, -1.33) 0.03, 0.4). Seven a treatment emergent adverse event (TEAE) (MDMA-AT, n 5 (9.4%); therapy, 2 (3.9%)). There no deaths serious TEAEs. These data suggest that reduced symptoms diverse population generally well tolerated. ClinicalTrials.gov identifier: NCT04077437 .

Language: Английский

Citations

193
A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder DOI
Adriana Feder, Sara Costi, Sarah Rutter

et al.

American Journal of Psychiatry, Journal Year: 2021, Volume and Issue: 178(2), P. 193 - 202

Published: Jan. 5, 2021

Posttraumatic stress disorder (PTSD) is a chronic and disabling disorder, for which available pharmacotherapies have limited efficacy. The authors' previous proof-of-concept randomized controlled trial of single-dose intravenous ketamine infusion in individuals with PTSD showed significant rapid symptom reduction 24 hours postinfusion. present study the first to test efficacy safety repeated infusions treatment PTSD.Individuals (N=30) were randomly assigned (1:1) receive six (0.5 mg/kg) or midazolam (0.045 (psychoactive placebo control) over 2 consecutive weeks. Clinician-rated self-report assessments administered after at weekly visits. primary outcome measure was change severity, as assessed Clinician-Administered Scale DSM-5 (CAPS-5), from baseline weeks (after completion all infusions). Secondary measures included Impact Event Scale-Revised, Montgomery-Åsberg Depression Rating (MADRS), side effect measures.The group significantly greater improvement CAPS-5 MADRS total scores than week 2. At 2, mean score 11.88 points (SE=3.96) lower (d=1.13, 95% CI=0.36, 1.91). Sixty-seven percent participants responders, compared 20% group. Among median time loss response 27.5 days following 2-week course infusions. Ketamine well tolerated overall, without serious adverse events.This provides evidence reducing severity PTSD. Further studies are warranted understand ketamine's full potential

Language: Английский

Citations

172
Prevalence of post-traumatic stress disorder in the United States: a systematic literature review DOI Creative Commons

Jeffrey Schein,

Christy R. Houle,

Annette Urganus

et al.

Current Medical Research and Opinion, Journal Year: 2021, Volume and Issue: 37(12), P. 2151 - 2161

Published: Sept. 9, 2021

Objective This study synthesized evidence regarding the prevalence of post-traumatic stress disorder (PTSD) in United States (US).Methods A systematic literature review (SLR) identified recently published (2015–2019) observational studies PTSD US via MEDLINE, EMBASE, and PsycINFO databases. Eligible studies' most recent data were collected no earlier than 2013. Data elements extracted included design, sample size, location, source/year(s), population(s), traumatic event type, prevalance estimates with corresponding look-back periods, clinical metrics.Results from 38 articles categorized by population, diagnostic criteria, lookback period. Among civilians, point ranged 8.0% to 56.7%, 1-year 2.3% 9.1%, lifetime 3.4% 26.9%. In military populations, 1.2% 87.5%, 6.7% 50.2%, 7.7% 17.0%. Within these ranges, several derived relatively high quality data; are highlighted review. Prevalence was elevated subpopulations including emergency responders, refugees, American Indian/Alaska Natives, individuals heavy substance use, a past suicide attempt, trans-masculine individuals, women prior sexual trauma. Female sex, lower income, younger age, behavioral health conditions as risk factors for PTSD.Conclusions varied widely, partly due different designs, methodologies, nationally representative lacking. Efforts increase screening improve disease awareness may allow better detection management PTSD.

Language: Английский

Citations

150
Comparison of Prolonged Exposure vs Cognitive Processing Therapy for Treatment of Posttraumatic Stress Disorder Among US Veterans DOI Creative Commons
Paula P. Schnurr,

Kathleen M. Chard,

Josef I. Ruzek

et al.

JAMA Network Open, Journal Year: 2022, Volume and Issue: 5(1), P. e2136921 - e2136921

Published: Jan. 19, 2022

Posttraumatic stress disorder (PTSD) is a prevalent and serious mental health problem. Although there are effective psychotherapies for PTSD, little information about their comparative effectiveness.To compare the effectiveness of prolonged exposure (PE) vs cognitive processing therapy (CPT) treating PTSD in veterans.This randomized clinical trial assessed PE CPT among veterans with military-related recruited from outpatient clinics at 17 Department Veterans Affairs medical centers across US October 31, 2014, to February 1, 2018, follow-up through 2019. The primary outcome was using centralized masking. Tested hypotheses were prespecified before initiation. Data analyzed 5, 2020, May 2021.Participants 1 2 individual cognitive-behavioral therapies, or CPT, delivered according flexible protocol 10 14 sessions.The change symptom severity on Clinician-Administered Scale DSM-5 (CAPS-5) treatment mean after posttreatment 3- 6-month follow-ups. Secondary outcomes included other symptoms, functioning, quality life.Analyses based all 916 participants (730 [79.7%] men 186 [20.3%] women; [range] age 45.2 [21-80] years), 455 (mean CAPS-5 score baseline, 39.9 [95% CI, 39.1-40.7] points) 461 40.3 39.5-41.1] points). improved substantially both (standardized difference [SMD], 0.99 0.89-1.08]) (SMD, 0.71 0.61-0.80]) groups treatment. Mean improvement greater than (least square mean, 2.42 0.53-4.31]; P = .01), but not clinically significant 0.17). Results self-reported symptoms comparable findings. group had higher odds response (odds ratio [OR], 1.32 1.00-1.65]; < .001), loss diagnosis (OR, 1.43 1.12-1.74]; remission 1.62 1.24-2.00]; .001) compared group. Groups did differ outcomes. Treatment dropout (254 [55.8%]) (215 [46.6%]; .01). Three participant withdrawn treatment, 3 each dropped out owing adverse events.This found that although statistically more significant, improvements meaningful groups. These findings highlight importance shared decision-making help patients understand evidence select preferred treatment.ClinicalTrials.gov Identifier: NCT01928732.

Language: Английский

Citations

120
War trauma and PTSD in Ukraine’s civilian population: comparing urban-dwelling to internally displaced persons DOI
Robert J. Johnson, Olena Antonaccio, Ekaterina V. Botchkovar

et al.

Social Psychiatry and Psychiatric Epidemiology, Journal Year: 2021, Volume and Issue: 57(9), P. 1807 - 1816

Published: Oct. 1, 2021

Language: Английский

Citations

111
Written Exposure Therapy vs Prolonged Exposure Therapy in the Treatment of Posttraumatic Stress Disorder DOI
Denise M. Sloan, Brian P. Marx, Ron Acierno

et al.

JAMA Psychiatry, Journal Year: 2023, Volume and Issue: 80(11), P. 1093 - 1093

Published: Aug. 23, 2023

Evidence-based treatments for posttraumatic stress disorder (PTSD) exist, but all require 8 to 15 sessions and thus are less likely be completed than brief treatments. Written exposure therapy (WET) is a efficacious treatment that has not been directly compared with prolonged (PE), more time-intensive, exposure-based treatment.

Language: Английский

Citations

46
The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline DOI
Paula P. Schnurr, Jessica L. Hamblen, Jonathan Wolf

et al.

Annals of Internal Medicine, Journal Year: 2024, Volume and Issue: 177(3), P. 363 - 374

Published: Feb. 26, 2024

The U.S. Department of Veterans Affairs (VA) and Defense (DoD) worked together to revise the 2017 VA/DoD Clinical Practice Guideline for Management Posttraumatic Stress Disorder Acute Disorder. This article summarizes 2023 clinical practice guideline (CPG) its development process, focusing on assessments treatments which evidence was sufficient support a recommendation or against.

Language: Английский

Citations

21