The Experts below are selected from a list of 8280 Experts worldwide ranked by ideXlab platform

Douglas L. Delahanty - One of the best experts on this subject based on the ideXlab platform.

  • ptsd symptom severity and psychiatric comorbidity in recent Motor Vehicle Accident victims a latent class analysis
    Journal of Anxiety Disorders, 2014
    Co-Authors: Bryce Hruska, Douglas L. Delahanty, Leah A Irish, Maria L Pacella, Eve M Sledjeski
    Abstract:

    We conducted a latent class analysis (LCA) on 249 recent Motor Vehicle Accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA.

  • an examination of ptsd symptoms as a mediator of the relationship between trauma history characteristics and physical health following a Motor Vehicle Accident
    Depression and Anxiety, 2013
    Co-Authors: Leah A Irish, Douglas L. Delahanty, Eve M Sledjeski, Crystal A Gabertquillen, Jeffrey A Ciesla, L Maria M A Pacella
    Abstract:

    BACKGROUND: It has been suggested that a history of trauma exposure is associated with increased vulnerability to the physical health consequences of subsequent trauma exposure, and that posttraumatic stress symptoms (PTSS) may serve as a key pathway in this vulnerability. However, few studies have modeled these relationships using mediation, and most have failed to consider whether specific characteristics of the prior trauma exposure have a differential impact on physical and mental health outcomes. METHODS: The present study examined 180 victims of a serious Motor Vehicle Accident (MVA) who reported prior exposure to traumatic events. PTSS were assessed by clinical interview 6 weeks post-MVA, and physical health was assessed 6 months post-MVA. Using structural equation modeling, the present study examined the extent to which event (age at first trauma, number, and types of trauma) and response (perceptions of life threat, physical injury, and distress) characteristics of prior trauma were related to physical health outcomes following a serious MVA, and whether these relationships were mediated by PTSS. RESULTS: Results revealed that both event and response characteristics of prior trauma history were associated with poorer physical health, and that PTSS served as a mechanism through which response characteristics, but not event characteristics, led to poorer physical health. CONCLUSIONS: These results highlight the enduring impact of trauma exposure on physical health outcomes, and underscore the importance of considering multiple mechanisms through which different aspects of prior trauma exposure may impact physical health. Language: en

  • trauma history characteristics and subsequent ptsd symptoms in Motor Vehicle Accident victims
    Journal of Traumatic Stress, 2008
    Co-Authors: Leah A Irish, Eileen Spoonster, Eve M Sledjeski, Sarah A Ostrowski, William F Fallon, Manfred H M Van Dulmen, Douglas L. Delahanty
    Abstract:

    The present study examined the relationship between trauma history characteristics (number and type of traumas, age at first trauma, and subjective responses to prior traumas) and the development of posttraumatic stress disorder (PTSD) symptoms following a Motor Vehicle Accident (MVA). One hundred eighty-eight adult MVA victims provided information about prior traumatization and were evaluated for PTSD symptoms 6 weeks and one year following the MVA. Results indicated that after controlling for demographics and depression, prior trauma history characteristics accounted for a small, but significant amount of the variance in PTSD symptoms. Distress from prior trauma and number of types of prior traumas were the most meaningful trauma history predictors. Results encourage further evaluation of trauma history as a multifaceted construct.

  • Injury severity, prior trauma history, urinary cortisol levels, and acute PTSD in Motor Vehicle Accident victims.
    Journal of Anxiety Disorders, 2002
    Co-Authors: Douglas L. Delahanty, A. Jay Raimonde, Eileen Spoonster, Michael Cullado
    Abstract:

    This study examined the relationship between prior history of traumatic events, life threat, and injury severity experienced during a Motor Vehicle Accident (MVA), and posttraumatic stress disorder (PTSD) assessed 1 month after the Accident. In addition, initial urinary cortisol levels after the Accident were examined as a possible mediator of this relationship. Fifteen-hour urinary cortisol samples were collected from MVA victims upon admission to the trauma unit. In the hospital, subjective life threat was measured and objective Injury Severity Scores (ISSs) were computed. One month after the Accident, participants were assessed for prior history of traumatic experiences, presence of acute PTSD, and levels of intrusive and avoidant thoughts and behaviors. Victims, who met PTSD diagnostic criteria, reported more prior traumatic events, and significantly greater life threat despite receiving significantly lower ISSs than victims who did not develop PTSD. The relationships between ISSs and PTSD symptoms and prior trauma history and PTSD symptoms were mediated by cortisol levels. Results suggest that cortisol levels in the acute aftermath of a traumatic event may serve as a mechanism through which various factors may increase risk for PTSD.

  • initial posttraumatic urinary cortisol levels predict subsequent ptsd symptoms in Motor Vehicle Accident victims
    Biological Psychiatry, 2000
    Co-Authors: Douglas L. Delahanty, Jay A Raimonde, Eileen Spoonster
    Abstract:

    Abstract Background: This study was designed to examine the relationship between urinary hormone levels collected upon admission to the trauma unit following a Motor Vehicle Accident and posttraumatic stress disorder symptomatology 1 month later. Methods: Fifteen-hour urine samples were collected from 63 male and 36 female Motor Vehicle Accident victims and were used to assess levels of catecholamines and cortisol reflecting peritraumatic and acute-phase posttraumatic levels. Presence of posttraumatic stress disorder symptomatology was assessed 1 month after the Accident. Results: Motor Vehicle Accident victims subsequently diagnosed with acute posttraumatic stress disorder excreted significantly lower levels of cortisol in 15-hour urines collected upon admission to the hospital. In addition, urinary levels of cortisol predicted a significant percentage of the variance in intrusive and avoidant thoughts 1 month after the Accident. Conclusions: The results of our study suggest that initial cortisol levels in the immediate aftermath of a traumatic event contribute, in part, to subsequent symptoms of posttraumatic stress disorder.

Yutaka Matsuoka - One of the best experts on this subject based on the ideXlab platform.

  • the role of high density lipoprotein cholesterol in risk for posttraumatic stress disorder taking a nutritional approach toward universal prevention
    European Psychiatry, 2014
    Co-Authors: Kei Hamazaki, Daisuke Nishi, Naohiro Yonemoto, H Noguchi, Y Kim, Yutaka Matsuoka
    Abstract:

    Several cross-sectional studies, but no prospective studies, have reported an association between an abnormal lipid profile and posttraumatic stress disorder (PTSD). We hypothesized that an abnormal lipid profile might predict risk for developing PTSD. In this prospective study, we analyzed data from 237 antidepressant-naive severely injured patients who participated in the Tachikawa Cohort of Motor Vehicle Accident Study. High-density lipoprotein cholesterol (HDL-C) levels at baseline were significantly lower in patients with PTSD than those without PTSD at 6 months after Motor Vehicle Accident (MVA) and were inversely associated with risk for PTSD. In contrast, triglycerides (TG) at baseline were significantly higher in patients with PTSD than in those without PTSD at 6 months post-MVA and were positively associated with risk for PTSD. There was no clear association between low-density lipoprotein cholesterol or total cholesterol and risk for PTSD. In conclusion, low HDL-C and high TG may be risk factors for PTSD. Determining lipid profiles might help identify those at risk for PTSD after experiencing trauma.

  • potential impact of propofol immediately after Motor Vehicle Accident on later symptoms of posttraumatic stress disorder at 6 month follow up a retrospective cohort study
    Critical Care, 2012
    Co-Authors: Masato Usuki, Yutaka Matsuoka, Daisuke Nishi, Yoshiharu Kim, Yasuhiro Otomo, Naohiro Yonemoto, Kenta Matsumura, Shigenobu Kanba
    Abstract:

    Introduction Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a Motor Vehicle Accident (MVA) affects the subsequent development of PTSD symptoms.

  • potential impact of propofol immediately after Motor Vehicle Accident on later symptoms of posttraumatic stress disorder at 6 month follow up a retrospective cohort study
    Critical Care, 2012
    Co-Authors: Masato Usuki, Yutaka Matsuoka, Daisuke Nishi, Yoshiharu Kim, Yasuhiro Otomo, Naohiro Yonemoto, Kenta Matsumura, Shigenobu Kanba
    Abstract:

    Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a Motor Vehicle Accident (MVA) affects the subsequent development of PTSD symptoms. We examined data obtained from a prospective cohort study of MVA-related injured patients, admitted to the intensive care unit of a general hospital. We investigated the effect of propofol administration within 72 h of MVA on outcome. Primary outcome was diagnosis of full or partial PTSD as determined by the Clinician-Administered PTSD Scale (CAPS) at 6 months. Secondary outcomes were diagnosis of full or partial PTSD at 1 month and CAPS score indicating PTSD at 1 and 6 months. Multivariate analysis was conducted adjusting for being female, age, injury severity score (ISS), and administration of ketamine or midazolam within 72 h of MVA. Among 300 patients recruited (mean ISS, 8.0; median Glasgow Coma Scale (GCS) score, 15.0; age, 18 to 69 years), propofol administration showed a higher risk for full or partial PTSD as determined by CAPS at 6 months (odds ratio = 6.13, 95% confidence interval (CI): 1.57 to 23.85, P = 0.009) and at 1 month (odds ratio = 1.31, 95% CI: 0.41 to 4.23, P = 0.647) in the multivariate logistic regression. Multivariate regression analysis showed a trend toward adverse effects of propofol on PTSD symptom development at 6 months after MVA (β = 4.08, 95% CI: -0.49 to 8.64, P = 0.080), but not at 1 month after MVA (β = -0.42, 95% CI: -6.34 to 5.51, P = 0.890). These findings suggest that using propofol in the acute phase after MVA might be associated with the development of PTSD symptoms 6 months later. However, since the design of this study was retrospective, these findings should be interpreted cautiously and further study is warranted.

  • posttraumatic growth posttraumatic stress disorder and resilience of Motor Vehicle Accident survivors
    Biopsychosocial Medicine, 2010
    Co-Authors: Daisuke Nishi, Yutaka Matsuoka, Yoshiharu Kim
    Abstract:

    Background Although some previous studies have suggested that posttraumatic growth (PTG) is comprised of several factors with different properties, few have examined both the association between PTG and posttraumatic stress disorder (PTSD) and between PTG and resilience, focusing on each of the factors of PTG. This study aimed to examine the hypothesis that some factors of PTG, such as personal strength, relate to resilience, whereas other factors, such as appreciation of life, relate to PTSD symptoms among Japanese Motor Vehicle Accident (MVA) survivors.

  • peritraumatic distress inventory as a predictor of post traumatic stress disorder after a severe Motor Vehicle Accident
    Psychiatry and Clinical Neurosciences, 2010
    Co-Authors: Diasuke Nishi, Yutaka Matsuoka, Yoshiharu Kim, Nakajima Yonemoto, Hiroko Noguchi, Shigenobu Kanba
    Abstract:

    AIM: The aim of this study was to examine the utility of the Peritraumatic Distress Inventory (PDI) as a predictor of subsequent post-traumatic stress disorder (PTSD) in severe Motor Vehicle Accident survivors. METHODS: Patients consecutively admitted to the intensive care unit were assessed immediately and 1 month after Accidents in this prospective study. The predictive value for post-traumatic stress symptoms at 1 month of the PDI at initial assessment was examined by using multivariate regression analysis. Moreover, the accuracy of the PDI as a predictor of PTSD was determined using receiver operator characteristic curve analysis. Post-traumatic stress symptoms were assessed using the Impact of Event Scale - Revised questionnaire, and PTSD was assessed using the Clinician-Administered PTSD Scale. RESULTS: Seventy-nine patients completed the Impact of Event Scale - Revised questionnaire, and 64 patients participated in a structured interview. Of 64 patients, 13 met the diagnostic criteria of full or partial PTSD. The PDI was an independent predictor of post-traumatic stress symptoms (P = 0.003). The data indicated that a cut-off score of 23 maximized the balance between sensitivity (77%) and specificity (82%) in this study. Compared with negative predictive value (93%), positive predictive value was not high (53%). CONCLUSION: The study suggests the predictive usefulness of the PDI for subsequent PTSD in Accident survivors. Its adequate usage should be further elaborated. Language: en

Yoshiharu Kim - One of the best experts on this subject based on the ideXlab platform.

  • potential impact of propofol immediately after Motor Vehicle Accident on later symptoms of posttraumatic stress disorder at 6 month follow up a retrospective cohort study
    Critical Care, 2012
    Co-Authors: Masato Usuki, Yutaka Matsuoka, Daisuke Nishi, Yoshiharu Kim, Yasuhiro Otomo, Naohiro Yonemoto, Kenta Matsumura, Shigenobu Kanba
    Abstract:

    Introduction Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a Motor Vehicle Accident (MVA) affects the subsequent development of PTSD symptoms.

  • potential impact of propofol immediately after Motor Vehicle Accident on later symptoms of posttraumatic stress disorder at 6 month follow up a retrospective cohort study
    Critical Care, 2012
    Co-Authors: Masato Usuki, Yutaka Matsuoka, Daisuke Nishi, Yoshiharu Kim, Yasuhiro Otomo, Naohiro Yonemoto, Kenta Matsumura, Shigenobu Kanba
    Abstract:

    Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a Motor Vehicle Accident (MVA) affects the subsequent development of PTSD symptoms. We examined data obtained from a prospective cohort study of MVA-related injured patients, admitted to the intensive care unit of a general hospital. We investigated the effect of propofol administration within 72 h of MVA on outcome. Primary outcome was diagnosis of full or partial PTSD as determined by the Clinician-Administered PTSD Scale (CAPS) at 6 months. Secondary outcomes were diagnosis of full or partial PTSD at 1 month and CAPS score indicating PTSD at 1 and 6 months. Multivariate analysis was conducted adjusting for being female, age, injury severity score (ISS), and administration of ketamine or midazolam within 72 h of MVA. Among 300 patients recruited (mean ISS, 8.0; median Glasgow Coma Scale (GCS) score, 15.0; age, 18 to 69 years), propofol administration showed a higher risk for full or partial PTSD as determined by CAPS at 6 months (odds ratio = 6.13, 95% confidence interval (CI): 1.57 to 23.85, P = 0.009) and at 1 month (odds ratio = 1.31, 95% CI: 0.41 to 4.23, P = 0.647) in the multivariate logistic regression. Multivariate regression analysis showed a trend toward adverse effects of propofol on PTSD symptom development at 6 months after MVA (β = 4.08, 95% CI: -0.49 to 8.64, P = 0.080), but not at 1 month after MVA (β = -0.42, 95% CI: -6.34 to 5.51, P = 0.890). These findings suggest that using propofol in the acute phase after MVA might be associated with the development of PTSD symptoms 6 months later. However, since the design of this study was retrospective, these findings should be interpreted cautiously and further study is warranted.

  • posttraumatic growth posttraumatic stress disorder and resilience of Motor Vehicle Accident survivors
    Biopsychosocial Medicine, 2010
    Co-Authors: Daisuke Nishi, Yutaka Matsuoka, Yoshiharu Kim
    Abstract:

    Background Although some previous studies have suggested that posttraumatic growth (PTG) is comprised of several factors with different properties, few have examined both the association between PTG and posttraumatic stress disorder (PTSD) and between PTG and resilience, focusing on each of the factors of PTG. This study aimed to examine the hypothesis that some factors of PTG, such as personal strength, relate to resilience, whereas other factors, such as appreciation of life, relate to PTSD symptoms among Japanese Motor Vehicle Accident (MVA) survivors.

  • peritraumatic distress inventory as a predictor of post traumatic stress disorder after a severe Motor Vehicle Accident
    Psychiatry and Clinical Neurosciences, 2010
    Co-Authors: Diasuke Nishi, Yutaka Matsuoka, Yoshiharu Kim, Nakajima Yonemoto, Hiroko Noguchi, Shigenobu Kanba
    Abstract:

    AIM: The aim of this study was to examine the utility of the Peritraumatic Distress Inventory (PDI) as a predictor of subsequent post-traumatic stress disorder (PTSD) in severe Motor Vehicle Accident survivors. METHODS: Patients consecutively admitted to the intensive care unit were assessed immediately and 1 month after Accidents in this prospective study. The predictive value for post-traumatic stress symptoms at 1 month of the PDI at initial assessment was examined by using multivariate regression analysis. Moreover, the accuracy of the PDI as a predictor of PTSD was determined using receiver operator characteristic curve analysis. Post-traumatic stress symptoms were assessed using the Impact of Event Scale - Revised questionnaire, and PTSD was assessed using the Clinician-Administered PTSD Scale. RESULTS: Seventy-nine patients completed the Impact of Event Scale - Revised questionnaire, and 64 patients participated in a structured interview. Of 64 patients, 13 met the diagnostic criteria of full or partial PTSD. The PDI was an independent predictor of post-traumatic stress symptoms (P = 0.003). The data indicated that a cut-off score of 23 maximized the balance between sensitivity (77%) and specificity (82%) in this study. Compared with negative predictive value (93%), positive predictive value was not high (53%). CONCLUSION: The study suggests the predictive usefulness of the PDI for subsequent PTSD in Accident survivors. Its adequate usage should be further elaborated. Language: en

  • the tachikawa cohort of Motor Vehicle Accident study investigating psychological distress design methods and cohort profiles
    Social Psychiatry and Psychiatric Epidemiology, 2009
    Co-Authors: Yutaka Matsuoka, Satomi Nakajima, Masato Homma, Yasuhiro Otomo, Diasuke Nishi, Nakajima Yonemoto, Kenji Hashimoto, Hiroko Noguchi, Yoshiharu Kim
    Abstract:

    The Tachikawa cohort of Motor Vehicle Accident (TCOM) Study has been carried out in Tokyo since 2004. This study examined the association of medical and psychosocial variables evaluated shortly after admission to the acute critical care center with long-term psychiatric morbidity risk in patients with Accidental injuries. Between May 2004 and January 2008, patients with Accidental injury consecutively admitted were recruited to the TCOM Study. Psychiatric morbidity as a primary endpoint was measured using a structured clinical interview at 1, 6, 18 and 36 months after involvement in a Motor Vehicle Accident (MVA). The baseline investigation consisted of self-administered questionnaires concerning acute psychological responses and personality. Medical information was obtained from patients’ medical charts. Various socio-demographic data, health-related habits and psychosocial factors were assessed by interview. To examine potential biomarkers of psychological distress, blood samples were collected. Out of 344 patients who were asked to participate in this study, 300 (87%) patients with MVA-related injury were enrolled. Corresponding rates for the questionnaires on psychological responses and blood sampling were 98–99 and 79%, respectively. The cohort sample was composed of 78% men; the median age was 34 years; and 45% of the participants were Motorcycle drivers. The TCOM Study should prove useful for researchers examining the association between bio-psychosocial variables and psychological distress and may contribute to the formation of a framework for providing care for patients with MVA-related injury.

Eileen Spoonster - One of the best experts on this subject based on the ideXlab platform.

  • trauma history characteristics and subsequent ptsd symptoms in Motor Vehicle Accident victims
    Journal of Traumatic Stress, 2008
    Co-Authors: Leah A Irish, Eileen Spoonster, Eve M Sledjeski, Sarah A Ostrowski, William F Fallon, Manfred H M Van Dulmen, Douglas L. Delahanty
    Abstract:

    The present study examined the relationship between trauma history characteristics (number and type of traumas, age at first trauma, and subjective responses to prior traumas) and the development of posttraumatic stress disorder (PTSD) symptoms following a Motor Vehicle Accident (MVA). One hundred eighty-eight adult MVA victims provided information about prior traumatization and were evaluated for PTSD symptoms 6 weeks and one year following the MVA. Results indicated that after controlling for demographics and depression, prior trauma history characteristics accounted for a small, but significant amount of the variance in PTSD symptoms. Distress from prior trauma and number of types of prior traumas were the most meaningful trauma history predictors. Results encourage further evaluation of trauma history as a multifaceted construct.

  • Injury severity, prior trauma history, urinary cortisol levels, and acute PTSD in Motor Vehicle Accident victims.
    Journal of Anxiety Disorders, 2002
    Co-Authors: Douglas L. Delahanty, A. Jay Raimonde, Eileen Spoonster, Michael Cullado
    Abstract:

    This study examined the relationship between prior history of traumatic events, life threat, and injury severity experienced during a Motor Vehicle Accident (MVA), and posttraumatic stress disorder (PTSD) assessed 1 month after the Accident. In addition, initial urinary cortisol levels after the Accident were examined as a possible mediator of this relationship. Fifteen-hour urinary cortisol samples were collected from MVA victims upon admission to the trauma unit. In the hospital, subjective life threat was measured and objective Injury Severity Scores (ISSs) were computed. One month after the Accident, participants were assessed for prior history of traumatic experiences, presence of acute PTSD, and levels of intrusive and avoidant thoughts and behaviors. Victims, who met PTSD diagnostic criteria, reported more prior traumatic events, and significantly greater life threat despite receiving significantly lower ISSs than victims who did not develop PTSD. The relationships between ISSs and PTSD symptoms and prior trauma history and PTSD symptoms were mediated by cortisol levels. Results suggest that cortisol levels in the acute aftermath of a traumatic event may serve as a mechanism through which various factors may increase risk for PTSD.

  • initial posttraumatic urinary cortisol levels predict subsequent ptsd symptoms in Motor Vehicle Accident victims
    Biological Psychiatry, 2000
    Co-Authors: Douglas L. Delahanty, Jay A Raimonde, Eileen Spoonster
    Abstract:

    Abstract Background: This study was designed to examine the relationship between urinary hormone levels collected upon admission to the trauma unit following a Motor Vehicle Accident and posttraumatic stress disorder symptomatology 1 month later. Methods: Fifteen-hour urine samples were collected from 63 male and 36 female Motor Vehicle Accident victims and were used to assess levels of catecholamines and cortisol reflecting peritraumatic and acute-phase posttraumatic levels. Presence of posttraumatic stress disorder symptomatology was assessed 1 month after the Accident. Results: Motor Vehicle Accident victims subsequently diagnosed with acute posttraumatic stress disorder excreted significantly lower levels of cortisol in 15-hour urines collected upon admission to the hospital. In addition, urinary levels of cortisol predicted a significant percentage of the variance in intrusive and avoidant thoughts 1 month after the Accident. Conclusions: The results of our study suggest that initial cortisol levels in the immediate aftermath of a traumatic event contribute, in part, to subsequent symptoms of posttraumatic stress disorder.

Daisuke Nishi - One of the best experts on this subject based on the ideXlab platform.

  • the role of high density lipoprotein cholesterol in risk for posttraumatic stress disorder taking a nutritional approach toward universal prevention
    European Psychiatry, 2014
    Co-Authors: Kei Hamazaki, Daisuke Nishi, Naohiro Yonemoto, H Noguchi, Y Kim, Yutaka Matsuoka
    Abstract:

    Several cross-sectional studies, but no prospective studies, have reported an association between an abnormal lipid profile and posttraumatic stress disorder (PTSD). We hypothesized that an abnormal lipid profile might predict risk for developing PTSD. In this prospective study, we analyzed data from 237 antidepressant-naive severely injured patients who participated in the Tachikawa Cohort of Motor Vehicle Accident Study. High-density lipoprotein cholesterol (HDL-C) levels at baseline were significantly lower in patients with PTSD than those without PTSD at 6 months after Motor Vehicle Accident (MVA) and were inversely associated with risk for PTSD. In contrast, triglycerides (TG) at baseline were significantly higher in patients with PTSD than in those without PTSD at 6 months post-MVA and were positively associated with risk for PTSD. There was no clear association between low-density lipoprotein cholesterol or total cholesterol and risk for PTSD. In conclusion, low HDL-C and high TG may be risk factors for PTSD. Determining lipid profiles might help identify those at risk for PTSD after experiencing trauma.

  • potential impact of propofol immediately after Motor Vehicle Accident on later symptoms of posttraumatic stress disorder at 6 month follow up a retrospective cohort study
    Critical Care, 2012
    Co-Authors: Masato Usuki, Yutaka Matsuoka, Daisuke Nishi, Yoshiharu Kim, Yasuhiro Otomo, Naohiro Yonemoto, Kenta Matsumura, Shigenobu Kanba
    Abstract:

    Introduction Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a Motor Vehicle Accident (MVA) affects the subsequent development of PTSD symptoms.

  • potential impact of propofol immediately after Motor Vehicle Accident on later symptoms of posttraumatic stress disorder at 6 month follow up a retrospective cohort study
    Critical Care, 2012
    Co-Authors: Masato Usuki, Yutaka Matsuoka, Daisuke Nishi, Yoshiharu Kim, Yasuhiro Otomo, Naohiro Yonemoto, Kenta Matsumura, Shigenobu Kanba
    Abstract:

    Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a Motor Vehicle Accident (MVA) affects the subsequent development of PTSD symptoms. We examined data obtained from a prospective cohort study of MVA-related injured patients, admitted to the intensive care unit of a general hospital. We investigated the effect of propofol administration within 72 h of MVA on outcome. Primary outcome was diagnosis of full or partial PTSD as determined by the Clinician-Administered PTSD Scale (CAPS) at 6 months. Secondary outcomes were diagnosis of full or partial PTSD at 1 month and CAPS score indicating PTSD at 1 and 6 months. Multivariate analysis was conducted adjusting for being female, age, injury severity score (ISS), and administration of ketamine or midazolam within 72 h of MVA. Among 300 patients recruited (mean ISS, 8.0; median Glasgow Coma Scale (GCS) score, 15.0; age, 18 to 69 years), propofol administration showed a higher risk for full or partial PTSD as determined by CAPS at 6 months (odds ratio = 6.13, 95% confidence interval (CI): 1.57 to 23.85, P = 0.009) and at 1 month (odds ratio = 1.31, 95% CI: 0.41 to 4.23, P = 0.647) in the multivariate logistic regression. Multivariate regression analysis showed a trend toward adverse effects of propofol on PTSD symptom development at 6 months after MVA (β = 4.08, 95% CI: -0.49 to 8.64, P = 0.080), but not at 1 month after MVA (β = -0.42, 95% CI: -6.34 to 5.51, P = 0.890). These findings suggest that using propofol in the acute phase after MVA might be associated with the development of PTSD symptoms 6 months later. However, since the design of this study was retrospective, these findings should be interpreted cautiously and further study is warranted.

  • posttraumatic growth posttraumatic stress disorder and resilience of Motor Vehicle Accident survivors
    Biopsychosocial Medicine, 2010
    Co-Authors: Daisuke Nishi, Yutaka Matsuoka, Yoshiharu Kim
    Abstract:

    Background Although some previous studies have suggested that posttraumatic growth (PTG) is comprised of several factors with different properties, few have examined both the association between PTG and posttraumatic stress disorder (PTSD) and between PTG and resilience, focusing on each of the factors of PTG. This study aimed to examine the hypothesis that some factors of PTG, such as personal strength, relate to resilience, whereas other factors, such as appreciation of life, relate to PTSD symptoms among Japanese Motor Vehicle Accident (MVA) survivors.

  • Incidence and prediction of psychiatric morbidity after a Motor Vehicle Accident in Japan: the Tachikawa Cohort of Motor Vehicle Accident Study.
    Critical care medicine, 2008
    Co-Authors: Yutaka Matsuoka, Daisuke Nishi, Satomi Nakajima, Yoshiharu Kim, Masato Homma, Yasuhiro Otomo
    Abstract:

    OBJECTIVES:: To assess both the incidence of new-onset psychiatric illness after involvement in a Motor Vehicle Accident in Japan for comparison with Western data and the predictors of psychiatric morbidity and posttraumatic stress disorder (PTSD) evaluated immediately after the Accident. DESIGN:: Prospective cohort study of injured patients assessed immediately and 4-6 wks after involvement in a Motor Vehicle Accident. SETTING:: Intensive care unit in a teaching hospital in Tokyo, Japan. PATIENTS:: Total of 100 consecutive patients with Motor Vehicle Accident-related injuries (mean Injury Severity Score, 11.2; mean Glasgow Coma Scale, 14.5; age, 18-69 yrs) admitted to the intensive care unit. Patients with traumatic brain injury, suicidality, current psychiatric or neurologic illness, or cognitive impairment were excluded. MEASUREMENTS:: An extensive clinical interview and evaluation of vital signs, sociodemographic variables, previous traumatic events, family history of psychopathology, Impact of Event Scale-Revised, Hospital Anxiety and Depression Scale, Clinician-Administered PTSD Scale, and Mini-International Neuropsychiatric Interview. RESULTS:: A total of 31 patients showed some form of new-onset psychiatric illness at the 4- to 6-wk follow-up. The majority of illnesses consisted of depression (major depression, n = 16; minor depression, n = 7) and PTSD (full PTSD, n = 8; partial PTSD, n = 16). Other illnesses included alcohol dependence (n = 3), obsessive-compulsive disorder (n = 2), agoraphobia (n = 2), and social phobia (n = 1). Both psychiatric morbidity and PTSD were predicted by a sense of life threat (odds ratio, 4.2 and 6.2, respectively), elevated heart rate (odds ratio, 1.6 and 1.7), and higher Impact of Event Scale-Revised intrusion subscale score (odds ratio, 1.1 ands 1.1). CONCLUSION:: This study showed that psychopathology and PTSD after a Motor Vehicle Accident in Japan is common and that the incidence is within the range of that in Western countries. A combination of a sense of life threat, heart rate, and Impact of Event Scale-Revised intrusion subscale allowed for significant prediction of psychiatric morbidity and PTSD. Language: en