Ketamine is a promising treatment for post-traumatic stress disorder (PTSD), but further research is required to extend early findings.

To determine the short-term efficacy and tolerability of intramuscular (i.m.) ketamine compared with i.m. fentanyl for treatment-resistant PTSD symptoms.

We completed a randomised double-blind psychoactive-controlled study with single doses of i.m. racemic ketamine 0.5 mg/kg or 1.0 mg/kg or i.m. fentanyl 50 μg (psychoactive control). Eligible participants were aged between 18 and 50 years old and had treatment-refractory PTSD. The primary efficacy measure was the Impact of Events Scale – Revised (IESR), and tolerability was measured with the Clinician-Administered Dissociative States Scale. Analysis of variance with dose and time as repeated measures was used to assess the effects of drug treatment on total IESR and Clinician-Administered Dissociative States Scale scores.

Thirty-three participants completed the study (26 females, mean age 34.5 years). Ketamine, particularly at 1 mg/kg, was associated with substantially reduced IESR ratings, with some effect remaining after 1 week. Ketamine was also associated with short-term dissociative and cardiovascular effects.

We provide preliminary support for the efficacy and tolerability of i.m. ketamine in a community sample of individuals with PTSD. Further work is required to establish the optimal dosing regimen and longer-term role of ketamine in treatment of PTSD, but our findings are encouraging given the well-known of treatments in this area.

Dissociative disorders frequently co-occur with post-traumatic stress disorder (PTSD), yet many individuals lack adequate treatment. Existing interventions often prioritise reducing arousal over promoting safety and self-soothing, tending to neglect the bodily experience.

This randomised clinical within-person pilot study examined the effects of the nest position, a physiotherapeutic intervention designed to enhance safety and self-soothing, on patients with dissociative disorders and healthy controls (German Clinical Trials Register No.: DRKS00030669).

Eighteen patients with dissociative disorders and 18 healthy controls alternated between the nest position and a neutral supine position across two rounds of a measurement session. The order of the experimental conditions (nest position or supine only) was randomised for each participant. We assessed self-reported distress and comfort (Subjective Units of Distress and Comfort) and autonomic nervous system activity during three baseline phases and imagination of stressful and comforting situations.

Both patients and healthy controls experienced lower distress and greater comfort in the nest position. Heart rate and sympathetic tone decreased, particularly in the healthy controls. There were no significant changes in parasympathetic tone in both groups. Linear mixed models revealed a significant effect of the nest position on distress, comfort and sympathetic tone.

The nest position is a potentially promising additional intervention for highly dissociative patients. Our findings help to better understand the importance of self-soothing and safety in these individuals and to address the research gap in physiotherapy within in-patient mental health care.

We aimed to reveal the psychological effects of old and young individuals after the earthquake by looking at their post-traumatic stress disorder (PTSD) and depression situations.

Data collected by face-to-face survey method were analyzed. The 4 provinces (Hatay, Kahramanmaraş, Adıyaman, and Gaziantep) most affected by the 7.7 and 7.6 magnitude earthquakes centered in Kahramanmaraş, Turkey on February 6, 2023 were included in the study. Peritraumatic distress inventory, impact of events scale, and Beck depression inventory were applied to 300 people (150 old, 150 young).

The presence of peritraumatic stress was observed in 94% (282 people), PTSD symptoms in 90% (270 people) and moderate to severe depression in 36.7% (110 people). When younger were compared with those elders, it was concluded that there was no significant difference in terms of presence of peritraumatic distress (49.6% vs. 50.4%, P=0.627), PTSD (49.6% vs. 50.4%, P=0.620) and moderate to severe depression (45.5% vs. 54.5%, P=0.258).

We found similar rates of PTSD and depression symptoms in older and younger adults exposed to earthquakes. Policies need to be developed to ensure psychological well-being after an earthquake disaster in the adult population regardless of age group.

This study aims to investigate the relationship between post-traumatic stress disorder (PTSD) and job-related stress among nurses working in both central and district areas of Adıyaman following the earthquake. Additionally, we assess potential risk factors influencing both PTSD and job-related stress.

This cross-sectional study involved 332 nurses. The study considered several independent variables, including age, gender, marital status, place of residence, experience of family loss due to the earthquake, and workplace location. The dependent variables for the study were identified as post-traumatic stress disorder and job stress.

Of the nurses surveyed, 69% showed symptoms of post-traumatic stress disorder.

Notably, higher job stress scale scores were identified among women (P = 0.028), married individuals (P = 0.005), those with children (P < 0.001), those who were in Adıyaman during the earthquake (P < 0.001), and those who experienced family loss due to the earthquake (P < 0.001). Furthermore, a significant positive correlation was observed between PTSD scores and job stress scores (r = 0.599; P < 0.001).

Given the bidirectional impact of PTSD and job stress, prompt and comprehensive interventions are essential for safeguarding nurses’ mental health and professional capacity following major events. These interventions should also consider other risk factors, such as female gender or experiencing a family loss.

A minority of earthquake-exposed individuals develop post-traumatic stress disorder (PTSD), often alongside comorbid depression and anxiety symptoms. No systematic review has examined psychological interventions for adults with substantial earthquake-related PTSD symptoms.

To synthesise studies evaluating psychological interventions for adult earthquake-related PTSD and conduct meta-analyses estimating overall effect sizes.

The review was pre-registered with PROSPERO (CRD42023441020). PsycINFO, MEDLINE, EMBASE, CINAHL and Scopus were searched for studies (last search conducted July 2024). Randomised controlled trials (RCTs), non-randomised and non-controlled studies evaluating psychological interventions for adults with substantial earthquake-related PTSD symptoms were eligible. Outcomes were PTSD, depression and anxiety symptoms. Narrative syntheses and meta-analyses summarised study findings. The Mixed Methods Appraisal Tool guided quality assessments.

Sixteen studies were identified (eight RCTs, four non-randomised and four non-controlled studies), representing 1315 participants receiving psychological intervention. Interventions included cognitive behavioural therapy (CBT), specific CBT variants, eye movement desensitisation and reprocessing, interpersonal psychotherapy and an internet-based intervention focusing on social cognitive theory. Studies generally reported statistically and clinically significant improvements associated with psychological interventions. Among studies included in meta-analyses, overall effect size was 2.11 (95% CI = 0.92, 3.31) for PTSD symptoms and 1.01 (95% CI = 0.50, 1.52) for depression symptoms.

Psychological interventions are associated with good outcomes among adults with earthquake-related PTSD. The most evidence currently exists for CBT-based interventions, which are recommended as first-line treatments. Efficient intervention options, including single-session and group-based treatments, also show promise and are recommended for addressing widespread treatment need.

We studied posttraumatic stress symptoms (PTSS) and disorder (PTSD), associated factors, and quality of life (QOL) of a group of passengers (n = 58) affected by the 2023 Odisha train accident, comparing it with health professionals (n = 42) such as doctors and nurses who treated them, and individuals from the local community (n = 65). We also checked the anxiety and depression of passengers.

In a cross-sectional study, we assessed accident experience and used the PTSD checklist, WHO-QOL-BREF, General Anxiety Disorder, and Patient Health Questionnaire scales.

The PTSS were common; specifically, intrusive memories (36.4%), feeling upset while reminded of the experience (33.9%), and avoidance of memories (30.9%). Strong negative feelings, loss of interest, feeling distant, and irritability or anger outbursts were significantly more common among passengers than others. PTSD was present in 20.7% of passengers, 19.0% of health professionals, and 7.7% of local participants. Seeing dead bodies significantly contributed to PTSD. Clinical levels of anxiety (58.3%) and depression (50%) were present in passengers, which were significantly associated with PTSD, along with fear of death. Passengers had the worst QOL and health satisfaction among the groups.

Following the train accident, stress-related psychiatric problems were common and highlighted the intervention needs of the affected people.

Traumatic experiences can trigger post-traumatic stress disorder (PTSD) and influence one’s future perspective, which can change over time with the sense of control.

We measured changes in predictions about the future among individuals who experienced a traumatic event, with or without PTSD, according to their sense of control, and its relationship with post-traumatic change (post-traumatic stress symptom severity, well-being and coping strategies).

Eighty-one exposed individuals (who experienced the 2015 Paris terrorist attacks), some with PTSD, and 71 non-exposed controls (who had not experienced the attacks) were asked to estimate the probable future occurrence of 20 controllable and 20 uncontrollable events, 7–18 and 31–43 months after the attacks. Repeated-measures analysis of variance and correlations were performed to measure inter-group differences in outcomes and relationships with post-traumatic change.

Exposed participants with PTSD and without PTSD estimated uncontrollable future events to be more likely over time. Uncontrollable predictions were related to increases in post-traumatic stress symptom severity for individuals without PTSD. Uncontrollable predictions were not correlated with well-being or coping in exposed individuals.

Over time, exposed individuals provide increasingly high probability ratings for the future occurrence of uncontrollable events, a tendency associated with an increase in post-traumatic stress symptom severity in exposed individuals without PTSD. This may reflect potential delayed PTSD symptoms over time in individuals who did not initially develop PTSD following the attacks. The range of the measurements and the use of a self-constructed questionnaire limit the internal validity of the results.

Post-traumatic stress disorder (PTSD) and hypertension are highly prevalent among Veterans. Cognitive dispersion, indicating within-person variability across neuropsychological measures at one time point, is associated with increased risk of dementia. We examined interactive effects of PTSD symptom severity and hypertension on cognitive dispersion among older Veterans.

We included 128 Vietnam-era Veterans from the Department of Defense-Alzheimer’s Disease Neuroimaging Initiative (DoD-ADNI) with a history of PTSD. Regression models examined interactions between PTSD symptom severity and hypertension on cognitive dispersion (defined as the intraindividual standard deviation across eight cognitive measures) adjusting for demographics and comorbid vascular risk factors.

There was an interaction between PTSD symptom severity and hypertension on cognitive dispersion (p = .026) but not on mean cognitive performance (p = .543). Greater PTSD symptom severity was associated with higher cognitive dispersion among those with hypertension (p = .002), but not among those without hypertension (p = .531). Results remained similar after adjusting for mean cognitive performance.

Findings suggest, among older Veterans with PTSD, those with both hypertension and more severe PTSD symptoms may be at greater risk for cognitive difficulties. Further, cognitive dispersion may be a useful marker of subtle cognitive difficulties. Future research should examine these associations longitudinally and in a diverse sample.

Economic variables such as socioeconomic status and debt are linked with an increased risk of a range of mental health problems and appear to increase the risk of developing of post-traumatic stress disorder (PTSD). Previous research has shown that people living in more deprived areas have more severe symptoms of depression and anxiety after treatment in England’s NHS Talking Therapies services. However, no research has examined if there is a relationship between neighbourhood deprivation and outcomes for PTSD specifically. This study was an audit of existing data from a single NHS Talking Therapies service. The postcodes of 138 service users who had received psychological therapy for PTSD were used to link data from the English Indices of Deprivation. This was analysed with the PCL-5 measure of PTSD symptoms pre- and post-treatment. There was no significant association between neighbourhood deprivation measures on risk of drop-out from therapy for PTSD, number of sessions received or PTSD symptom severity at the start of treatment. However, post-treatment PCL-5 scores were significantly more severe for those living in highly deprived neighbourhoods, with lower estimated income and greater health and disability. There was also a non-significant trend for the same pattern based on employment and crime rates. There was no impact of access to housing and services or living environment. Those living in more deprived neighbourhoods experienced less of a reduction in PTSD symptoms after treatment from NHS Talking Therapies services. Given the small sample size in a single city, this finding needs to be replicated with a larger sample.

1. (1) Previous literature has shown that socioeconomic deprivation increases the risk of a range of mental health problems.

2. (2) Existing research suggests that economic variables such as income and employment are associated with greater incidence of PTSD.

3. (3) In the current study, those living in more deprived areas experienced less of a reduction in PTSD symptoms following psychological therapy through NHS Talking Therapies.

4. (4) The relatively poorer treatment outcomes in the current study are not explained by differences in baseline PTSD severity or drop-out rates, which were not significantly different comparing patients from different socioeconomic strata.

Post-traumatic stress disorder (PTSD) is a mental health condition caused by the dysregulation or overgeneralization of memories related to traumatic events. Investigating the interplay between explicit narrative and implicit emotional memory contributes to a better understanding of the mechanisms underlying PTSD.

This case–control study focused on two groups: unmedicated patients with PTSD and a trauma-exposed control (TEC) group who did not develop PTSD. Experiments included real-time measurements of blood oxygenation changes using functional near-infrared spectroscopy during trauma narration and processing of emotional and linguistic data through natural language processing (NLP).

Real-time fNIRS monitoring showed that PTSD patients (mean [SD] Oxy-Hb activation, 0.153 [0.084], 95% CI 0.124 to 0.182) had significantly higher brain activity in the left anterior medial prefrontal cortex (L-amPFC) within 10 s after expressing negative emotional words compared with the control group (0.047 [0.026], 95% CI 0.038 to 0.056; p < 0.001). In the control group, there was a significant time-series correlation between the use of negative emotional memory words and activation of the L-amPFC (latency 3.82 s, slope = 0.0067, peak value = 0.184, difference = 0.273; Spearman’s r = 0.727, p < 0.001). In contrast, the left anterior cingulate prefrontal cortex of PTSD patients remained in a state of high activation (peak value = 0.153, difference = 0.084) with no apparent latency period.

PTSD patients display overactivity in pathways associated with rapid emotional responses and diminished regulation in cognitive processing areas. Interventions targeting these pathways may alleviate symptoms of PTSD.