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ptsd improvement and incident cardiovascular disease in more than 1000 veterans

JOURNAL OF PSYCHOSOMATIC RESEARCH 2020年第0期134卷 110128-110128页

作者： Scherrer, Jeffrey F. Salas, Joanne Schneider, F. David Friedman, Matthew J. van den Berk-Clark, Carissa Chard, Kathleen M. Norman, Sonya B. Lustman, Patrick J. Tuerk, Peter Schnurr, Paula P. Cohen, Beth E. St Louis Univ Sch Med Dept Family & Community Med St Louis MO 63104 USA Harry S Truman Mem Vet Hosp Columbia MO USA Univ Texas Southwestern Dept Family & Community Med Dallas TX USA Geisel Sch Med Dartmouth Natl Ctr PTSD Hanover NH USA Geisel Sch Med Dartmouth Dept Psychiat Hanover NH USA Univ Cincinnati Trauma Recovery Ctr Cincinnati VAMC Cincinnati OH 45221 USA Univ Cincinnati Dept Psychiat & Behav Neurosci Cincinnati OH 45221 USA Univ Calif San Diego Natl Ctr PTSD San Diego CA 92103 USA Univ Calif San Diego Dept Psychiat San Diego CA 92103 USA Washington Univ Sch Med Dept Psychiat St Louis MO 63110 USA VA St Louis Hlth Care Syst Bell St Clin Opioid Addict Treatment Program St Louis MO USA Univ Virginia Dept Human Serv Sheila C Johnson Ctr Clin Serv Charlottesville VA USA Univ Calif San Diego Sch Med Dept Med La Jolla CA 92093 USA San Francisco VA Med Ctr San Francisco CA USA

Background: Posttraumatic stress disorder (ptsd) is associated with increased risk for cardiovascular disease (CVD). Whether clinically meaningful ptsd improvement is associated with lowering CVD risk is unknown. Methods: Eligible patients (n = 1079), were 30-70 years old, diagnosed with ptsd and used Veterans Health Affairs ptsd specialty clinics. Patients had a ptsd Checklist score (PCL) >= 50 between Fiscal Year (FY) 2008 and FY2012 and a second PCL score within 12 months and at least 8 weeks after the first PCL >= 50. Clinically meaningful ptsd improvement was defined by >= 20 point PCL decrease between the first and second PCL score. Patients were free of CVD diagnoses for 1 year prior to index. Index date was 12 months following the first PCL. Follow-up continued to FY2015. Cox proportional hazard models estimated the association between clinically meaningful ptsd improvement and incident CVD and incident ischemic heart disease (IHD). Sensitivity analysis stratified by age group (30-49 vs. 50-70 years) and depression. Confounding was controlled using propensity scores and inverse probability of exposure weighting. Results: Patients were 48.9 +/- 10.9 years of age on average, 83.3% male, 60.1% white, and 29.5% black. After controlling for confounding, patients with vs. without ptsd improvement did not differ in CVD risk (HR = 1.08;95%CI: 0.72-1.63). Results did not change after stratifying by age group or depression status. Results were similar for incident IHD. Conclusions: Over a 2-7 year follow-up, we did not find an association between clinically meaningful ptsd improvement and incident CVD. Additional research is needed using longer follow-up.

关键词： Posttraumatic stress disorder Psychotherapy Cardiovascular disease Epidemiology Veterans

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Blood-based DNA methylation and exposure risk scores predict ptsd with high accuracy in military and civilian cohorts

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BMC MEDICAL GENOMICS 2024年第1期17卷 235页

作者： Wani, Agaz H. Katrinli, Seyma Zhao, Xiang Daskalakis, Nikolaos P. Zannas, Anthony S. Aiello, Allison E. Baker, Dewleen G. Boks, Marco P. Brick, Leslie A. Chen, Chia-Yen Dalvie, Shareefa Fortier, Catherine Geuze, Elbert Hayes, Jasmeet P. Kessler, Ronald C. King, Anthony P. Koen, Nastassja Liberzon, Israel Lori, Adriana Luykx, Jurjen J. Maihofer, Adam X. Milberg, William Miller, Mark W. Mufford, Mary S. Nugent, Nicole R. Rauch, Sheila Ressler, Kerry J. Risbrough, Victoria B. Rutten, Bart P. F. Stein, Dan J. Stein, Murray B. Ursano, Robert J. Verfaellie, Mieke H. Vermetten, Eric Vinkers, Christiaan H. Ware, Erin B. Wildman, Derek E. Wolf, Erika J. Nievergelt, Caroline M. Logue, Mark W. Smith, Alicia K. Uddin, Monica Univ S Florida Coll Publ Hlth Genom Program Tampa FL 33620 USA Emory Univ Dept Gynecol & Obstet Atlanta GA USA Boston Univ Sch Publ Hlth Dept Biostat Boston MA USA Broad Inst MIT & Harvard Stanley Ctr Psychiat Res Cambridge MA USA Harvard Med Sch Dept Psychiat Boston MA USA McLean Hosp Ctr Excellence Depress & Anxiety Disorders Belmont MA USA Univ North Carolina Chapel Hill Carolina Stress Initiat Chapel Hill NC USA Univ North Carolina Chapel Hill Dept Genet Chapel Hill NC USA Univ North Carolina Chapel Hill Dept Psychiat Chapel Hill NC USA Univ North Carolina Chapel Hill Inst Trauma Recovery Chapel Hill NC USA Columbia Univ Robert N Butler Columbia Aging Ctr Dept Epidemiol New York NY USA Univ Calif San Diego Dept Psychiat La Jolla CA USA Vet Affairs San Diego Healthcare Syst Ctr Excellence Stress & Mental Hlth San Diego CA USA Vet Affairs San Diego Healthcare Syst Psychiat Serv San Diego CA USA Univ Med Ctr Utrecht Dept Psychiat Brain Ctr Utrecht Netherlands Brown Univ Dept Psychiat & Human Behav Warren Alpert Med Sch Providence RI USA Biogen Inc Translat Sci Cambridge MA USA Univ Cape Town Dept Pathol Cape Town Western Provinc South Africa Univ Cape Town Div Human Genet Cape Town Western Provinc South Africa TRACTS GRECC VA Boston Healthcare Syst Boston MA USA Netherlands Minist Def Brain Res & Innovat Ctr Utrecht Netherlands UMC Utrecht Brain Ctr Rudolf Magnus Dept Psychiat Utrecht UT Netherlands Ohio State Univ Dept Psychol Columbus OH USA Harvard Med Sch Dept Hlth Care Policy Boston MA USA Ohio State Univ Inst Behav Med Res Coll Med Columbus OH USA Univ Cape Town Dept Psychiat & Mental Hlth Cape Town Western Provinc South Africa Univ Cape Town Neurosci Inst Cape Town Western Provinc South Africa Univ Cape Town SA MRC Unit Risk & Resilience Mental Disorders Cape Town Western Provinc South Africa Texas A&M Univ Coll Med Dept Psychiat & Behav Sci Bryan TX USA Emory Univ Dept Psychiat & Behav Sci Atlanta GA US

Background Incorporating genomic data into risk prediction has become an increasingly popular approach for rapid identification of individuals most at risk for complex disorders such as ptsd. Our goal was to develop and validate Methylation Risk Scores (MRS) using machine learning to distinguish individuals who have ptsd from those who do not. Methods Elastic Net was used to develop three risk score models using a discovery dataset (n = 1226;314 cases, 912 controls) comprised of 5 diverse cohorts with available blood-derived DNA methylation (DNAm) measured on the Illumina Epic BeadChip. The first risk score, exposure and methylation risk score (eMRS) used cumulative and childhood trauma exposure and DNAm variables;the second, methylation-only risk score (MoRS) was based solely on DNAm data;the third, methylation-only risk scores with adjusted exposure variables (MoRSAE) utilized DNAm data adjusted for the two exposure variables. The potential of these risk scores to predict future ptsd based on pre-deployment data was also assessed. External validation of risk scores was conducted in four independent cohorts. Results The eMRS model showed the highest accuracy (92%), precision (91%), recall (87%), and f1-score (89%) in classifying ptsd using 3730 features. While still highly accurate, the MoRS (accuracy = 89%) using 3728 features and MoRSAE (accuracy = 84%) using 4150 features showed a decline in classification power. eMRS significantly predicted ptsd in one of the four independent cohorts, the BEAR cohort (beta = 0.6839, p=0.006), but not in the remaining three cohorts. Pre-deployment risk scores from all models (eMRS, beta = 1.92;MoRS, beta = 1.99 and MoRSAE, beta = 1.77) displayed a significant (p < 0.001) predictive power for post-deployment ptsd. Conclusion The inclusion of exposure variables adds to the predictive power of MRS. Classification-based MRS may be useful in predicting risk of future ptsd in populations with anticipated trauma exposure. As more data

关键词： DNA methylation Machine learning ptsd Risk scores

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ptsd and epigenetic aging: a longitudinal meta-analysis

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PSYCHOLOGICAL MEDICINE 2025年 55卷 e142-e142页

作者： Zhao, Xiang Katrinli, Seyma McCormick, Beth M. Miller, Mark W. Nugent, Nicole R. Wani, Agaz H. Zannas, Anthony S. Aiello, Allison E. Baker, Dewleen G. Boks, Marco P. Chen, Chia-Yen Fortier, Catherine B. Gelernter, Joel Geuze, Elbert Koenen, Karestan C. Linnstaedt, Sarah D. Luykx, Jurjen J. Maihofer, Adam X. McLean, Samuel A. Milberg, William P. Ratanatharathorn, Andrew Ressler, Kerry J. Risbrough, Victoria B. Rutten, Bart P. F. Smoller, Jordan W. Stein, Murray B. Ursano, Robert J. Vermetten, Eric Vinkers, Christiaan H. Ware, Erin B. Wildman, Derek E. Zhao, Ying Logue, Mark W. Nievergelt, Caroline M. Smith, Alicia K. Uddin, Monica Wolf, Erika J. Boston Univ Sch Publ Hlth Dept Biostat Boston MA USA Emory Univ Dept Gynecol & Obstet Atlanta GA USA Boston Univ Chobanian & Avedisian Sch Med Dept Psychiat Boston MA 02215 USA VA Boston Healthcare Syst Natl Ctr PTSD Boston MA 02130 USA Alpert Brown Med Sch Dept Emergency Med Providence RI USA Alpert Brown Med Sch Dept Pediat Providence RI USA Alpert Brown Med Sch Dept Psychiat & Human Behav Providence RI USA Univ S Florida Coll Publ Hlth Genom Program Tampa FL USA Univ North Carolina Chapel Hill Carolina Stress Initiat Chapel Hill NC USA Univ North Carolina Chapel Hill Dept Genet Chapel Hill NC USA Univ North Carolina Chapel Hill Dept Psychiat Chapel Hill NC USA Univ North Carolina Chapel Hill Inst Trauma Recovery Chapel Hill NC USA Columbia Univ Robert N Butler Columbia Aging Ctr Dept Epidemiol New York NY USA Univ Calif San Diego Dept Psychiat La Jolla CA USA Univ Med Ctr Utrecht Dept Psychiat Utrecht Netherlands Biogen Inc Translat Sci Cambridge MA USA Harvard Med Sch Dept Psychiat Boston MA USA VA Boston Healthcare Syst Geriatr Res Educ & Clin Ctr GRECC Boston MA USA VA Boston Healthcare Syst Translat Res Ctr Traumat Brain Injury & Stress Di Boston MA USA VA Connecticut Healthcare Ctr Psychiat Serv West Haven CT USA Yale Univ Sch Med Dept Genet & Neurosci New Haven CT USA Netherlands Minist Def Brain Res & Innovat Ctr Utrecht Netherlands UMC Utrecht Brain Ctr Rudolf Magnus Dept Psychiat Utrecht Netherlands Broad Inst & Harvard Stanley Ctr Psychiat Res Cambridge MA USA Harvard TH Chan Sch Publ Hlth Dept Epidemiol Boston MA USA Massachusetts Gen Hosp Psychiat & Neurodev Genet Unit PNGU Boston MA USA Univ North Carolina Chapel Hill Dept Anesthesiol Chapel Hill NC USA Univ Amsterdam Med Ctr Amsterdam Neurosci Res Inst Mood AnxietyPsychosis Stress & Sleep Program Amsterdam Netherlands Univ Amsterdam Med Ctr Amsterdam Publ Hlth Res Inst Mental Hlth Program Amsterdam Netherlands Univ Amsterdam Med Ctr Dept Psychiat

Background Posttraumatic stress disorder (ptsd) has been associated with advanced epigenetic age cross-sectionally, but the association between these variables over time is unclear. This study conducted meta-analyses to test whether new-onset ptsd diagnosis and changes in ptsd symptom severity over time were associated with changes in two metrics of epigenetic aging over two time *** We conducted meta-analyses of the association between change in ptsd diagnosis and symptom severity and change in epigenetic age acceleration/deceleration (age-adjusted DNA methylation age residuals as per the Horvath and GrimAge metrics) using data from 7 military and civilian cohorts participating in the Psychiatric Genomics Consortium ptsd Epigenetics Workgroup (total N = 1,367).Results Meta-analysis revealed that the interaction between Time 1 (T1) Horvath age residuals and new-onset ptsd over time was significantly associated with Horvath age residuals at T2 (meta beta = 0.16, meta p = 0.02, p-adj = 0.03). The interaction between T1 Horvath age residuals and changes in ptsd symptom severity over time was significantly related to Horvath age residuals at T2 (meta beta = 0.24, meta p = 0.05). No associations were observed for GrimAge *** Results indicated that individuals who developed new-onset ptsd or showed increased ptsd symptom severity over time evidenced greater epigenetic age acceleration at follow-up than would be expected based on baseline age acceleration. This suggests that ptsd may accelerate biological aging over time and highlights the need for intervention studies to determine if ptsd treatment has a beneficial effect on the aging methylome.

关键词： accelerated aging DNA methylation meta-analysis longitudinal ptsd

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Childhood adversities and risk of posttraumatic stress disorder and major depression following a motor vehicle collision in adulthood

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EPIDEMIOLOGY AND PSYCHIATRIC SCIENCES 2023年 32卷 e1-e1页

作者： Ziobrowski, H. N. Holt-Gosselin, B. Petukhova, M. V. King, A. J. Lee, S. House, S. L. Beaudoin, F. L. An, X. Stevens, J. S. Zeng, D. Neylan, T. C. Clifford, G. D. Linnstaedt, S. D. Germine, L. T. Bollen, K. A. Rauch, S. L. Haran, J. P. Storrow, A. B. Lewandowski, C. Musey, P. I. Hendry, P. L. Sheikh, S. Jones, C. W. Punches, B. E. Kurz, M. C. Swor, R. A. Hudak, L. A. Pascual, J. L. Seamon, M. J. Harris, E. Pearson, C. Merchant, R. C. Domeier, R. M. Rathlev, N. K. O'Neil, B. J. Sergot, P. Sanchez, L. D. Bruce, S. E. Miller, M. W. Pietrzak, R. H. Joormann, J. Barch, D. M. Pizzagalli, D. A. Harte, S. E. Elliott, J. M. Ressler, K. J. McLean, S. A. Koenen, K. C. Kessler, R. C. Harvard Med Sch Dept Hlth Care Policy Boston MA 02115 USA Yale Univ Dept Psychol New Haven CT USA Yale Sch Med Interdept Neurosci Grad Program New Haven CT USA Washington Univ Sch Med Dept Emergency Med St Louis MO USA Brown Univ Rhode Isl Hosp Alpert Med Sch Dept Emergency Med Providence RI USA Brown Univ Rhode Isl Hosp Alpert Med Sch Dept Hlth Serv Policy & Practice Providence RI USA Miriam Hosp Providence RI USA Univ N Carolina Inst Trauma Recovery Dept Anesthesiol Chapel Hill NC USA Emory Univ Sch Med Dept Psychiat & Behav Sci Atlanta GA USA Northwestern Univ Feinberg Sch Med Phys Therapy & Human Movement Sci Feinberg Chicago IL USA Univ N Carolina Dept Emergency Med Chapel Hill NC USA Univ N Carolina Inst Trauma Recovery Dept Psychiat Chapel Hill NC USA Harvard Univ Harvard TH Chan Sch Publ Hlth Dept Epidemiol Boston MA USA Emory Univ Atlanta GA USA McLean Hosp Inst Technol Psychiat Belmont MA USA Many Brains Project Belmont MA USA Harvard Med Sch Dept Psychiat Boston MA USA Univ N Carolina Dept Psychol & Neurosci Chapel Hill NC USA Univ N Carolina Dept Sociol Chapel Hill NC USA McLean Hosp Dept Psychiat Belmont MA USA Univ Massachusetts Chan Med Sch Dept Emergency Med Worcester MA USA Vanderbilt Univ Sch Med Dept Emergency Med Nashville TN USA Henry Ford Hlth Syst Dept Emergency Med Detroit MI USA Indiana Univ Sch Med Dept Emergency Med Indianapolis IN USA Univ Florida Coll Med Jacksonville Dept Emergency Med Jacksonville FL USA Rowan Univ Cooper Med Sch Dept Emergency Med Camden NJ USA Ohio State Univ Coll Med Dept Emergency Med Columbus OH USA Ohio State Univ Coll Nursing Columbus OH USA Univ Alabama Birmingham Sch Med Dept Emergency Med Birmingham AL USA Univ Alabama Birmingham Sch Med Dept Surg Div Acute Care Surg Birmingham AL USA Univ Alabama Birmingham Ctr Injury Sci Birmingham AL USA Oakland Univ William Beaumont Sch Med Dept Emergency Med Rochester MI USA Emory Univ Sch Med Dept Emergen

AimsChildhood adversities (CAs) predict heightened risks of posttraumatic stress disorder (ptsd) and major depressive episode (MDE) among people exposed to adult traumatic events. Identifying which CAs put individuals at greatest risk for these adverse posttraumatic neuropsychiatric sequelae (APNS) is important for targeting prevention interventions. MethodsData came from n = 999 patients ages 18-75 presenting to 29 U.S. emergency departments after a motor vehicle collision (MVC) and followed for 3 months, the amount of time traditionally used to define chronic ptsd, in the Advancing Understanding of Recovery After trauma (AURORA) study. Six CA types were self-reported at baseline: physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect and bullying. Both dichotomous measures of ever experiencing each CA type and numeric measures of exposure frequency were included in the analysis. Risk ratios (RRs) of these CA measures as well as complex interactions among these measures were examined as predictors of APNS 3 months post-MVC. APNS was defined as meeting self-reported criteria for either ptsd based on the ptsd Checklist for DSM-5 and/or MDE based on the PROMIS Depression Short-Form 8b. We controlled for pre-MVC lifetime histories of ptsd and MDE. We also examined mediating effects through peritraumatic symptoms assessed in the emergency department and ptsd and MDE assessed in 2-week and 8-week follow-up surveys. Analyses were carried out with robust Poisson regression models. ResultsMost participants (90.9%) reported at least rarely having experienced some CA. Ever experiencing each CA other than emotional neglect was univariably associated with 3-month APNS (RRs = 1.31-1.60). Each CA frequency was also univariably associated with 3-month APNS (RRs = 1.65-2.45). In multivariable models, joint associations of CAs with 3-month APNS were additive, with frequency of emotional abuse (RR = 2.03;95% CI = 1.43-2.87) and bullying (RR = 1.44;95% CI =

关键词： Depression mental health post traumatic stress disorder trauma

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Cell-type-specific and inflammatory DNA methylation patterns associated with ptsd

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BRAIN BEHAVIOR AND IMMUNITY 2025年 128卷 540-548页

作者： Smith, Alicia K. Katrinli, Seyma Maihofer, Adam X. Aiello, Allison E. Baker, Dewleen G. Boks, Marco P. Brick, Leslie A. Chen, Chia-Yen Dalvie, Shareefa Fani, Negar Fortier, Catherine B. Gelernter, Joel Geuze, Elbert Gillespie, Charles F. Hayes, Jasmeet P. Hong, Suzi Kessler, Ronald C. King, Anthony P. Koen, Nastassja Koenen, Karestan C. Liberzon, Israel Linnstaedt, Sarah D. Mclean, Samuel A. Michopoulos, Vasiliki Milberg, William P. Miller, Mark W. Mufford, Mary S. Nugent, Nicole R. Orcutt, Holly K. Powers, Abigail Rauch, Sheila A. M. Ressler, Kerry J. Risbrough, Victoria B. Rutten, Bart P. F. Smoller, Jordan W. Stein, Dan J. Stein, Murray B. Ursano, Robert J. Verfaellie, Mieke H. Vermetten, Eric Vinkers, Christiaan H. Wani, Agaz H. Warevinkers, Erin B. Wildman, Derek E. Wolf, Erika J. Zhao, Ying Logue, Mark W. Nievergelt, Caroline M. Uddin, Monica Zannas, Anthony S. Emory Univ Dept Gynecol & Obstet Atlanta GA USA Emory Univ Dept Human Genet Atlanta GA USA Emory Univ Dept Psychiat & Behav Sci Atlanta GA USA Univ Calif San Diego Dept Psychiat La Jolla CA USA Vet Affairs San Diego Healthcare Syst Ctr Excellence Stress & Mental Hlth San Diego CA USA Vet Affairs San Diego Healthcare Syst Res Serv San Diego CA USA Columbia Univ Robert N Butler Columbia Aging Ctr Dept Epidemiol New York NY USA Amsterdam UMC Dept Psychiat Amsterdam Netherlands Dimence Specialised Mental Hlth Mood Disorders Deventer OV Netherlands Univ Med Ctr Utrecht Dept Psychiat Netherland Utrecht UT Netherlands Brown Univ Alpert Med Sch Dept Psychiat & Human Behav Providence RI USA Biogen Inc Translat Med Cambridge MA USA Univ Cape Town Div Human Genet Cape Town Western Provinc South Africa Harvard Med Sch Dept Psychiat Boston MA USA VA Boston Healthcare Syst Geriatr Res Educ & Clin Ctr GRECC Boston MA USA VA Boston Healthcare Syst Translat Res Ctr Traumat Brain Injury & Stress Dis Boston MA USA VA Connecticut Healthcare Ctr Psychiat Serv West Haven CT USA Yale Univ Sch Med Dept Psychiat New Haven CT USA Yale Univ Sch Med Dept Genet & Neurosci New Haven CT USA Netherlands Minist Def Brain Res & Innovat Ctr Utrecht UT Netherlands UMC Utrecht Brain Ctr Rudolf Magnus Dept Psychiat Utrecht UT Netherlands Ohio State Univ Dept Psychol Columbus OH USA Univ Calif San Diego Herbert Wertheim Sch Publ Hlth & Human Longev Sci La Jolla CA USA Harvard Med Sch Dept Hlth Care Policy Boston MA USA Ohio State Univ Inst Behav Med Res Coll Med Columbus OH USA Ohio State Univ Coll Med Psychiat & Behav Hlth Columbus OH USA Univ Cape Town Dept Psychiat & Mental Hlth Cape Town Western Provinc South Africa Univ Cape Town Neurosci Inst Cape Town Western Provinc South Africa Univ Cape Town SA MRC Unit Risk & Resilience Mental Disorders Cape Town Western Provinc South Africa Broad Inst MIT & Harvard Stanley Ctr Psychiat Res Cambridge MA U

Background: Epigenetic modifications, including DNA methylation (DNAm), can change in response to traumatic stress exposure, and may help to distinguish between individuals with and without ptsd. Here, we examine the DNAm patterns specific to immune cell types and inflammation in those with ptsd. Methods: This study includes 3,277 participants from 11 cohorts participating in the Psychiatric Genomics Consortium (PGC) ptsd Epigenetics Workgroup. DNAm was assayed from blood with the MethylationEPIC BeadChip. A standardized QC pipeline was applied and used to impute cell composition. Within each cohort, we identified cell-type-specific DNAm patterns associated with ptsd, controlling for sex (if applicable), age, and ancestry. Meta-analyses were performed from summary statistics. Results: ptsd cases had lower proportions of B cells and NK cells as well as higher proportions of neutrophils when compared to trauma-exposed controls. Overall, we identified 96 ptsd-associated CpGs across six types of immune cells. Most of these differences were identified in B cells, with 95 % exhibiting lower methylation levels in those with ptsd. Interestingly, the ptsd-associated CpGs annotated to a gene in B cells were enriched in a recent GWAS of ptsd (p < 0.0001). Conclusions: This study identifies novel ptsd-associated CpGs in individual immune cell types and supports the role of immune dysregulation and inflammation in ptsd.

关键词： ptsd trauma Inflammation CRP B-cells Immune EWAS DNA methylation

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Alcohol use and alcohol use disorder differ in their genetic relationships with ptsd: A genomic structural equation modelling approach

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DRUG AND ALCOHOL DEPENDENCE 2022年第0期234卷 1页

作者： Bountress, Kaitlin E. Brick, Leslie A. Sheerin, Christina Grotzinger, Andrew Bustamante, Daniel Hawn, Sage E. Gillespie, Nathan Kirkpatrick, Robert M. Kranzler, Henry Morey, Rajendra Edenberg, Howard J. Maihofer, Adam X. Disner, Seth Ashley-Koch, Allison Peterson, Roseann Lori, Adriana Stein, Dan J. Kimbrel, Nathan Nievergel, Caroline Andreassen, Ole A. Luykx, Jurjen Javanbakht, Arash Youssef, Nagy A. Amstadter, Ananda B. Virginia Commonwealth Univ Virginia Inst Psychiat & Behav Genet Richmond VA 23284 USA Brown Univ Dept Psychiat & Human Behav Quantitat Sci Program Alpert Med Sch Providence RI 02912 USA Univ Colorado Inst Behav Genet Behav Psychiat & Stat Genet Boulder CO USA Virginia Commonwealth Univ Integrat Life Sci Doctoral Program Richmond VA 23284 USA VA Boston Healthcare Syst Natl Ctr PTSD Boston MA USA Boston Univ Sch Med Dept Psychiat Boston MA USA Univ Penn Sch Med Dept Psychiat Perelman Sch Med Philadelphia PA 19104 USA Crescenz Vet Affairs Med Ctr Educ & Clin Ctr Mental Illness Res Philadelphia PA USA Durham VAMC VA Mid Atlantic Mental Illness Res Educ & Clin Ct Durham NC USA Duke Univ Dept Psychiat & Behav Sci Durham NC USA Duke Univ Duke UNC Brain Imaging & Anal Ctr Durham NC USA Indiana Univ Sch Med Dept Biochem & Mol Biol Indianapolis IN 46202 USA Indiana Univ Sch Med Dept Med & Mol Genet Indianapolis IN 46202 USA Univ Calif San Diego Dept Psychiat San Diego CA 92103 USA Vet Affairs San Diego Healthcare Syst Ctr Excellence Stress & Mental Hlth San Diego CA USA Minneapolis VA Hlth Care Syst Minneapolis MN USA Univ Minnesota Dept Psychiat & Behav Sci Med Sch Minneapolis MN USA Duke Univ Duke Mol Physiol Inst Med Ctr Durham NC USA Emory Univ Dept Psychiat & Behav Sci Atlanta GA 30322 USA Univ Cape Town Dept Psychiat Cape Town South Africa Univ Cape Town Neurosci Inst Cape Town South Africa Univ Oslo Inst Clin Med NORMENT Oslo Norway Oslo Univ Hosp Div Mental Hlth & Addict Oslo Norway Maastricht Univ Sch Mental Hlth & Neurosci Dept Psychiat & Neuropsychol Maastricht Med Ctr Maastricht Netherlands Univ Utrecht Univ Med Ctr Utrecht Dept Psychiat Utrecht UMC Utrecht Brain Ctr Utrecht Netherlands GGNet Mental Hlth Outpatient Second Opin Clin Warnsveld Netherlands Wayne State Univ Dept Psychiat & Behav Neurosci Stress Trauma & Anxiety Res Clin STARC Detroit MI 48207 USA Ohio State Univ Dept Psychiat & Behav Hlth Columbus OH 4

Purpose: Posttraumatic Stress Disorder (ptsd) is associated with increased alcohol use and alcohol use disorder (AUD), which are all moderately heritable. Studies suggest the genetic association between ptsd and alcohol use differs from that of ptsd and AUD, but further analysis is needed. Basic procedures: We used genomic Structural Equation Modeling (genomicSEM) to analyze summary statistics from large-scale genome-wide association studies (GWAS) of European Ancestry participants to investigate the genetic relationships between ptsd (both diagnosis and re-experiencing symptom severity) and a range of alcohol use and AUD phenotypes. Main findings: When we differentiated genetic factors for alcohol use and AUD we observed improved model fit relative to models with all alcohol-related indicators loading onto a single factor. The genetic correlations (rG) of ptsd were quite discrepant for the alcohol use and AUD factors. This was true when modeled as a threecorrelated-factor model (ptsd-AUD rG:.36, p <.001;ptsd-alcohol use rG: 0.17, p <.001) and as a Bifactor model, in which the common and unique portions of alcohol phenotypes were pulled out into an AUD-specific factor (rG with ptsd:.40, p <.001), AU-specific factor (rG with ptsd: 0.57, p <.001), and a common alcohol factor (rG with ptsd:.16, NS). Principal conclusions: These results indicate the genetic architecture of alcohol use and AUD are differentially associated with ptsd. When the portions of variance unique to alcohol use and AUD are extracted, their genetic associations with ptsd vary substantially, suggesting different genetic architectures of alcohol phenotypes in people with ptsd.

关键词： Genomic structural equation modeling (genomicSEM) Posttraumatic stress disorder (ptsd) Alcohol use Alcohol use disorder Genetic correlation Genetic architecture

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Resilience to traumatic events related to urban violence and increased IL10 serum levels

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PSYCHIATRY RESEARCH 2017年 250卷 136-140页

作者： Teche, Stefania P. Rovaris, Diego L. Aguiar, Bianca W. Hauck, Simone Vitola, Eduardo S. Bau, Claiton H. D. Freitas, Lucia H. Grevet, Eugenio H. Univ Fed Rio Grande do Sul PostGrad Program Psychiat & Behav Sci BR-90046900 Porto Alegre RS Brazil Univ Fed Rio Grande do Sul Fac Med FAMED Dept Psychiat BR-90046900 Porto Alegre RS Brazil Univ Fed Rio Grande do Sul Inst Biociencias Dept Genet Porto Alegre RS Brazil Hosp Clin Porto Alegre PTSD Outpatient Program NET Trauma Porto Alegre RS Brazil

The exposition to traumatic events related to urban violence is epidemic in Brazil, with rate of 80% in the general population, and is becoming a major cause of post-traumatic stress disorder (ptsd). The objective of the study was to compare serum levels of pro-inflammatory interleukin-6 (IL-6) and anti-inflammatory interleukin-10 (IL-10) in ptsd and resilient individuals. We hypothesized that resilient individuals present an attenuated pro-inflammatory and enhanced anti-inflammatory state. We conducted a case-control study comparing 30 resilient individuals and 30 ptsd patients exposed to traumatic events related to urban violence. The groups were evaluated using Self-Report Questionnaire (SRQ-20), Mini-International Neuropsychiatric Interview (MINI) and the Davidson trauma Scale. For all individuals, blood samples were collected to determine IL-6, IL-10 and cortisol serum levels. All samples were frozen at -80 degrees C until the assay and were analyzed with the same immunoassay kit and in duplicates. The resilient group presented higher IL-10 levels than ptsd patients [mean (CI95%);1.03 (0.52-2.08) pg/mL vs. 0.29 (0.20-0.43) pg/mL;P=0.002]. There were no differences in terms of IL-6 or cortisol levels. The results provided evidence for increased levels of IL-10 in resilient individuals when compared to ptsd patients, probably conferring them a better anti-inflammatory response after exposition.

关键词： ptsd Resilience Urban violence IL-6 IL-10 Low- or middle-income country

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Prevalence of post-traumatic stress disorder symptoms in adult critical care survivors: a systematic review and meta-analysis

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CRITICAL CARE 2019年第1期23卷 213-213页

作者： Righy, Cassia Rosa, Regis Goulart Amancio da Silva, Rodrigo Teixeira Kochhann, Renata Migliavaca, Celina Borges Robinson, Caroline Cabral Teche, Stefania Pigatto Teixeira, Cassiano Bozza, Fernando Augusto Falavigna, Maicon Fundacao Oswaldo Cruz Inst Nacl Infectol Evandro Chagas Ave Brasil 4365 BR-21040360 Rio De Janeiro RJ Brazil Inst Estadual Cerebro Paulo Niemeyer Rua Rezende 156 BR-20230026 Rio De Janeiro RJ Brazil HMV Intens Care Unit Rua Ramiro Barcelos 9103 Andar BR-90035001 Porto Alegre RS Brazil HMV Res Projects Off Porto Rua Ramiro Barcelos 9103 Andar BR-90035001 Porto Alegre RS Brazil Hosp Fed Servidores Estado Rua Sacadura Cabral 178 BR-20221903 Rio De Janeiro RJ Brazil Univ Fed Rio Grande do Sul Natl Inst Hlth Technol Assessment Ave Paulo Gama 110 BR-90040060 Porto Alegre RS Brazil Univ Fed Rio Grande do Sul Postgrad Program Psychiat & Behav Sci Porto Alegre RS Brazil Hosp Clin Porto Alegre PTSD Outpatient Program NET Trauma Porto Alegre RS Brazil DOr Inst Res & Educ Rua Diniz Cordeiro 30 BR-22281100 Rio De Janeiro RJ Brazil

BackgroundAs more patients are surviving intensive care, mental health concerns in survivors have become a research priority. Among these, post-traumatic stress disorder (ptsd) can have an important impact on the quality of life of critical care survivors. However, data on its burden are conflicting. Therefore, this systematic review and meta-analysis aimed to evaluate the prevalence of ptsd symptoms in adult critical care patients after intensive care unit (ICU) *** searched MEDLINE, EMBASE, LILACS, Web of Science, PsycNET, and Scopus databases from inception to September 2018. We included observational studies assessing the prevalence of ptsd symptoms in adult critical care survivors. Two reviewers independently screened studies and extracted data. Studies were meta-analyzed using a random-effects model to estimate ptsd symptom prevalence at different time points, also estimating confidence and prediction intervals. Subgroup and meta-regression analyses were performed to explore heterogeneity. Risk of bias was assessed using the Joanna Briggs Institute tool and the GRADE *** 13,267 studies retrieved, 48 were included in this review. Overall prevalence of ptsd symptoms was 19.83% (95% confidence interval [CI], 16.72-23.13;I-2=90%, low quality of evidence). Prevalence varied widely across studies, with a wide range of expected prevalence (from 3.70 to 43.73% in 95% of settings). Point prevalence estimates were 15.93% (95% CI, 11.15-21.35;I-2=90%;17 studies), 16.80% (95% CI, 13.74-20.09;I-2=66%;13 studies), 18.96% (95% CI, 14.28-24.12;I-2=92%;13 studies), and 20.21% (95% CI, 13.79-27.44;I-2=58%;7 studies) at 3, 6, 12, and >12months after discharge, *** symptoms may affect 1 in every 5 adult critical care survivors, with a high expected prevalence 12months after discharge. ICU survivors should be screened for ptsd symptoms and cared for accordingly, given the potential negative impact of ptsd on quality of life. I

关键词： Critical care Intensive care units Meta-analysis Post-traumatic stress disorder Prevalence Systematic review

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Expanding the concept of shared decision making for mental health: systematic search and scoping review of interventions

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MENTAL HEALTH REVIEW JOURNAL 2017年第3期22卷 191-213页

作者： Zisman-Ilani, Yaara Barnett, Erin Harik, Juliette Pavlo, Anthony O'Connell, Maria Temple Univ Coll Publ Hlth Dept Rehabil Sci Philadelphia PA 19122 USA Dartmouth Hitchcock Med Ctr Geisel Sch Med Dartmouth Trauma Intervent Res Ctr Lebanon NH 03766 USA Natl Ctr PTSD White River Jct VT USA Geisel Sch Med Lebanon NH USA Yale Univ Program Recovery & Community Hlth New Haven CT USA Yale Univ New Haven CT USA

Purpose - Much of the existing literature on shared decision making (SDM) in mental health has focused on the use of decision aids (DAs). However, DAs tend to focus on information exchange and neglect other essential elements to SDM in mental health. The purpose of this paper is to expand the review of SDM interventions in mental health by identifying important components, in addition to information exchange, that may contribute to the SDM process in mental health. Design/methodology/approach - The authors conducted a systematic literature search using the Ovid-Medline database with supplementary scoping search of the literature on SDM in mental health treatment. To be eligible for inclusion, studies needed to describe (in a conceptual work or development paper) or evaluate (in any type of research design) a SDM intervention in mental health. The authors included studies of participants with a mental illness facing a mental health care decision, their caregivers, and providers. Findings - A final sample of 31 records was systematically selected. Most interventions were developed and/or piloted in the USA for adults in community psychiatric settings. Although information exchange was a central component of the identified studies, important additional elements were: eliciting patient preferences and values, providing patient communication skills training, eliciting shared care planning, facilitating patient motivation, and eliciting patient participation in goal setting. Originality/value - The review indicates that additional elements, other than information exchange such as sufficient rapport and trusting relationships, are important and needed as part of SDM in mental health. Future SDM interventions in mental health could consider including techniques that aim to increase patient involvement in activities such as goal settings, values, and preference clarification, or facilitating patient motivation, before and after presenting treatment options.

关键词： Intervention Psychiatry Mental health Decision aid Shared decision making

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Cortical volume abnormalities in posttraumatic stress disorder: an ENIGMA-psychiatric genomics consortium ptsd workgroup mega-analysis

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MOLECULAR PSYCHIATRY 2021年第8期26卷 4331-4343页

作者： Wang, Xin Xie, Hong Chen, Tian Cotton, Andrew S. Salminen, Lauren E. Logue, Mark W. Clarke-Rubright, Emily K. Wall, John Dennis, Emily L. O'Leary, Brian M. Abdallah, Chadi G. Andrew, Elpiniki Baugh, Lee A. Bomyea, Jessica Bruce, Steven E. Bryant, Richard Choi, Kyle Daniels, Judith K. Davenport, Nicholas D. Davidson, Richard J. DeBellis, Michael DeRoon-Cassini, Terri Disner, Seth G. Fani, Negar Fercho, Kelene A. Fitzgerald, Jacklynn Forster, Gina L. Frijling, Jessie L. Geuze, Elbert Gomaa, Hassaan Gordon, Evan M. Grupe, Dan Harpaz-Rotem, Ilan Haswell, Courtney C. Herzog, Julia I. Hofmann, David Hollifield, Michael Hosseini, Bobak Hudson, Anna R. Ipser, Jonathan Jahanshad, Neda Jovanovic, Tanja Kaufman, Milissa L. King, Anthony P. Koch, Saskia B. J. Koerte, Inga K. Korgaonkar, Mayuresh S. Krystal, John H. Larson, Christine Lebois, Lauren A. M. Levy, Ifat Li, Gen Magnotta, Vincent A. Manthey, Antje May, Geoffrey McLaughlin, Katie A. Mueller, Sven C. Nawijn, Laura Nelson, Steven M. Neria, Yuval Nitschke, Jack B. Olff, Miranda Olson, Elizabeth A. Peverill, Matthew Luan Phan, K. Rashid, Faisal M. Ressler, Kerry Rosso, Isabelle M. Sambrook, Kelly Schmahl, Christian Shenton, Martha E. Sierk, Anika Simons, Jeffrey S. Simons, Raluca M. Sponheim, Scott R. Stein, Murray B. Stein, Dan J. Stevens, Jennifer S. Straube, Thomas Suarez-Jimenez, Benjamin Tamburrino, Marijo Thomopoulos, Sophia I. van der Wee, Nic J. A. van der Werff, Steven J. A. van Erp, Theo G. M. van Rooij, Sanne J. H. van Zuiden, Mirjam Varkevisser, Tim Veltman, Dick J. Vermeiren, Robert R. J. M. Walter, Henrik Wang, Li Zhu, Ye Zhu, Xi Thompson, Paul M. Morey, Rajendra A. Liberzon, Israel Univ Toledo Dept Psychiat 2801 W Bancroft St Toledo OH 43606 USA Univ Toledo Dept Neurosci 2801 W Bancroft St Toledo OH 43606 USA Univ Toledo Dept Math & Stat 2801 W Bancroft St Toledo OH 43606 USA Univ Southern Calif Keck Sch Med Imaging Genet Ctr Mark & Mary Stevens Neuroimaging & Informat Inst Marina Del Rey CA USA VA Boston Healthcare Syst Natl Ctr PTSD Boston MA USA Boston Univ Dept Psychiat Sch Med Boston MA 02215 USA Duke Univ Brain Imaging & Anal Ctr Durham NC USA Durham VA Hlth Care Syst VISN 6 MIRECC Durham NC USA Univ Utah Dept Neurol Salt Lake City UT USA VA Connecticut Healthcare Syst Natl Ctr PTSD Clin Neurosci Div West Haven CT USA Yale Univ Dept Psychiat Sch Med New Haven CT USA Univ Sydney Westmead NSW Australia Univ South Dakota Sanford Sch Med Div Basic BioMed Sci Vermillion SD USA Univ South Dakota Ctr Brain & Behav Res Vermillion SD USA Sioux Falls VA Hlth Care Syst Sioux Falls SD USA VA San Diego Healthcare Syst Ctr Excellence Stress & Mental Hlth San Diego CA USA Univ Calif San Diego Dept Psychiat La Jolla CA 92093 USA Univ Missouri Ctr Trauma Recovery Dept Psychol Sci St Louis MO USA Univ New South Wales Sch Psychol Sydney NSW Australia Univ Calif San Diego Hlth Serv Res Ctr La Jolla CA 92093 USA Univ Groningen Dept Clin Psychol Groningen Netherlands Minneapolis VA Hlth Care Syst Minneapolis MN USA Univ Minnesota Dept Psychiat & Behav Sci Minneapolis MN USA Univ Wisconsin Ctr Hlth Minds Madison WI USA Univ Wisconsin Dept Psychol 1202 W Johnson St Madison WI 53706 USA Univ Wisconsin Dept Psychiat Madison WI 53706 USA Duke Univ Dept Psychiat & Behav Sci Durham NC USA Med Coll Wisconsin Dept Surg Div Trauma & Acute Care Surg Milwaukee WI USA Emory Univ Dept Psychiat & Behav Sci Sch Med Atlanta GA 30322 USA US Fed Avit Adm Civil Aerosp Med Inst Oklahoma City OK USA Marquette Univ Dept Psychol Milwaukee WI 53233 USA Univ Otago Brain Hlth Res Ctr Dept Anat Dunedin New Zealand Univ Amsterd

Studies of posttraumatic stress disorder (ptsd) report volume abnormalities in multiple regions of the cerebral cortex. However, findings for many regions, particularly regions outside commonly studied emotion-related prefrontal, insular, and limbic regions, are inconsistent and tentative. Also, few studies address the possibility that ptsd abnormalities may be confounded by comorbid depression. A mega-analysis investigating all cortical regions in a large sample of ptsd and control subjects can potentially provide new insight into these issues. Given this perspective, our group aggregated regional volumes data of 68 cortical regions across both hemispheres from 1379 ptsd patients to 2192 controls without ptsd after data were processed by 32 international laboratories using ENIGMA standardized procedures. We examined whether regional cortical volumes were different in ptsd vs. controls, were associated with posttraumatic stress symptom (PTSS) severity, or were affected by comorbid depression. Volumes of left and right lateral orbitofrontal gyri (LOFG), left superior temporal gyrus, and right insular, lingual and superior parietal gyri were significantly smaller, on average, in ptsd patients than controls (standardized coefficients = -0.111 to -0.068, FDR corrected P values < 0.039) and were significantly negatively correlated with PTSS severity. After adjusting for depression symptoms, the ptsd findings in left and right LOFG remained significant. These findings indicate that cortical volumes in ptsd patients are smaller in prefrontal regulatory regions, as well as in broader emotion and sensory processing cortical regions.

关键词： Neuroscience Psychiatric disorders Psychology Medicine/Public Health general Psychiatry Neurosciences Behavioral Sciences Pharmacotherapy Biological Psychology

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