Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Combat Disorders”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed1988

The interrelationship of substance abuse and posttraumatic stress disorder. Epidemiological and clinical considerations.

This chapter reviews the data available on the relationship of substance abuse and posttraumatic stress disorder (PTSD). Delimiting the review to those studies of Vietnam veterans, we found that levels of combat exposure seemed to be positively related to subsequent alcohol use, although not all studies confirmed this relationship. When studies of patients seeking treatment for PTSD were examined, we learned that 60-80% of these patients had concurrent diagnoses of substance abuse, alcohol abuse, or dependence. Methodological limitations of all the studies are discussed and conclusions regarding the status of the PTSD-substance abuse relationship are drawn cautiously. Alternative suggestions for treatment are presented and discussed.

Alcoholism↗
PubMed2004

A placebo-controlled study of nefazodone for the treatment of chronic posttraumatic stress disorder: a preliminary study.

Nefazodone is a unique serotonergic antidepressant that acts as both a presynaptic serotonin reuptake inhibitor and a postsynaptic 5-hydroxytryptamine 2A receptor antagonist. Based on the positive results of open-label trials of nefazodone, including one from our group, we tested nefazodone's efficacy in the treatment of posttraumatic stress disorder (PTSD) under placebo-controlled conditions. Forty-one patients with chronic PTSD, predominantly male combat veterans, were enrolled in a randomized, double-blind, placebo-controlled 12-week trial of nefazodone. The primary outcome measure was the Clinician-Administered PTSD Scale. Fifteen patients were randomized to placebo and 26 were randomized to nefazodone. In a repeated-measures analysis of variance with last observation carried forward, patients on nefazodone showed a significant improvement in the percentage change of Clinician-Administered PTSD Scale Total score from baseline compared with those on placebo (P = 0.04; effect size = 0.6). Sample size was not powered to test group differences in the Clinician-Administered PTSD Scale criterion B, C, or D subscale. However, the criterion D subscale showed significant improvement in patients treated with nefazodone compared with those treated with placebo (P = 0.007). In addition, the Hamilton Rating Scale for Depression showed significant improvement compared with placebo (P = 0.008). The nefazodone group also reported an improvement on the PTSD Checklist (self-report scale; P = 0.08) and the Clinician-Administered Dissociative States Scale (P = 0.06). This pilot study supports the efficacy of nefazodone for the treatment of PTSD. However, larger placebo-controlled studies in more diverse patient population are warranted.

Adult↗
PubMed2006

Aripiprazole in the management of post-traumatic stress disorder symptoms in returning Global War on Terrorism veterans.

The present study illustrates the potential use of aripiprazole as part of the management of post-traumatic stress disorder (PTSD) in returning Global War on Terrorism (GWOT) veterans. Five consecutive cases of GWOT combat-related PTSD, managed in part with the atypical antipsychotic medication aripiprazole, are presented and discussed. In four of the five cases reported, the medication was well-tolerated and was effective in the management of sleep disturbances, such as nightmares and agitated behaviours during sleep, and was also helpful in the management of hyper-arousal. In one case, the veteran experienced a paradoxical excitation response to the medication. Aripiprazole, in conjunction with other medications or psychotherapeutic interventions, should be studied further for its potential role in the management of PTSD.

Adult↗
PubMed2002

Fluoxetine versus placebo in posttraumatic stress disorder.

BACKGROUND: This study was designed to address the efficacy and tolerability of fluoxetine in patients with posttraumatic stress disorder (PTSD) as diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders and the Clinician-Administered PTSD Scale (CAPS). The patient population included both civilians and combat veterans. METHOD: This was a double-blind, randomized, placebo-controlled study conducted in Europe, Israel, and South Africa, primarily in war-torn countries. Patients were predominantly male (81%) and white (91%), with 48% exposed to a combat-related traumatic episode. Patients were randomly assigned to 12 weeks of acute treatment with fluoxetine, 20 to 80 mg/day (N = 226), or placebo (N = 75). The primary efficacy measurement was the mean change from baseline in the Treatment Outcome PTSD rating scale (TOP-8) total score, which was analyzed using a repeated-measures analysis of variance. Secondary assessments included the CAPS, the Davidson Trauma Scale, the Clinical Global Impressions-Severity of Illness scale (CGI-S), the CGI-Improvement scale (CGI-I), the Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Rating Scale for Anxiety (HAM-A), and the Hopkins 90-Item Symptom Checklist-Revised. RESULTS: Fluoxetine was associated with a greater improvement from baseline in total TOP-8 score than was placebo. This difference was statistically significant by week 6 of treatment (p < .001) through the end of the acute phase of the study (week 12; p = .006). Compared with placebo, fluoxetine was also associated with significantly greater improvement in CAPS total score as well as intrusive and hyperarousal subscores and in CGI-S, CGI-I, HAM-A, and MADRS scores (p < .05). The presence of dissociative symptoms at baseline appeared to be a predictor of high placebo response. The mean fluoxetine dose at endpoint was 57 mg. There were no clinically significant safety differences. CONCLUSION: Fluoxetine is effective and well tolerated in the treatment of PTSD. Most PTSD patients will respond satisfactorily at doses in the upper normal range for the usual antidepressant doses of fluoxetine.

Adult↗
PubMed1991

The love of war: Vietnam and the traumatized veteran.

Many veterans treated for posttraumatic stress disorder (PTSD) keep alive their war experiences because of their significance and meaning. For these veterans, combat was a positive as well as a negative experience. The authors suggest that many veterans suffer from PTSD because they are continuing to live out their war experiences and to hold onto the meaning of these experiences. Effective treatment requires these veterans to develop a competent peacetime self that incorporates the positive features of the warrior identity.

Combat Disorders↗
PubMed1998

[Social medicine expert assessment of post-traumatic stress disorder].

The concept of a posttraumatic stress disorder (PTSD) has become important for psychiatric diagnosis and research, particularly following US-american studies on Vietnam war veterans. Recently, studies on traindrivers involved in suicide accidents have shown symptoms of anxiety and depression in more than 30% of concerned drivers and typical symptoms of a PTSD in 15%. Here, we present the case of a traindriver who was involved in 6 suicide accidents within 17 years of traindriving (the average is 2 suicide accidents). Following the 3rd accident, the driver developed increasingly symptoms like anxiety, sleep disturbances, flashbacks and irritability. Following the 6th accident, he has been unable to work. A former expert opinion saw no relationship between the symptoms of the driver and the suicide accidents. Therefore, further information about the concept of a PTSD seems necessary to ensure early psychotherapeutic and pharmacological treatment of patients with such a disorder.

Accidents, Traffic↗
PubMed1993

Personality subgroups in an inpatient Vietnam veteran treatment program.

Millon Clinical Multiaxial Inventory personality profiles of 250 male inpatient Vietnam veterans were examined to locate subgroups within that population. Using a hierarchical cluster analysis to form relatively homogeneous groups, four clusters were identified which accounted for 98% of the population. Three clusters had Millon profiles suggestive of a stress reaction and one cluster had a profile indicative of an antisocial adjustment. As measured by a PTSD subscale of the Minnesota Multiphasic Personality Inventory two clusters are high stress groups and two clusters are lower stress groups. The two Millon personality profiles in the high stress category were an 8-2-1/6 group and a 2-8-1-3 group. The lower stress groups had profiles of /8-2 and 6/8-5. The high stress groups are considered Posttraumatic Stress Disorder groups and the lower stress groups are considered nonPosttraumatic Stress Disorder groups.

Adult↗
PubMed2000

Elevated circulatory level of GABA(A)--antagonistic neurosteroids in patients with combat-related post-traumatic stress disorder.

BACKGROUND: Post-traumatic stress disorder (PTSD) is a multisystem neurobiological disorder with chronic alterations in various neurochemical systems. Levels of the GABA(A)--antagonistic neurosteroids plasma dehydroepiandrosterone (DHEA) and its sulphate derivate, dehydroepiandrosterone sulphate (DHEAS) may be relevant to depressive and anxiety disorders, including PTSD. METHODS: We assessed the circulatory levels of morning plasma DHEA and DHEAS in 21 male outpatients with untreated chronic combat-related PTSD (CR-PTSD), and 18 healthy control male subjects. RESULTS: Compared with the control subjects, the PTSD patients showed significantly higher plasma DHEA and DHEAS levels. CONCLUSIONS: Chronic CR-PTSD may be associated with increased circulatory level of neuroactive steroids with inhibitory activity at the GABA(A) receptors. Neurosteroid-induced decreased GABAergic tone may be relevant to the symptomatology and pathophysiology of chronic PTSD, as well as to the frequent co-morbidity of PTSD with depression and anxiety disorders.

Adult↗
PubMed2004

Cavum septum pellucidum in monozygotic twins discordant for combat exposure: relationship to posttraumatic stress disorder.

BACKGROUND: Abnormally large cavum septum pellucidum has been reported in posttraumatic stress disorder; however, the origin of this association is uncertain. METHODS: We utilized magnetic resonance imaging to measure cavum septum pellucidum in pairs of identical twins discordant for combat exposure in Vietnam. RESULTS: Presence of abnormal cavum septum pellucidum was significantly correlated between exposed and unexposed twins, indicating that it is partially determined by heredity and/or shared environment. There was a greater proportion of cavum septum pellucidum in combat-exposed twins with posttraumatic stress disorder and their noncombat-exposed co-twins. CONCLUSIONS: The presence of abnormally large cavum septum pellucidum is a familial vulnerability factor for posttraumatic stress disorder.

Chi-Square Distribution↗
PubMed2002

Elevation of serum total triiodothironine and free triiodothironine in Croatian veterans with combat-related post-traumatic stress disorder.

OBJECTIVE: To asses possible differences in serum-free triiodothironine (FT3), total triiodothironine (TT3), free thyroxine, total thyroxine, and thyroid-stimulating hormone levels between male combat veterans with chronic post-traumatic stress disorder and healthy male control subjects. METHOD: Male combat veterans (N = 38; ages 23-53 years; mean +/- SD = 35.9 +/- 7.5 years) with chronic post-traumatic stress disorder (duration of illness was 2-6 years; mean +/- SD = 3.53 +/- 0.95 years) were compared with healthy male control subjects (N = 32; ages 25-50 years; mean +/- SD = 36.5 +/- 8.3 years). Serum samples were analyzed by luminoimmunochemical assays for basal levels of thyroid-stimulating hormone, total thyroxine, TT3, free thyroxine, and FT3. RESULTS: Combat veterans with chronic combat-related post-traumatic stress disorder had significantly increased values of FT3 (mean +/- SD, 5.92 +/- 1.11; t = 2.27; p < 0.02), as well as TT3 (mean +/- SD, 2.04 +/- 0.32; t = 6.26; p < 0.0001) than the control group. CONCLUSION: Elevated serum TT3 and FT3 are associated with chronic combat-related post-traumatic stress disorder.

Adult↗
PubMed1988

Life events, combat stress reaction and post-traumatic stress disorder.

The implication of life events just preceding a war in acute combat stress reaction and chronic PTSD were assessed in a sample of 716 Israeli combatants. Results show that life events were unrelated to combat stress reaction but were related to subsequent PTSD. Conceptual and methodological issues were discussed to explain the results.

Adaptation, Psychological↗