BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential the...BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential therapeutic impact of using pharmacotherapy to target sleep disturbance in patients with PTSD.Eszopiclone(ESZ)is a non-benzodiazepine y-aminobutyric acid-A receptor agonist indicated for the treatment of sleep and may affect sleep in patients with PTSD.AIM To evaluate the efficacy of ESZ vs placebo(PBO)for patients with PTSD and insomnia.METHODS The study was a 12-wk,double blind,randomized controlled trial with 3 mg of ESZ(n=13)or PBO(n=12).RESULTS Patients in both arms experienced significant improvement in PTSD symptoms as assessed by the Clinician-Administered PTSD Scale for DSM-IV(CAPS):ESZ(t11=-3.12,P=0.005)and PBO(t11=-3.5,P=0.002)and by self-report with the Short PTSD Rating Interview(ESZ t11=-3.38,P=0.003 and PBO t11=-4.48,P=0.0005).There were no significant differences between treatments on the CAPS(t22=-0.13,P=0.70)or the Short PTSD Rating Interview(t22=-0.58,P=0.56).Similarly,both treated groups improved on sleep measures as assessed by the Pittsburgh Sleep Quality Index with PTSD Addendum(PSQI)and on total sleep time(TST)and sleep latency assessed by actigraphy with no significant differences between groups(PSQI t22=-0.24,P=0.81;total sleep time t10=0.13,P=0.90 and sleep latency t10=0.68,P=0.50).There was a significant correlation between improvement in sleep and overall improvement in PTSD as measured by change scores on the PSQI and CAPS,r(8)=0.79,P=0.01 for ESZ treated subjects,but not for those treated with PBO r(9)=0.16,P=0.69.Adverse events of ESZ were consistent with the known profile of the medication including dysgeusia(30%,mild),sedation(20%,mild)and headache(20%,moderate to severe).CONCLUSION Results do not support the hypothesis of a specific positive effect of ESZ compared to PBO for measures of PTSD and associated sleep disturbance.展开更多
Background: Little is known about post-traumatic stress (PTSD) prevalence rates in community samples. This is especially true for the African continent where child-soldiers, HIV/AIDS affected and orphans have been the...Background: Little is known about post-traumatic stress (PTSD) prevalence rates in community samples. This is especially true for the African continent where child-soldiers, HIV/AIDS affected and orphans have been the target for PTSD prevalence studies. Objectives: The aim of this study is to investigate the indirect and direct exposure to 20 potentially traumatic events and its relation with PTSD in a Ugandan sample of senior 3rd year students and to perform cross-cultural comparisons with previous studies examining this age group. Socio-economic status, coping styles, negative affect, and somatization are further examined. Method: A convenience sample of 408 senior secondary school students, from eight schools, across three major towns, Kampala, Mbarara, and Jinja, were selected. The Harvard Trauma Questionnaire (HTQ) was used to establish PTSD prevalence rates, The Coping Style Questionnaire (CSQ) was used to assess coping styles, and the Trauma Symptom Checklist (TSC) were used to measure negative affect and somatization. Results: The subjects had been exposed to a mean of 6.6 direct events and a mean of 7.2 indirect events. The estimated prevalence rate of PTSD was 37.7% and a further 28.2% reached a subclinical level, missing one symptom to have the full diagnosis. Variables related to a PTSD diagnosis were female gender, number of directly experienced events, emotional coping, negative affect, and somatization. Conclusions: Ugandan youth have been exposed to significantly more potentially traumatic events and negative life events than European youth, and subsequently PTSD prevalence rates are higher. In addition, fewer gender differences are found in the Ugandan sample compared to the European samples.展开更多
基金Supported by National Institute of Mental Health,No.5R34MH91338-03 and No.K23 MH103394(to Zalta AK)
文摘BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential therapeutic impact of using pharmacotherapy to target sleep disturbance in patients with PTSD.Eszopiclone(ESZ)is a non-benzodiazepine y-aminobutyric acid-A receptor agonist indicated for the treatment of sleep and may affect sleep in patients with PTSD.AIM To evaluate the efficacy of ESZ vs placebo(PBO)for patients with PTSD and insomnia.METHODS The study was a 12-wk,double blind,randomized controlled trial with 3 mg of ESZ(n=13)or PBO(n=12).RESULTS Patients in both arms experienced significant improvement in PTSD symptoms as assessed by the Clinician-Administered PTSD Scale for DSM-IV(CAPS):ESZ(t11=-3.12,P=0.005)and PBO(t11=-3.5,P=0.002)and by self-report with the Short PTSD Rating Interview(ESZ t11=-3.38,P=0.003 and PBO t11=-4.48,P=0.0005).There were no significant differences between treatments on the CAPS(t22=-0.13,P=0.70)or the Short PTSD Rating Interview(t22=-0.58,P=0.56).Similarly,both treated groups improved on sleep measures as assessed by the Pittsburgh Sleep Quality Index with PTSD Addendum(PSQI)and on total sleep time(TST)and sleep latency assessed by actigraphy with no significant differences between groups(PSQI t22=-0.24,P=0.81;total sleep time t10=0.13,P=0.90 and sleep latency t10=0.68,P=0.50).There was a significant correlation between improvement in sleep and overall improvement in PTSD as measured by change scores on the PSQI and CAPS,r(8)=0.79,P=0.01 for ESZ treated subjects,but not for those treated with PBO r(9)=0.16,P=0.69.Adverse events of ESZ were consistent with the known profile of the medication including dysgeusia(30%,mild),sedation(20%,mild)and headache(20%,moderate to severe).CONCLUSION Results do not support the hypothesis of a specific positive effect of ESZ compared to PBO for measures of PTSD and associated sleep disturbance.
文摘Background: Little is known about post-traumatic stress (PTSD) prevalence rates in community samples. This is especially true for the African continent where child-soldiers, HIV/AIDS affected and orphans have been the target for PTSD prevalence studies. Objectives: The aim of this study is to investigate the indirect and direct exposure to 20 potentially traumatic events and its relation with PTSD in a Ugandan sample of senior 3rd year students and to perform cross-cultural comparisons with previous studies examining this age group. Socio-economic status, coping styles, negative affect, and somatization are further examined. Method: A convenience sample of 408 senior secondary school students, from eight schools, across three major towns, Kampala, Mbarara, and Jinja, were selected. The Harvard Trauma Questionnaire (HTQ) was used to establish PTSD prevalence rates, The Coping Style Questionnaire (CSQ) was used to assess coping styles, and the Trauma Symptom Checklist (TSC) were used to measure negative affect and somatization. Results: The subjects had been exposed to a mean of 6.6 direct events and a mean of 7.2 indirect events. The estimated prevalence rate of PTSD was 37.7% and a further 28.2% reached a subclinical level, missing one symptom to have the full diagnosis. Variables related to a PTSD diagnosis were female gender, number of directly experienced events, emotional coping, negative affect, and somatization. Conclusions: Ugandan youth have been exposed to significantly more potentially traumatic events and negative life events than European youth, and subsequently PTSD prevalence rates are higher. In addition, fewer gender differences are found in the Ugandan sample compared to the European samples.
