Ten-year follow-up study of PTSD diagnosis, symptom severity and psychosocial indices in aging holocaust survivors

Objective: We performed a longitudinal study of holocaust survivors with and without post‐traumatic stress disorder (PTSD) by assessing symptoms and other measures at two intervals, approximately 10 years apart. Method: The original cohort consisted of 63 community‐dwelling subjects, of whom 40 were available for follow‐up. Results: There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n = 4), new instances of delayed onset PTSD developed between time 1 and time 2. Self‐report ratings at both assessments revealed a worsening of trauma‐related symptoms over time in persons without PTSD at time 1, but an improvement in those with PTSD at time 1. Conclusion: The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of delayed onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD.     

Surgical therapy for multiple sclerosis tremor: a 12‐year follow‐up study

Background and purpose: Severe multiple sclerosis (MS) tremor causes disability poorly responsive to medication. Deep brain stimulation (DBS) or thalamotomy can suppress tremor, but long‐term outcomes are unclear. Methods: Nine patients with MS tremor underwent disability measures at baseline and 12 months post‐surgery (six thalamotomy, three DBS) in 1997–1998 (previously reported, Matsumoto et al., Neurology 2001;57:1876–82). We report the prospective 12‐year follow‐up of this cohort for tremor, disability, and death. Results: Surgery was initially successful in all. Tremor recurred in all patients within median 3 months, although two DBS patients were tremor‐free for 5 years. Median tremor‐free survival (tremor‐free time/survival time) was 4.3%. At 12‐year follow‐up, four survivors (two thalamotomy, two DBS) (Expanded Disability Status Scale scores 8–8.5) were severely disabled. Five patients were dead (four thalamotomy, one DBS) median 5.8 years post‐operative. Conclusions: Surgery benefit for severe tremor was overall short‐lived (median 3 months), with long‐term poor prognosis. Although two DBS patients had sustained 5‐year tremor‐suppression, the observed progressive disability and death in this cohort bear importance for long‐term success in future MS tremor surgery trials.     

The 10-year course of PTSD in borderline patients and axis II comparison subjects

Zanarini MC, Hörz S, Frankenburg FR, Weingeroff J, Reich DB, Fitzmaurice G. The 10‐year course of PTSD in borderline patients and axis II comparison subjects. Objective: The first objective is to detail the prevalence of post‐traumatic stress disorder (PTSD) over a decade of follow‐up for those in both study groups. The second is to determine time‐to‐remission, recurrence, and new onset of PTSD, and the third is to assess the relationship between sexual adversity and the likelihood of remission and recurrence of PTSD. Method: The SCID I was administered to 290 borderline in‐patients and 72 axis II comparison subjects during their index admission and re‐administered at five contiguous 2‐year follow‐up periods. Results: The prevalence of PTSD declined significantly over time for patients with borderline personality (BPD) (61%). Over 85% of borderline patients meeting criteria for PTSD at baseline experienced a remission by the time of the 10‐year follow‐up. Recurrences (40%) and new onsets (27%) were less common. A childhood history of sexual abuse significantly decreased the likelihood of remission from PTSD, and an adult history of sexual assault significantly increased the likelihood of a recurrence of PTSD. Conclusion: Taken together, the results of this study suggest that PTSD is not a chronic disorder for the majority of borderline patients. They also suggest a strong relationship between sexual adversity and the course of PTSD among patients with BPD.     

Heart rate reactivity and current post-traumatic stress disorder when data are missing

Aims: This study demonstrates that auxiliary and exclusion criteria variables increase the effectiveness of missing imputation in correcting underestimation of physiologic reactivity in relation to post‐traumatic stress disorder (PTSD) caused by deleting cases with missing physiologic data. Methods: This study used data from survivors of the 1995 Oklahoma City bombing and imputed missing heart rate data using auxiliary and exclusion criteria variables. Logistic regression was used to examine heart rate reactivity in relation to current PTSD. Results: Of 113 survivors who participated in the bombing study's 7‐year follow‐up interview, 42 (37%) had missing data on heart rate reactivity due to exclusion criteria (medical illness or use of cardiovascular or psychotropic medications) or non‐participation. Logistic regression results based on imputed heart rate data using exclusion criteria and auxiliary (the presence of any current PTSD arousal symptoms) variables showed that survivors with current bombing‐related PTSD had significantly higher heart rates at baseline and recovered more slowly back to baseline heart rate during resting periods than survivors without current PTSD, while results based on complete cases failed to show significant correlations between current PTSD and heart rates at any assessment points. Conclusions: Suggested methods yielded an otherwise undetectable link between physiology and current PTSD.     

A follow-up study of juvenile obsessive-compulsive disorder from India

Objective: To study the long‐term course and outcome of juvenile obsessive–compulsive disorder (OCD). Method: Two to 9‐year follow‐up of largely self‐referred, drug‐naïve subjects (n = 58) by employing catch‐up longitudinal design. Results: The mean follow‐up period was 5 years. Nearly three‐fourth of the sample was adequately treated with medications. Only 21% of the subjects had clinical OCD at follow‐up and 48% were in true remission (no OCD and not on treatment). Earlier age‐at‐onset was associated with better course and outcome. Conclusion: Juvenile OCD has favorable outcome. Our findings are applicable to psychiatric hospital settings in India and perhaps to the general psychiatric settings in the Western countries. Whether the better outcome in this sample is the result of differing clinical characteristics or because of true cross‐cultural variation in the course needs further exploration. It is speculated that early onset OCD could be a subtype of juvenile OCD with better outcome.     

Natural history of solitary cerebral cysticercosis cases after albendazole therapy: a longitudinal follow‐up study from India

Goel D, Mittal M, Bansal KK, Singhal A. Natural history of solitary cerebral cysticercosis cases after albendazole therapy: a longitudinal follow‐up study from India.
Acta Neurol Scand: 2010: 121: 204–208.
© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives – To find out natural course of solitary cerebral cysticercosis (SCC) cases after treating them with 2 weeks albendazole therapy. Material and methods – All patients with SCC were treated with 2 weeks of albendazole therapy with follow‐up radiological scan at 6 months and 2 years. The evolution of lesion was noted as complete resolution, calcification or persistent active. Antiepileptic drugs (AED) prophylaxis was given for 1 year in patients with complete resolution and for 2 years in calcified lesion, respectively. AED was continued in persistent lesion group till it became calcified or resoluted completely. One‐year follow‐up was done in all after stopping AED. Results – Among 345 cases, 226 (65.5%) had complete resolution with very low seizure relapse rate with 1 year of seizure free period on AED treatment. On the contrary, 105 (30.5%) had calcified lesion with high seizure relapse rate after stopping AED treatment with 2 years of seizure free period. Fourteen patients (4%) could not stop their antiepileptic medication at all because of active lesion. Conclusion – Two‐third of patients with SCC have favorable outcome with complete resolution and needs short‐term AED prophylaxis and the rest one‐third requires long AED treatment to prevent seizures.     

Prevalence and risk factors for posttraumatic stress disorder: a cross‐sectional study among survivors of the Wenchuan 2008 earthquake in China

Background: The impact of the May 2008 Wenchuan earthquake, measuring a massive 8.0 on the surface wave magnitude scale, on public health in China has been significant and multifaceted. In light of extant data on prevalence and risk factors for posttraumatic stress disorder (PTSD) after other natural diasters, we collected data from the Wenchuan earthquake survivors to estimate the prevalence of PTSD and to characterize a range of PTSD risk factors. Methods: A cross‐sectional multicluster sample survey of 446 respondents (201 from the Qiang ethnic‐minority group, 245 the majority Han Chinese group) was conducted in August 2008 in Beichuan county, Sichuan province, a region that was severely affected by the earthquake. In total, 240 households were represented, with a mean of 2.2 respondents per household. Data were collected from structured interviews and the Harvard Trauma Questionnaire (HTQ) and DSM‐IV criteria were used to diagnose PTSD. Results: The prevalence of PTSD was 45.5% (203/446). Low household income, being from an ethnic minority, living in a shelter or temporary house, death in family, and household damage were factors significantly related to increased odds of PTSD. Conclusions: PTSD is common after a major disaster. Postdisaster mental health recovery programs that include early identification, ongoing monitoring, preventive and intervention programs, and sustained psychosocial support are needed for the highest‐risk population, namely, the bereaved, people without incomes and those with serious household damage. These populations may also benefit from governmental and nongovernmental programs that provide social and economic support, as suggested by earlier studies. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Mental health problems among children and adolescents experiencing two major earthquakes in remote mountainous regions: A longitudinal study

ObjectiveMillions of children were exposed to major earthquake in China, with serious psychological and developmental consequences. To obtain accurate rate of post-disaster related disorder and identify predictors may help inform post-disaster rescue and rehabilitation efforts. The present longitudinal study explored correlations of demographic and socioeconomic characteristics of juvenile survivors of the Ya'an and Wenchuan earthquakes in China with their trajectories of post-disaster related disorder.MethodsA total of 435 Chinese children and adolescents who survived the 2013 Ya'an earthquake were recruited from six primary, secondary and high schools in Baoxing County. All survivors were assessed at 12 months after the disaster, when a trained psychiatrist assessed mental health problems in a face-to-face structured interview, and 153 survivors were followed up at 30 months after the earthquake via telephone.ResultsThe 12-month assessment indicated a post-traumatic stress disorder (PTSD) prevalence of 43.9% as well as depression (20.9%) or the criteria for both PTSD and depression (18.2%) and the other disorder (0.9%). The 30-month assessment indicated that 15.7% of subjects met the criteria for PTSD, 21.6% met the criteria for depression. No subjects met the criteria for other affective or anxiety disorders. Significant predictors of PTSD and depression were death in the family, previous earthquake experience, a poor parent–child relationship and economic pressure or poverty.LimitationsClinical interview face to face is quite different from via telephone and the attrition rate in the longitudinal cohort is high, which would directly affect our results of the assessment.ConclusionsPTSD and depression may be as prevalent and persistent in disaster victims in China as elsewhere, and high co-comorbidities remain poorly understood. Although many adolescents recover over time, some exhibit chronic, delayed-onset PTSD and depression, especially those with poor relationships with their parents or those living in precarious economic conditions. Family-based therapy may be needed to support child and adolescent trauma survivors in order to prevent mental illness.     

Epidemiologic psychiatric studies on post-disaster impact among Chi-Chi earthquake survivors in Yu-Chi, Taiwan

The aim of the present study was to survey a cohort population for the risk factors of post-traumatic stress disorder (PTSD) and major depression, and the prevalence of different psychiatric disorders at 6 months and 2 and 3 years after a major earthquake. The Disaster-Related Psychological Screening Test (DRPST), part I, and the Mini-International Neuropsychiatric Interview (MINI) were, respectively, administered by trained interviewers and psychiatrists in this community-interview program. The prevalence of PTSD decreased from 8.3% at 6 months to 4.2% at 3 years after the earthquake. Suicidality increased from 4.2% at 6 months and 5.6% at 2 years to 6.0% at 3 years after the earthquake; drug abuse/dependence increased from 2.3% at 6 months to 5.1% at 3 years after the disaster. The risk factors for PTSD and major depression in various post-disaster stages were determined. Earthquake survivors had a high percentage of psychiatric disorders in the first 2 years, and then the prevalence declined. Following the devastation caused by the Chi-Chi earthquake, it is important to focus on treating symptoms of major depression and PTSD and eliminating the risk factors for both of these disorders in survivors to avoid the increase in suicidality.     

Adolescent vulnerability to PTSD and effects of community‐based intervention: Longitudinal study among adolescent survivors of the Ehime Maru sea accident

The aim of the present study was to examine the psychological impact on adolescent survivors of a maritime disaster that resulted in the deaths of nine people, including four high school students, and the effects of psychiatric intervention for the survivors. Methods: Long‐term multidimensional intervention consisting of psychoeducation, hospital treatment, family support and day care, was provided for nine adolescent survivors. To evaluate these effects, the survivors were also assessed using self‐rating scales (Impact of Event Scale, General Health Questionnaire and Self‐rating Depression Scale) and psychiatric structured interviews (Clinician‐Administered Post‐Traumatic Stress Disorder [PTSD] Scale) at 2, 8, 14, 26, and 38 months after the accident. Results: Prevalence of PTSD among adolescent survivors was much higher than in adult survivors at the 2‐month examination (78% vs 12%, respectively). Although the observed prevalence remained high until the 14‐month examination, remarkable improvement occurred thereafter and none was diagnosed with PTSD at the 38‐month examination. Conclusion: Adolescents may have a specific vulnerability to PTSD and community‐based intervention is effective for adolescents with serious symptoms of PTSD.     

Time course and risk factors of post‐stroke fatigue: a prospective cohort study

Background: Post‐stroke fatigue (PSF) often occurs after stroke and has a negative impact on the rehabilitation process. Several studies focused either on short‐ or on long‐term PSF and their relations with stroke characteristics. However, possible pre‐stroke risk factors such as history of depression, pre‐existent white matter lesions or brain atrophy were usually not taken into account. Therefore, the precise mechanisms underlying PSF remain still unclear. This study was aimed at assessing the possible contributions of (pre‐)stroke factors to both short‐term PSF and its course over time. Methods: This study pertains to 108 patients with an acute cerebral infarction. PSF was rated by the Checklist Individual Strength at 2 months and 1.5 year post‐stroke. The relation between (pre‐)stroke factors and PSF was assessed with multivariate regression analysis. Results: The prevalence of baseline PSF was 35% and at follow‐up 33%. Older age had a protective effect on PSF at baseline (OR 0.95; 95% CI 0.91–0.98), whereas post‐stroke depressive symptoms and infratentorial infarctions were related to an increased risk for PSF (OR 1.40; 95% CI 1.21–1.63 and OR 4.69; 95% CI 1.03–21.47, respectively). Baseline fatigue was related to an increased risk of PSF at follow‐up (OR 1.15; 95% CI 1.09–1.22). Conclusions: Predictors for baseline fatigue were younger age, post‐stroke depressive symptoms, and infratentorial infarctions. Baseline fatigue did predict fatigue outcome over time, suggesting that early interventions might be useful to prevent deteriorated PSF.     

Long‐term outcome of phenobarbital treatment for epilepsy in rural China: A prospective cohort study

Purpose: To evaluate the long‐term outcome of phenobarbital treatment for convulsive epilepsy in rural China, and to explore factors associated with overall seizure outcomes. Methods: We carried out follow‐up assessments of people who took part in an epilepsy community management program conducted in rural counties of six provinces in China. People with convulsive epilepsy who were previously untreated (or on irregular treatment) were commenced on regular treatment with phenobarbital. Information was collected using a standardized questionnaire by face‐to‐face interviews of the individuals (and their families where necessary). Information collected included treatment status, medication change, seizure frequency, and mortality. Key Findings: Among the 2,455 people who participated in the original program, outcomes were successfully ascertained during the follow‐up assessment in 1986. Among them, 206 had died. Information on treatment response was obtained in 1,780 (56% male; mean age 33.9 years, range 3–84; mean duration of follow‐up 6.4 years). Among them, 939 (53%) were still taking phenobarbital. The most common reasons for stopping phenobarbital were seizure freedom or substantial seizure reduction, socioeconomic reasons, and personal preference. Four hundred fifty‐three individuals (25%) became seizure‐free for at least 1 year while taking phenobarbital, 88% of whom did so at daily doses of 120 mg or below. Four hundred six (23%) reported adverse events, which led to withdrawal of phenobarbital in <1%. The most common adverse effects were malaise/somnolence (7.4%), dizziness (3%), and lethargy (2.6%). At the follow‐up assessment, 688 (39%) individuals had been seizure free for at least the previous year. People with persistent seizures had significantly longer duration of epilepsy and higher number of seizures in the 12 months before treatment. People who were taking AED treatment irregularly at recruitment were less likely to become seizure‐free. Significance: We observed long‐term benefits of regular treatment with phenobarbital for convulsive epilepsy in rural China. One hundred years after the discovery of its antiepileptic effect, phenobarbital is still playing an important role in the management of epilepsy.     

Mediating role of peritraumatic dissociation and depression on post-MVA distress: path analysis

Background: The aim of this study was to examine the role of pre‐trauma, traumatic event, and peri‐traumatic psychological characteristics on post‐motor vehicle accident (MVA) Posttraumatic Stress Disorder (PTSD) and depression. Methods: The sample comprised 333 (54% female) hospital accident and emergency attendees who completed a self‐report postal screening survey approximately 1‐month post‐accident and 128 (62% female) participants who completed a follow‐up survey at 3‐months. Results: Path analysis (Model 1) showed that dissociation partially mediated the relationship between past emotional problems and initial post‐MVA distress, as well as between fear of dying and levels of distress. Level of alertness and perceived accident severity had no direct effects on post‐MVA distress. However, higher levels of exposure contributed to distress predominantly in the presence of high levels of fear and subsequent dissociative experiences. When ongoing PTSD and depression symptoms were included (Model 2), feeling depressed/sad at 1‐month was the strongest predictor of both PTSD and depression symptom severity at 3‐months post‐MVA, explaining 53% and 40% of the variance, respectively. Dissociation remained an important mediating variable at both time points. Conclusions: These models show the influence of previous emotional vulnerability factors and the important mediating role of peri‐traumatic experiences (in the presence of fear due to increased levels of accident severity) on post‐MVA morbidity. Additionally, MVA survivors who report feeling depressed/sad 1‐month after their accident are at greater risk of developing both PTSD and depression. Depression and Anxiety 28:218–226, 2011. © 2011 Wiley‐Liss, Inc.     

Peritraumatic Distress Inventory as a predictor of post‐traumatic stress disorder after a severe motor vehicle accident

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.     

A multi‐site Canadian perspective: examining the functional outcome from first‐episode psychosis

Objective: To examine factors contributing to variance in functional outcome in first‐episode psychosis (FEP) following 1 year of treatment. Method: Naturalistic 1‐year follow‐up of a FEP cohort (n = 200), from programs in four university centers in Ontario, Canada. Functional recovery was defined by ‘Social and Occupational Functioning Assessment Scale’ (SOFAS) score>60. Regression analysis examined the contribution of independent variables to variance in functional outcome. Results: Twelve‐month outcome measures were available for 76.5% of the original cohort. Of these, 70% reported being in school/work and in satisfactory relationships. The functional recovery rate was 51%, compared to 74% attaining symptomatic remission. The greatest contributors to variance in outcome were ongoing symptoms at 6 months and substance abuse comorbidity. Conclusion: After 1 year of treatment, FEP patients show high rates of symptomatic remission and relatively lower rates of functional recovery. Symptoms and substance abuse contribute to variance in outcome.     

Motor nerve excitability after childhood Guillain‐Barré syndrome

Residual motor nerve dysfunction after pediatric Guillain‐Barré syndrome (GBS) was determined in an observational cross‐sectional cohort study in patients who previously developed GBS during childhood (<18 years). Ulnar motor nerve dysfunction was defined by compound motor action potential (CMAP) scan in patients after a follow up of at least 1 year compared with age‐matched healthy controls, in relation to clinical course and outcome. A total of 37 persons previously diagnosed with GBS in childhood were included with a mean age at current examination of 20.6 years (4–39 years). The median time between diagnosis and follow‐up was 11 years (range: 1–22 years). CMAP scanning indicated ulnar motor nerve dysfunction in 25 (68%) participants. The most frequent abnormality was a reduction in nerve excitability observed both in those with residual limb weakness and in the majority of those with complete recovery. CMAP scan characteristics were not related to prognostic factors or outcome. In conclusion, GBS in childhood results in residual motor nerve excitability disturbances, even in those completely recovered, probably reflecting altered physiology of regenerated peripheral nerves.     

PTSD following terrorist attacks: a prospective evaluation

OBJECTIVE: This study evaluated the prevalence of posttraumatic stress disorder (PTSD) and the longitudinal course of early PTSD symptoms in survivors of terrorist attacks. It additionally assessed the effect of continuous terrorism on the course of early symptoms of PTSD. METHOD: Thirty-nine survivors of terrorist attacks and 354 survivors of motor vehicle accidents were evaluated upon admission to a general hospital emergency room and 1 week and 4 months later. Heart rate was measured upon admission to the emergency room. Peritraumatic dissociation was assessed at 1 week. PTSD symptoms, anxiety, and depression were measured at 1 week and 4 months. The Clinician-Administered PTSD Scale conferred a diagnosis of PTSD at 4 months. Additionally, the course of early PTSD symptoms during an era of frequent terrorist attacks (N=137) was compared with that seen during years of relative calm (N=256). RESULTS: Survivors of terrorist attacks had higher rates of PTSD than motor vehicle accident survivors (37.8% versus 18.7%). The type of traumatic event, however, did not add to the prediction of PTSD from the emergency room heart rate, peritraumatic dissociation symptoms, and early PTSD symptoms. The longitudinal course of early PTSD symptoms was not affected by the greater frequency of terrorist attacks. CONCLUSIONS: Early symptoms are reliable risk indicators of PTSD across events and circumstances. Converging effects of terror-induced fear, adjustment, and resiliency might explain the lack of effect of intense terrorism on the course of PTSD symptoms.     

Memory and prefrontal functions in earthquake survivors: differences between current and past post-traumatic stress disorder patients

Objective: Many studies reported deficits in cognitive functions in post‐traumatic stress disorder (PTSD). Most were, however, conducted on man‐made trauma survivors. The high comorbidity of alcohol use and depression with PTSD in these studies further complicated the interpretation of their results. We compared prefrontal lobe functions and memory in three earthquake survivor groups: current PTSD, past PTSD and no PTSD. We hypothesized that prefrontal performances of the current and past PTSD groups would be worse than that of control group. Method: Survivors of the 1999 earthquakes in Turkey were evaluated for current and lifetime PTSD. Memory and prefrontal functions were assessed by a neuropsychological test battery. Results: Current PTSD patients performed worse on attention, verbal memory, verbal fluency, and psychomotor speed. Past PTSD group was similar to the controls on most cognitive measures, except for their vulnerability to proactive interference and low performance in verbal fluency for animal names. Conclusion: Our findings indicate that the prefrontal organization and monitorization of verbally processed information are defective in earthquake‐related PTSD patients, more so in the current PTSD group.     

The Post‐Deployment Mental Health (PDMH) study and repository: A multi‐site study of US Afghanistan and Iraq era veterans

The United States (US) Department of Veterans Affairs (VA) Mid‐Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) Post‐Deployment Mental Health (PDMH) multi‐site study examines post‐deployment mental health in US military Afghanistan/Iraq‐era veterans. The study includes the comprehensive behavioral health characterization of over 3600 study participants and the genetic, metabolomic, neurocognitive, and neuroimaging data for many of the participants. The study design also incorporates an infrastructure for a data repository to re‐contact participants for follow‐up studies. The overwhelming majority (94%) of participants consented to be re‐contacted for future studies, and our recently completed feasibility study indicates that 73–83% of these participants could be reached successfully for enrollment into longitudinal follow‐up investigations. Longitudinal concurrent cohort follow‐up studies will be conducted (5–10+ years post‐baseline) to examine predictors of illness chronicity, resilience, recovery, functional outcome, and other variables, and will include neuroimaging, genetic/epigenetic, serum biomarker, and neurocognitive studies, among others. To date, the PDMH study has generated more than 35 publications from the baseline data and the repository has been leveraged in over 20 publications from follow‐up studies drawing from this cohort. Limitations that may affect data collection for a longitudinal follow‐up study are also presented.     

Post‐traumatic stress symptoms in Guillain–Barré syndrome patients after prolonged mechanical ventilation in ICU: a preliminary report

Thirty percent of Guillain–Barré syndrome (GBS) patients require mechanical ventilation (MV) in intensive care unit (ICU). Post‐traumatic stress disorder (PTSD) is found in ICU survivors, and the traumatic aspects of intubation and MV have been previously reported as risk factors for PTSD after ICU. Our objective was to determine long‐term PTSD or post‐traumatic stress symptoms (PTSS) in GBS patients after prolonged MV in ICU. We assessed GBS patients who had MV for more than 2 months. PTSD was assessed using Horowitz Impact of Event Scale (IES), IES‐Revisited (IES‐R), and the Post‐traumatic CheckList Scale; functional outcome using Rankin and Barthel scales; quality of life (QoL) using Nottingham Health Profile (NHP) and 36‐Item Short Form Health Survey (SF‐36) and depression using Hospital Anxiety and Depression Scale (HAD) and Beck questionnaire. Thirteen patients could be identified and analyzed. They had only mild disability. They were neither anxious nor depressed with an anxiety HAD at 5 (4–11.5), a depression HAD at 1 (0–3.5) and a Beck at 1 (0–5). QoL was mildly decreased in our population with a NHP at 78.5 (12.8–178.8) and mild decreased SF‐36. Compared with the French population, the SF‐36 sub‐categories were, however, not statistically different. Twenty‐two percentage of our 13 patients had PTSD and PTSS with a Horowitz IES at 12 (2–29), and an IES‐R at 16 (2–34.5). Although severe GBS patients requiring prolonged MV had good functional recovery and no difference in QoL, they had a high incidence of PTSS.