Arquivo da tag: PTSD

Quase metade dos sobreviventes do último coronavírus teve transtornos mentais (Folha de S.Paulo)

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Artigo original

Matheus Moreira – 12 de fevereiro de 2020

Entre 2002 e 2003, um coronavírus provocou pânico no mundo e quase 800 mortes pela Sars (síndrome respiratória aguda grave). Mas os estragos não pararam ali: quatro anos depois, 42% dos sobreviventes haviam desenvolvido algum transtorno mental. 

A maioria deles (54,5%) manifestou transtorno de estresse pós-traumático, e 39% tiveram depressão, de acordo com um estudo publicado em 2014 na revista especializada East Asian Arch Psychiatry.

O medo é comum em momentos de crise em saúde pública e, portanto, faz parte da resposta a epidemias, aponta outro artigo, publicado na semana passada na revista médica The Lancet e que trata dos impactos da nova epidemia de coronavírus para a saúde mental.

Segundo os autores, há poucos dados sobre o programa desenvolvido pelo governo chinês para acompanhamento e tratamento psicossocial de seus cidadãos, mas, por outro lado, há um extenso plano de “intervenção emergencial em crises psicológicas” para profissionais de saúde da China, fruto do aprendizado da epidemia da Sars.

A cartilha prevê o acompanhamento psicológico de grupos de risco entre os infectados e familiares para prevenção de comportamentos impulsivos e tendências suicidas, por exemplo. 

No dia 28 de janeiro, o governo chinês inaugurou uma linha direta para que os cidadãos possam ligar para requerer ajuda psicológica emergencial, outra forma de prevenir que o que aconteceu após a epidemia de Sars.

Pacientes infectados ou com suspeita de infecção podem manifestar, principalmente, medo das consequências de portar a doença. Já aqueles que estão em quarentena podem ter experiências que vão do tédio à solidão, incluindo acessos de raiva. 

Esses sentimentos e sintomas de sofrimento psíquico podem levar a transtornos de ansiedade, ataques de pânico, depressão, agitação psicomotora (movimentos indesejados devido ao estresse), delírio e suicídio. 

Os efeitos psicológicos de epidemias também podem afetar equipes em hospitais. Durante a Sars, os profissionais de saúde que participaram dos esforços contra a doença apresentaram transtorno de estresse pós-traumático, depressão, ansiedade, medo e frustração devido à possibilidade de serem contaminados e contaminarem familiares e amigos e à impossibilidade de salvar todos os pacientes atendidos.

Até a terça (11), mais de 43 mil pessoas foram infectadas pelo novo coronavírus e outras 1.018 morreram. A epidemia atual já superou a Sars em todos os níveis. 

Os dados são importantes e são atualizados diariamente como serviço à população, mas o excesso de informação pode levar ao medo, senão pânico, segundo o artigo. 

Ana Bock, professora de psicologia social da PUC de São Paulo, explica que o medo da epidemia pode gerar a sensação de que ela é ainda maior.  

“Apesar da informação qualificada, as pessoas nem sempre estão preparadas para compreendê-la. O medo está ligado à fragilidade de lidar com a informação”, afirma. 

Já o professor de medicina da USP (Universidade de São Paulo) Esper Kallás aponta que apesar de haver muita informação disponível, a divulgação e a discussão sobre o tema podem ser benéficos. Para ele, cada segundo gasto em conversas sobre ciência é, na verdade, um investimento.

“Vejo o acesso à informação como oportunidade de discutir saúde pública com a população, de discutir investimento em pesquisa. Acho que isso constrói uma relação com a sociedade que nos permite avançar nesses assuntos.”

Além do sofrimento psicológico de pessoas que tem acesso à essas informações, Bock ressalta que pessoas já fragilizadas e/ou com quadros de transtornos mentais podem sofrer neste momento com mais intensidade. 

No domingo (9), 34 brasileiros e seus parentes que foram evacuados da China chegaram ao Brasil para ficar de quarentena em uma base militar em Anápolis (GO). 

Eles estão sujeitos aos efeitos do isolamento na saúde mental, mas há diferentes tipos de isolamento. 

De acordo com Bock, o isolamento costuma ser usado para promover sofrimento, mas o caso não se aplica aos repatriados. “O isolamento é uma questão ruim para o psicológico. Quando colocamos um filho de castigo, o mandamos para o quarto, para ficar sozinho. Nas prisões,  há a solitária como punição”, lembra. 

No caso dos brasileiros repatriados, buscou-se atenuar a sensação de isolamento. No local onde eles passarão as próximas semanas, há brinquedos para as sete crianças que integram o grupo, telão para filmes, Wi-Fi, plantas, doces e comidas saborosas.

O plano de quarentena do governo, disponível no site do Ministério da Saúde, indica que há uma equipe de assistência psicossocial à disposição dos brasileiros para atenuar o sofrimento psíquico e prevenir o transtorno de estresse pós-traumático). 

A equipe conta com um psicologo e um psiquiatra. Além da avaliação psicológica primária, já na chegada, haverá avaliações semanais. Em casos de sofrimento psíquico, o plano prevê avaliação de risco e abordagem terapêutica (psicoterapia, administração de remédios e observação).

Gut feeling: Research examines link between stomach bacteria, PTSD (Science Daily)

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Date:
April 25, 2016
Source:
Office of Naval Research
Summary:
Could bacteria in your gut be used to cure or prevent neurological conditions such as post-traumatic stress disorder (PTSD), anxiety or even depression? Two researchers think that’s a strong possibility.

Dr. John Bienenstock (left) and Dr. Paul Forsythe in their lab. The researchers are studying whether bacteria in the gut can be used to cure or prevent neurological conditions such as post-traumatic stress disorder (PTSD), anxiety or depression. Credit: Photo courtesy of Dr. John Bienenstock and Dr. Paul Forsythe

Could bacteria in your gut be used to cure or prevent neurological conditions such as post-traumatic stress disorder (PTSD), anxiety or even depression? Two researchers sponsored by the Office of Naval Research (ONR) think that’s a strong possibility.

Dr. John Bienenstock and Dr. Paul Forsythe–who work in The Brain-Body Institute at McMaster University in Ontario, Canada–are investigating intestinal bacteria and their effect on the human brain and mood.

“This is extremely important work for U.S. warfighters because it suggests that gut microbes play a strong role in the body’s response to stressful situations, as well as in who might be susceptible to conditions like PTSD,” said Dr. Linda Chrisey, a program officer in ONR’s Warfighter Performance Department, which sponsors the research.

The trillions of microbes in the intestinal tract, collectively known as the gut microbiome, profoundly impact human biology–digesting food, regulating the immune system and even transmitting signals to the brain that alter mood and behavior. ONR is supporting research that’s anticipated to increase warfighters’ mental and physical resilience in situations involving dietary changes, sleep loss or disrupted circadian rhythms from shifting time zones or living in submarines.

Through research on laboratory mice, Bienenstock and Forsythe have shown that gut bacteria seriously affect mood and demeanor. They also were able to control the moods of anxious mice by feeding them healthy microbes from fecal material collected from calm mice.

Bienenstock and Forsythe used a “social defeat” scenario in which smaller mice were exposed to larger, more aggressive ones for a couple of minutes daily for 10 consecutive days. The smaller mice showed signs of heightened anxiety and stress–nervous shaking, diminished appetite and less social interaction with other mice. The researchers then collected fecal samples from the stressed mice and compared them to those from calm mice.

“What we found was an imbalance in the gut microbiota of the stressed mice,” said Forsythe. “There was less diversity in the types of bacteria present. The gut and bowels are a very complex ecology. The less diversity, the greater disruption to the body.”

Bienenstock and Forsythe then fed the stressed mice the same probiotics (live bacteria) found in the calm mice and examined the new fecal samples. Through magnetic resonance spectroscopy (MRS), a non-invasive analytical technique using powerful MRI technology, they also studied changes in brain chemistry.

“Not only did the behavior of the mice improve dramatically with the probiotic treatment,” said Bienenstock, “but it continued to get better for several weeks afterward. Also, the MRS technology enabled us to see certain chemical biomarkers in the brain when the mice were stressed and when they were taking the probiotics.”

Both researchers said stress biomarkers could potentially indicate if someone is suffering from PTSD or risks developing it, allowing for treatment or prevention with probiotics and antibiotics.

Later this year, Bienenstock and Forsythe will perform experiments involving fecal transplants from calm mice to stressed mice. They also hope to secure funding to conduct clinical trials to administer probiotics to human volunteers and use MRS to monitor brain reactions to different stress levels.

Gut microbiology is part of ONR’s program in warfighter performance. ONR also is looking at the use of synthetic biology to enhance the gut microbiome. Synthetic biology creates or re-engineers microbes or other organisms to perform specific tasks like improving health and physical performance. The field was identified as a top ONR priority because of its potential far-ranging impact on warfighter performance and fleet capabilities.

Journal Reference:

  1. S. Leclercq, P. Forsythe, J. Bienenstock. Posttraumatic Stress Disorder: Does the Gut Microbiome Hold the Key? The Canadian Journal of Psychiatry, 2016; 61 (4): 204 DOI: 10.1177/0706743716635535

Ceremonial PTSD therapies favored by Native American veterans (Science Daily)

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Date: June 30, 2014

Source: Washington State University

Summary: Traditional healing therapies are the treatment of choice for many Native American veterans, — half of whom say usual PTSD treatments don’t work — according to a recent survey. In the Arizona desert, wounded warriors from the Hopi Nation can join in a ceremony called Wiping Away the Tears. The traditional cleansing ritual helps dispel a chronic “ghost sickness” that can haunt survivors of battle.

Urquhart is a Native veteran and graduate student in the WSU College of Education. Credit: Rebecca E. Phillips

Native American veterans battling Post Traumatic Stress Disorder find relief and healing through an alternative treatment called the Sweat Lodge ceremony offered at the Spokane Veterans Administration Hospital.

In the Arizona desert, wounded warriors from the Hopi Nation can join in a ceremony called Wiping Away the Tears. The traditional cleansing ritual helps dispel a chronic “ghost sickness” that can haunt survivors of battle.

These and other traditional healing therapies are the treatment of choice for many Native American veterans, — half of whom say usual PTSD treatments don’t work — according to a recent survey conducted at Washington State University. The findings will be presented at the American Psychological Association conference in Washington D.C. this August.

The study is available online at https://www.surveymonkey.com/s/nativeveterans.

Led by Greg Urquhart and Matthew Hale, both Native veterans and graduate students in the College of Education, the ongoing study examines the attitudes, perceptions, and beliefs of Native American veterans concerning PTSD and its various treatment options. Their goal is to give Native veterans a voice in shaping the types of therapies available in future programs.

“Across the board, Native vets don’t feel represented. Their voices have been silenced and ignored for so long that they were happy to provide feedback on our survey,” said Hale.

Historically, Native Americans have served in the military at higher rates than all other U.S. populations. Veterans are traditionally honored as warriors and esteemed in the tribal community.

A 2012 report by the Department of Veterans Affairs showed that the percentage of Native veterans under age 65 outnumbers similar percentages for veterans of all other racial groups combined.

The WSU survey provides a first-hand look at the veterans’ needs, but more importantly, reveals the unique preferences they have as Native American veterans, said Phyllis Erdman, executive associate dean for academic affairs at the college and mentor for the study.

Cultural worldview

Urquhart said many Native veterans are reluctant to seek treatment for PTSD because typical western therapy options don’t represent the Native cultural worldview.

“The traditional Native view of health and spirituality is intertwined,” he explained. “Spirit, mind, and body are all one — you can’t parcel one out from the other — so spirituality is a huge component of healing and one not often included in western medicine, although there have been a few studies on the positive effects of prayer.”

For many years, the U.S. government banned Native religious ceremonies, which subsequently limited their use in PTSD programs, said Urquhart. Seeking to remedy the situation, many Veterans Administration hospitals now offer traditional Native practices including talking circles, vision quests, songs, drumming, stories, sweat lodge ceremonies, gourd dances and more. Elders or traditional medicine men are also on staff to help patients process their physical and emotional trauma.

“PTSD is a big issue and it’s not going away anytime soon,” said Hale who identifies as Cherokee and was a mental health technician in the Air Force.

Urquhart, who is also Cherokee and developed mild symptoms of PTSD after a tour as a cavalry scout in Iraq, said there have been very few studies on Native veterans and PTSD. He and Hale designed their survey to be broader and more inclusive than any previous assessments. It is the first to address the use of equine therapy as a possible adjunct to both western treatments and Native ceremonial approaches.

Standard treatments disappointing

So far, 253 veterans from all five branches of the military have completed the survey, which includes 40 questions, most of them yes or no answers. It also includes an open-ended section where participants can add comments. The views reflect a diverse Native population ranging from those living on reservations to others who live in cities.

The majority of survey takers felt that “most people who suffer from PTSD do not receive adequate treatment,” said Urquhart. For Native veterans who did seek standard treatment, the results were often disappointing. Sixty percent of survey respondents who had attempted PTSD therapy reported “no improvement” or “very unsatisfied.”

Individual counseling reportedly had no impact on their PTSD or made the symptoms worse for 49 percent of participants. On the other hand, spiritual or religious guidance was seen as successful or highly successful by 72 percent of Native respondents. Animal assisted therapy — equine, canine, or other animals — was also highly endorsed.

“The unique thing about equine therapy is that it’s not a traditional western, sit-down-with-a-therapist type program. It’s therapeutic but doesn’t have the stigma of many therapies previously imposed on Native Americans,” said Urquhart.

Strongly supportive of such efforts, Erdman is expanding the long-running WSU Palouse Area Therapeutic Horsemanship (PATH) program to include a section open to all veterans called PATH to Success: A Warrior’s Journey.

Giving veterans a voice

Urquhart, Hale, and teammate, Nasreen Shah say their research is gaining wide support in Native communities throughout the nation.

The team plans to distribute the survey results to all U.S. tribes, tribal governments, Native urban groups, and veteran warrior societies. They also hope the departments of Veterans Affairs and Indian Health Services will take notice and continue to incorporate more traditional healing methods into their programs.

As one Iroquois Navy veteran commented on the survey, “Traditional/spiritual healing can be very effective together with in depth education and background in modern treatment methods.”

A Nahua Army veteran agreed, writing, “Healing ceremonies are absolutely essential, as is story telling in front of supportive audiences. We need rituals to welcome back the warriors.”

Story Source:

The above story is based on materials provided by Washington State University. The original article was written by Rebecca E. Phillips. Note: Materials may be edited for content and length.