Fear, safety and the role of sleep in human PTSD: Fragmented REM sleep may hinder effective treatment
August 27, 2014
Science Daily/University of California, San Diego Health Sciences
The effectiveness of post-traumatic stress disorder (PTSD) treatment may hinge significantly upon sleep quality, report researchers. PTSD is an often difficult-to-treat mental health condition triggered by a terrifying event. It is characterized by severe anxiety, flashbacks, nightmares and uncontrollable thoughts, often fearful. Research has shown that fear conditioning, considered an animal model of PTSD, results in disruption of animals' rapid eye movement (REM) sleep -- periods of deeper, dream-filled slumber.
"I think these findings help us understand why sleep disturbances and nightmares are such important symptoms in PTSD," said Sean P.A. Drummond, PhD, professor of psychiatry and director of the Behavioral Sleep Medicine Program at the VA San Diego Healthcare System. "Our study suggests the physiological mechanism whereby sleep difficulties can help maintain PTSD. It also strongly implies a mechanism by which poor sleep may impair the ability of an individual to fully benefit from exposure-based PTSD treatments, which are the gold standard of interventions.
"The implication is that we should try treating sleep before treating the daytime symptoms of PTSD and see if those who are sleeping better when they start exposure therapy derive more benefit."
PTSD is an often difficult-to-treat mental health condition triggered by a terrifying event. It is frequently associated with persons who have served in war zones and is characterized by severe anxiety, flashbacks, nightmares and uncontrollable thoughts, often fearful.
Research has shown that fear conditioning, considered an animal model of PTSD, results in disruption of animals' rapid eye movement (REM) sleep -- periods of deeper, dream-filled slumber. Fear conditioning is a form of learning in which the animal model is trained to associate an aversive stimulus, such as an electrical shock, with a neutral stimulus, such as a tone or beep.
"In PTSD, humans learn to associate threat with a stimulus that used to be neutral or even pleasant. Often, this fear generalizes so that they have a hard time learning that other stimuli are safe. For example, a U.S. Marine in Iraq might suffer trauma when her personnel carrier is blown up by road side bomb hidden in trash alongside the road. When she comes home, she should learn that trash on the side of I-5 does not pose a threat -- it's a safe stimulus -- but that may be difficult for her."
The researchers found that increased safety signaling was associated with increased REM sleep consolidation at night and that the quality of overnight REM sleep was related to how well volunteers managed fear conditioning.
Drummond said stimuli representing safety increased human REM sleep and that "helps humans distinguish threatening stimuli from safe stimuli the next day. So while animal studies focused on learning and unlearning a threat, our study showed REM sleep in humans is more related to learning and remembering safety."
"A very large percentage of missions in both Iraq and Afghanistan were at night," said Drummond, who is also associate director of the Mood Disorders Psychotherapy Program at VA San Diego Healthcare System. "So soldiers learned the night was a time of danger. When they come home, they have a hard time learning night here is a time to relax and go to sleep."
http://www.sciencedaily.com/releases/2014/08/140827090138.htm
Sleep drunkenness disorder may affect one in seven
August 25, 2014
Science Daily/American Academy of Neurology (AAN)
A study is shining new light on a sleep disorder called “sleep drunkenness.” The disorder may be as prevalent as affecting one in every seven people. Sleep drunkenness disorder involves confusion or inappropriate behavior, such as answering the phone instead of turning off the alarm, during or following arousals from sleep, either during the first part of the night or in the morning. An episode, often triggered by a forced awakening, may even cause violent behavior during sleep or amnesia of the episode.
Sleep drunkenness disorder involves confusion or inappropriate behavior, such as answering the phone instead of turning off the alarm, during or following arousals from sleep, either during the first part of the night or in the morning. An episode, often triggered by a forced awakening, may even cause violent behavior during sleep or amnesia of the episode.
Among those who had an episode, 37.4 percent also had a mental disorder. People with depression, bipolar disorder, alcoholism, panic or post-traumatic stress disorder and anxiety were more likely to experience sleep drunkenness.
The research also found that about 31 percent of people with sleep drunkenness were taking psychotropic medications such as antidepressants. Both long and short sleep times were associated with the sleep disorder. About 20 percent of those getting less than six hours of sleep per night and 15 percent of those getting at least nine hours experienced sleep drunkenness. People with sleep apnea also were more likely to have the disorder.
"These episodes of confused awakening have not gotten much attention, but given that they occur at a high rate in the general population, more research should be done on when they occur and whether they can be treated," said Ohayon. "People with sleep disorders or mental health issues should also be aware that they may be at greater risk of these episodes."
http://www.sciencedaily.com/releases/2014/08/140825185311.htm
Vets' alcohol problems linked to stress on home front
July 31, 2014
Science Daily/Columbia University's Mailman School of Public Health
Regardless of traumatic events experienced during deployment, returning National Guard soldiers were more likely to develop a drinking problem if faced with civilian life setbacks, including job loss, legal problems, divorce, and serious financial and legal problems -- all commonplace in military families. Researchers found having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders.
Alcohol abuse is a major concern for reservists returning home. Nearly 7% of Americans abuse or are dependent on alcohol, but among reserve soldiers returning from deployment, the rate of alcohol abuse is 14%, almost double that of the civilian population.
The study looked at a group of 1,095 Ohio National Guard soldiers who had primarily served in either Iraq or Afghanistan in 2008 and 2009. Over three years, the soldiers were interviewed three times via telephone and were asked about their alcohol use, exposure to deployment-related traumatic events and stressors like land mines, vehicle crashes, taking enemy fire, and witnessing casualties, and any stress related to everyday life since returning from duty.
More than half (60%) of the responding soldiers experienced combat-related trauma, 36% of soldiers experience civilian stressors, and 17% reported being sexually harassed during their most recent deployment. Among the group, 13% reported problems consistent with an alcohol use disorder in the first interview, 7% during the second, and 5% during the third. Alcohol use disorder is defined as alcohol abuse or dependence.
The researchers found having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders. The effect of the stressors was restricted to cases of new-onset alcohol use disorders, and wasn't seen among those with a history of problem drinking. In contrast, combat-related traumatic events were only marginally associated with alcohol problems.
The study highlights the important role civilian life and the accompanying stress plays in cases of alcohol use disorder in the National Guard.
"Exposure to the traumatic event itself has an important effect on mental health in the short-term, but what defines long-term mental health problems is having to deal with a lot of daily life difficulties that arise in the aftermath -- when soldiers come home," explains lead investigator Magdalena Cerdá, DrPH, MPH, assistant professor of Epidemiology at the Mailman School of Public Health. "The more traumatic events soldiers are exposed to during and after combat, the more problems they are likely to have in their daily life -- in their relationships, in their jobs -- when they come home. These problems can in turn aggravate mental health issues, such as problems with alcohol, that arise during and after deployment."
With high rates of alcohol abuse among soldiers, there is a critical need for targeted interventions to help soldiers handle stressful life events without alcohol, the investigators observe. More than 1.6 million service members have been deployed in support of war efforts Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn.
"Guardsmen who return home need help finding jobs, rebuilding their marriages and families, and reintegrating into their communities," says Karestan Koenen, PhD, professor of Epidemiology at the Mailman School and senior author of the study. "Too many of our warriors fall through the cracks in our system when they return home. This is particularly true of Guardsmen who do not have the same access to services as regular military personnel. We need to support our soldiers on the home front just as we do in the war zone."
http://www.sciencedaily.com/releases/2014/07/140731095005.htm
Greater odds of adverse childhood experiences in those with military service
July 23, 2014
Science Daily/The JAMA Network Journals
Men and women who have served in the military have a higher prevalence of adverse childhood events (ACEs), suggesting that enlistment may be a way to escape adversity for some. ACEs can result in severe adult health consequences such as posttraumatic stress disorder, substance use and attempted suicide.
The prevalence of ACEs among U.S. military members and veterans is largely unknown. ACEs can result in severe adult health consequences such as posttraumatic stress disorder, substance use and attempted suicide.
Authors compared the prevalence of ACEs among individuals with and without a history of military service using data from a behavioral risk surveillance system, along with telephone interviews, for an analytic sample of more than 60,000 people. ACEs in 11 categories were examined, including living with someone who is mentally ill, alcoholic or incarcerated, as well as witnessing partner violence, being physically abused, touched sexually or forced to have sex. Authors considered military service during the all-volunteer era (since 1973) vs. the draft era.
In the sample, 12.7 percent of the individuals reported military service, which was more common among men (24 percent) than women (2 percent). During the all-volunteer-era, men with military service had a higher prevalence of ACEs in all 11 categories than men without military service. For example, men with a history of military service had twice the prevalence of all forms of sexual abuse than their nonmilitary male peers: being touched sexually (11 percent vs. 4.8 percent), being forced to touch another sexually (9.6 percent vs. 4.2 percent) and being forced to have sex (3.7 percent vs. 1.6 percent). During the draft era, the only difference among men was in household drug use, where men with military service had a lower prevalence than men without military service.
Fewer differences in ACEs were found among women with and without military service than among men. Women with a history of military service in both eras had similar patterns of elevated odds for physical abuse, household alcohol abuse, exposure to domestic violence and emotional abuse compared with women who had not been in the military. Women who served in the military during the all-volunteer era also were more likely to report being touched sexually.
http://www.sciencedaily.com/releases/2014/07/140723162044.htm
What are the risks of post-traumatic stress disorder after an accident?
July 17, 2014
Science Daily/INSERM (Institut national de la santé et de la recherche médicale)
Many patients continue to suffer from symptoms (headaches, pain) several months after an accident. Now, a research team has studied the subsequent development of 1,300 people who were admitted to hospital for trauma. The researchers demonstrate that it is possible to identify people who will develop post-traumatic stress disorder, which generally occurs when the individual's life was put in danger.
Every year, one in ten people in France are taken to A&E with a trauma following an accident. The large majority of the victims have only mild injuries and are discharged from hospital quickly. However, a number of them continue to suffer long after their direct injuries have healed. They may, for example, have headaches, uncontrollable fear or maladies of various kinds, vision problems, balancing problems or be irritable.When the symptoms occur simultaneously in a single context, they constitute what is called a syndrome.
Following a trauma, two syndromes are described: post-concussion syndrome (PCS), which occurs after a mild cranial trauma, and post-traumatic stress disorder (PTSD), which is encountered in people who have been exposed to a stressful situation wherein their life, or that of another person, was put in danger. Post-traumatic stress disorder was initially described in soldiers who, after exposure to combat or an explosion, complain of nightmares or obsessive thoughts which they are unable to get rid of. The two syndromes have been described for several years in the successive editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association, which is a current standard reference in the area of diagnosis in mental health.
Post-traumatic stress disorder in the general population
The results obtained also make it possible to have a better understanding of post-traumatic stress disorder, which is still insufficiently described for non-military contexts. In the general population, this disorder occurs in 2% of injured people but this figure rises to 9% when the trauma is cranial. However, it is more frequent among women and people who have been in a road accident or have been attacked. The occurrence of PTSD is also influenced by the state of the victim's physical and mental health before the accident. All this information can enable doctors to determine if early treatment should be provided.
This study puts the classification of post-traumatic complaints into question because it also questions the very existence of post-concussion syndrome, which should be seen as only one part of post-traumatic stress disorder. These results do not, however, question the reality of the suffering of a significant number of people affected by this disorder, for whom the symptoms continue to persist and considerably impact the quality of their lives.
http://www.sciencedaily.com/releases/2014/07/140717114925.htm
Poor sleep quality linked to lower physical activity in people with PTSD
July 16, 2014
Science Daily/American Academy of Sleep Medicine
A new study shows that worse sleep quality predicts lower physical activity in people with post-traumatic stress disorder. Results show that PTSD was independently associated with worse sleep quality at baseline, and participants with current PTSD at baseline had lower physical activity one year later.
"We found that sleep quality was more strongly associated with physical activity one year later than was having a diagnosis of PTSD," said lead author Lisa Talbot, postdoctoral fellow at the San Francisco VA Medical Center and the University of California, San Francisco. "The longitudinal aspect of this study suggests that sleep may influence physical activity."
Further analysis found that sleep quality completely mediated the relationship between baseline PTSD status and physical activity at the one-year follow-up, providing preliminary evidence that the association of reduced sleep quality with reduced physical activity could comprise a behavioral link to negative health outcomes such as obesity.
"This study adds to the literature that shows that better sleep leads to healthier levels of exercise, and previous research has shown that better sleep leads to healthier food choices," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler. "It is clear that healthy sleep is an essential ingredient in the recipe for a healthy life."
"The findings also tentatively raise the possibility that sleep problems could affect individuals' willingness or ability to implement physical activity behavioral interventions," she said. "Sleep improvements might encourage exercise participation."
According to the National Center for PTSD of the U.S. Department of Veterans Affairs, PTSD symptoms such as nightmares or flashbacks usually start soon after a traumatic event, but they may not appear until months or years later. Symptoms that last longer than four weeks, cause great distress or interfere with daily life may be a sign of PTSD.
http://www.sciencedaily.com/releases/2014/07/140716123841.htm
Portable brain-mapping device allows researchers to 'see' where memory fails
June 18, 2014
Science Daily/University of Texas at Arlington
The use of functional near infrared spectroscopy to map brain activity responses during cognitive activities allows researchers to "see" which brain region or regions fail to memorize or recall learned knowledge in student veterans with PTSD.
Bioengineering Professor Hanli Liu, left, and Alexa Smith-Osborne, associate professor of Social Work, discuss their work with student veterans who have Post Traumatic Stress Disorder.
The study by bioengineering professor Hanli Liu and Alexa Smith-Osborne, an associate professor of social work, and two other collaborators was published in the May 2014 edition of NeuroImage: Clinical. The team used functional near infrared spectroscopy to map brain activity responses during cognitive activities related to digit learning and memory retrial.
Numerous neuropsychological studies have linked learning dysfunctions -- such as memory loss, attention deficits and learning disabilities -- with PTSD.
The new study involved 16 combat veterans previously diagnosed with PTSD who were experiencing distress and functional impairment affecting cognitive and related academic performance. The veterans were directed to perform a series of number-ordering tasks on a computer while researchers monitored their brain activity through near infrared spectroscopy, a noninvasive neuroimaging technology.
The research found that participants with PTSD experienced significant difficulty recalling the given digits compared with a control group. This deficiency is closely associated with dysfunction of a portion in the right frontal cortex. The team also determined that near infrared spectroscopy was an effective tool for measuring cognitive dysfunction associated with PTSD.
With that information, Smith-Osborne said mental healthcare providers could customize a treatment plan best suited for that individual. "It's not a one-size-fits-all treatment plan but a concentrated effort to tailor the treatment based on where that person is on the learning scale," Smith-Osborne said.
http://www.sciencedaily.com/releases/2014/06/140618184642.htm
The Mental Health Benefits of Pet Ownership
March 21, 2017
By Anne Foy, Guest Contributor
We live in a society where we are increasingly challenged by stress, as the levels of national stress in America continue to rise. According to the American Psychological Association, 75% of adults have reported that at some point over the last month they have experienced moderate to high levels of stress whilst the American Institute of Stress have found that 80% of workers feel stress in their workplace, and struggle to control that stress. There are many ways in which you can learn to control your stress, and many different techniques you can adopt to help you reduce your levels of stress within the workplace. However, the simple companionship offered by a pet, such as a dog or cat, is a great way to reduce stress and anxiety when you return home each evening. Here are just some of the mental health benefits of pet ownership:
Dogs Force You to Get Outside
From a physical health point of view, owning a dog forces you to get outside in the fresh air and enjoy some exercise, because dogs love to be walked at least once a day. Given that regular exercise has been shown to have a positive impact on levels of depression, stress and anxiety, this physical health benefit will quickly serve double duty as a mental health benefit too. Exercise elevates your mood, and exercising outside will increase your exposure to the health-boosting vitamin D in the sunshine, which can help prevent conditions such as depression, cancer, obesity, and heart disease. When you are outside with your pet, why not use this as an opportunity to practice mindfulness: to enjoy the nature around you and focus on the calming environment you find yourself in?
Pets Help you Relax
For those suffering from depression and other depression-related disorders, such as post-traumatic stress disorder (PTSD) research has found that pet ownership has proved particularly beneficial, and many veterans returning to the US with PTSD are now routinely being offered forms of animal and in particular canine therapy to help them treat their conditions. The rhythmic petting and stroking of an animal forms a bond between the two of you and helps you to relax by releasing oxytocin. This is a hormone which is related to stress and anxiety relieve, which is why it proves so useful in PTSD treatment, and which can help to reduce blood pressure and lower cortisol levels in everyone, making stroking a pet you have a bond with a great natural stress reliever, and one that you can enjoy daily.
You’ll Never Be Lonely
Pets present a constant form of companionship, helping to alleviate any feelings of loneliness, particularly if you live alone. What’s more, pets are great listeners and provide a sounding board in which you can remove the stress of your day by talking about it. You can talk to your pet about anything, without fear or repercussions or loose lips sharing your secrets with others, and that can be very comforting if you’re struggling with stress or anxiety and want to share your thoughts and feelings in a safe environment. If you live alone then a pet gives you someone to share the routine of daily life with, and can help to give you an anchor in the world: someone who will both depend on you and love you unconditionally. Of course, the only negative aspect of pet ownership is that their lifespan isn't as long as ours, and even with the right food and exercise schedule, regular vet visits and the protection of a decent pet insurance policy, you are still likely to outlive your pet and have to grieve for him. However the joy that pets bring into our lives mean that, for most people, this return to loneliness when they pass is worth the sacrifice.
Pets Make You Playful
When was the last time you played a game of hide and seek or tossed a frisbee? Owning a pet gives you the perfect excuse to play, to laugh, and to act like a child again! You’ll love the interaction, and your pet will love you forever for the undivided attention you are giving to him: it will also help improve your long-term bond and connection with each other. Laughter releases serotonin and dopamine, which are both mood enhancing hormones that can help alleviate stress and depression. Dancing with your dog, watching him wrestle with a bone or roll around chasing his own tail are all sure to raise a smile and improve your overall mental wellbeing at the same time.
Low cortisol levels may increase risk of depression in bipolar disorder
June 18, 2014
Science Daily/Umea University
Depression is almost twice as common, and poor quality of life almost five times as common, in people with bipolar disorder who have elevated or low levels of the stress hormone cortisol in the blood. Bipolar disorder is a lifelong disease that causes recurrent episodes of both mania and depression. Stress is a known trigger for these episodes, and depression and mania also adds to the accumulated stress load.
"In bipolar depression the stress system is often activated, which means that the affected individuals have elevated cortisol levels in the blood. We have now been able to show that both over- and underactivity in the stress system, with corresponding elevated or reduced cortisol levels, can impair mental health in terms of depression and poor quality of life in these patients," says Martin Maripuu, a PhD student at the Department of Clinical Sciences, Psychiatry Unit Umeå University and physician at the psychiatric clinic, Östersund Hospital.
Bipolar disorder is a lifelong disease that causes recurrent episodes of both mania and depression. Stress is a known trigger for these episodes, and depression and mania also adds to the accumulated stress load.
One of the body's main stress systems is the HPA axis. This system regulates the production and level of the vital stress hormone cortisol. Cortisol is a hormone that everyone needs in everyday life in order to cope with various stressful situations, such as pain, illness and stress at work.
Stress causes overactivity in the stress system, resulting in elevated levels of cortisol. If the stress continues in the long-term, it is believed to cause an underactivity in the stress system, which results in low cortisol levels.
Previous studies have shown that the stress system is often overactive in patients with bipolar depression. To investigate the relationship between cortisol levels and depression among these patients, the researchers at Umeå University conducted a study with 145 patients who had bipolar disorder, as well as 145 people in a control group. The researchers measured cortisol levels in the participants, both under normal conditions and after the participants had completed a so-called dexamethasone suppression test, which is sensitive to early abnormalities in the stress system.
The results of the study show that more than half of the patients with bipolar disorder who had elevated or low levels of cortisol in the blood, also had depression. Depression was additionally almost twice as common in those who had high cortisol levels and in those who had low cortisol levels, compared with those who had normal levels of the hormone in the blood. Prevalence of low quality of life was six times more common in the group with low cortisol levels and nearly five times more common among those with high cortisol levels, compared with those who exhibited normal activity in the stress system.
The study also shows that people who had low cortisol levels, on average, have had their disease longer than those with high cortisol levels, which could suggest that chronic stress in bipolar disorder can lead to an "exhaustion" of the stress system with reduced cortisol levels as a result. The researchers also believe that the low cortisol levels, once developed, can contribute to a more chronic, manifested state of the disorder.
"These are important results that in the future could contribute to a more personally tailored medical treatment of bipolar disorder. The results may also ultimately lead to the development of new drugs that work by normalizing the stress system and cortisol levels," says Martin Maripuu.
http://www.sciencedaily.com/releases/2014/06/140618100610.htm
In military personnel, no difference between blast- and nonblast-related concussions
- June 16, 2014
Science Daily/Washington University in St. Louis
Explosions are the most common cause of traumatic brain injuries in veterans returning from Iraq and Afghanistan. A new study shows that military personnel with mild brain trauma related to such blasts had outcomes similar to those with mild brain injury from other causes, according to researchers. However, nearly 80 percent of patients in both categories of brain trauma suffered moderate to severe overall disability within a year after injury.
"We are interested in whether there are fundamental differences between the effects of concussions caused by a blast versus other kinds of blunt head trauma," said senior author David L. Brody, MD, PhD, associate professor of neurology. "This study and others make us a bit skeptical of the notion that the long-term effects of blast injury to the brain are somehow unique.
"We still think the physics of how a blast interacts with the brain is quite different from other kinds of brain trauma," he added. "But we have yet to find the consequences of that -- if there are any -- for patients."
About 20 percent of U.S. forces in Iraq and Afghanistan are estimated to have experienced a head injury during deployment. Of those injuries, about 83 percent are considered mild forms of traumatic brain injury or concussion.
"For our patients with blast-related concussions, I want to emphasize that the explosion was always in combination with another event, such as a motor vehicle crash, a fall or an object striking the head," Brody said. "It's important that we're mostly studying the combination of blast plus impact, compared to impact alone. Blast injury alone -- without a secondary impact -- appears to be extraordinarily rare."
Comparing the two groups with traumatic brain injury (blast- versus nonblast-related), the research team saw no difference in overall disability, with 77 percent of the blast group suffering moderate to severe disability compared with 79 percent of the nonblast group. They also saw no differences between these groups in severity of headaches, depression, post-traumatic stress disorder (PTSD) and performance on cognitive tests. That was despite the fact that the blast-related group reported seeing significantly more active combat.
"In patients with brain injury, combat exposure by itself did not seem to correlate with the high rate of PTSD or depression or the other measures we reported," Brody said.
Both brain injury groups showed worse overall disability compared with the two control groups evacuated for medical reasons unrelated to concussions. In contrast to the brain injury groups, 59 percent of the blast-without-head-injury group experienced moderate to severe disability as did 41 percent of the group that had experienced no blasts and no head injuries.
The group exposed to a blast without head injury had elevated rates of PTSD and headaches compared with the group with no blasts and no head injuries. But they were still better off than the two groups with head injuries.
"This may suggest an additive effect, where blast exposure and combat exposure combined have some effect, and brain injury on top of that has additional influence on PTSD and other outcome measures," Brody said.
"Poor outcomes appear to be associated most strongly with having a traumatic brain injury while on active military duty," Brody said. "It's also possible these brain injuries in military personnel that resulted in medical evacuation were more severe than we typically see in a civilian population. After a sports-related concussion, for example, many people make a good recovery over several weeks."
Brody said the researchers' next step in understanding whether blast-related brain injury is unique is to examine military personnel whose brain injuries were mild enough to allow a return to active duty, a situation that is perhaps more similar to typical civilian concussions.
http://www.sciencedaily.com/releases/2014/06/140616203937.htm
PTSD, major depressive episode appears to increase risk of preterm birth
- June 11, 2014
Science Daily/The JAMA Network Journals
Diagnoses of both post-traumatic stress disorder and a major depressive episode appear to be associated with a sizable increase in risk for preterm birth that seems to be independent of antidepressant and benzodiazepine medication use.
Preterm birth is responsible for many infant deaths. Clinicians and patients are concerned about the risks associated with psychiatric illness during pregnancy and the medications used for treatment.
The study included a group of 2,654 pregnant women recruited before 17 weeks gestation.
The authors looked for PTSD, major depressive episode, and the use of antidepressant and benzodiazepine medications. They measured preterm births, defined as birth before 37 weeks gestation.
Of the women, 129 (4.9 percent) had symptoms consistent with PTSD. Pregnant women with both PTSD and a major depressive episode had a four-fold increased risk of preterm birth. Each one-point increase on a scale measuring PTSD symptoms increased the risk for preterm birth by 1 percent to 2 percent. Women prescribed serotonin reuptake inhibitor and benzodiazepine medications had higher odds for preterm birth.
"The risk appears independent of antidepressant or benzodiazepine use and is not simply a function of mood or anxiety symptoms. Further exploration of the biological and genetic factors will help risk-stratify patients and illuminate the pathways leading to this risk."
http://www.sciencedaily.com/releases/2014/06/140611171000.htm