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Assess the changes in post-traumatic stress disorder (PTSD), burnout, anxiety, depression, jobstrain, and isostrain levels over time among healthcare workers in emergency departments (EDs) after successive outbreaks of COVID-19. A prospective, multicenter study was conducted in 3 EDs and an emergency medical service. Healthcare workers who participated in our previous study were invited to participate in a follow-up 16 and 18 months and completed the questionnaires to assess symptoms of PTSD, burnout, anxiety, depression, jobstrain, and isostrain. Among the 485 healthcare workers asked to participate, 211 (43.5%) completed the survey at inclusion (122 were followed up at 3 months) and 59 participate to the follow-up study. At 16 months, 10.9% of healthcare workers had symptoms of PTSD and 17.4% at 18 months. At inclusion, 33.5% and 11.7% of healthcare workers had symptoms of anxiety and depression, respectively. A decrease in anxiety between inclusion and 16 months (p = 0.02) and an increase between 16 and 18 months (p = 0.009) was observed. At inclusion, 40.8% of all healthcare workers had symptoms of burnout. There was an increase in symptoms of burnout between inclusion and 18 months (p = 0.006). At inclusion, 43.2% and 29.5% of healthcare workers were exposed to jobstrain and isostrain, respectively. Jobstrain were higher among paramedics and administrative staff compared to physicians (p = 0.001 and p = 0.026, respectively). Successive outbreaks of COVID-19 led to long-term mental health consequences among ED healthcare workers that differed according to occupation. This must be taken into account to rethink the management of teams.

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BACKGROUND: Fear learning is a core component of conceptual models of how adverse experiences may influence psychopathology. Specifically, existing theories posit that childhood experiences involving childhood trauma are associated with altered fear learning processes, while experiences involving deprivation are not. Several studies have found altered fear acquisition in youth exposed to trauma, but not deprivation, although the specific patterns have varied across studies. The present study utilizes a longitudinal sample of children with variability in adversity experiences to examine associations among childhood trauma, fear learning, and psychopathology in youth. METHODS: The sample includes 170 youths aged 10-13 years (M = 11.56, s.d. = 0.47, 48.24% female). Children completed a fear conditioning task while skin conductance responses (SCR) were obtained, which included both acquisition and extinction. Childhood trauma and deprivation severity were measured using both parent and youth report. Symptoms of anxiety, externalizing problems, and post-traumatic stress disorder (PTSD) were assessed at baseline and again two-years later. RESULTS: Greater trauma-related experiences were associated with greater SCR to the threat cue (CS+) relative to the safety cue (CS-) in early fear acquisition, controlling for deprivation, age, and sex. Deprivation was unrelated to fear learning. Greater SCR to the threat cue during early acquisition was associated with increased PTSD symptoms over time controlling for baseline symptoms and mediated the relationship between trauma and prospective changes in PTSD symptoms. CONCLUSIONS: Childhood trauma is associated with altered fear learning in youth, which may be one mechanism linking exposure to violence with the emergence of PTSD symptoms in adolescence.

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OBJECTIVE: We aimed to evaluate the frequency of Post Traumatic Stress Disorder (PTSD), to determine the risk factors, and to monitor the change of symptoms after 6 months among individuals who survived the avalanche disaster in Van. METHOD: Face-to-face interviews were conducted with 35 people who were rescued from two consecutive avalanche disasters in Van 2 months and 6 months after the avalanche disaster. The socio-demographic and clinical data of the cases were evaluated. The Post Traumatic Stress Disorder Symptom Scale-Self Report version (PSS-SR) and clinical interviews were used for PTSD diagnosis. The level of trauma was assessed by using the Impact of Event Scale (IES). RESULTS: All participants were rescuers who went to the avalanche site for rescue mission. Of the cases, 16 were volunteers from the local community and 19 were professional rescuers. The frequency of PTSD was 71.4% in the early assessment, and 57.1% in the long term. Staying in avalanche for more than 30 minutes, the absence of a history of disaster exposure and being in the group of volunteers were found to increase the risk for PTSD development. CONCLUSION: There is a high risk of developing PTSD as a result of an avalanche. People who will intervene with the disasters should be educated and prepared in terms of preventing negative psychological consequences of the disaster. The relationship between the severity of trauma and PTSD was replicated in our study.

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BACKGROUND: The incidence of comorbid depression and post-traumatic stress disorder (PTSD) symptoms is higher in snakebite victims. However, the present state and contributing factors of depression and PTSD among Chinese snakebite victims remain unclear. METHODS: A representative sample of 6837 snakebite victims were assessed with the Post-traumatic Stress Disorder Checklist (Civilian Version) and The Center for Epidemiologic Studies Depression Scale. Multivariate analyses, including network analysis, evaluated the contributing factors of PTSD and depression symptoms caused by snake bites, as well as the bridge symptoms of comorbidity networks. RESULTS: Among 6,837 snakebite victims, 79.5% reported PTSD symptoms and 81.4% reported depression symptoms. Comorbidity of PTSD and depression symptoms was found in 75.1%. Key factors included the presence sequelae after snakebite (ORPTSD = 2.31, ORDepression = 1.89), time to medical facilities (6-8 h: ORPTSD = 3.17, ORDepression = 2.46), and marital status (divorced/widowed: ORPTSD = 1.78, ORDepression = 1.76). Symptoms I1 ("Repeated disturbing memories") and D1 ("Bothered by things that don't usually bother me") bridged PTSD and depression networks. CONCLUSION: The primary psychological challenges for snakebite victims in China are PTSD and depression symptoms, which is concerning. Standardized diagnosis and treatments, timely medical care, and stable marital relationships can reduce risks. Additional psychological support and management of negative memories, especially for those with severe bridge symptoms, can be beneficial. Further research should concentrate on understanding victims' psychological states and developing effective interventions.

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Post-traumatic stress disorder (PTSD) is a severe stress-dependent psychiatric disorder characterized by impairment of fear memory extinction; however, biological markers to determine impaired fear memory extinction in PTSD remain unclear. In male mice with PTSD-like behaviors elicited by single prolonged stress (SPS), 19 differentially expressed proteins in the hippocampus were identified compared with controls. Among them, a biological macromolecular protein named deleted in colorectal cancer (DCC) was highly upregulated. Specific overexpression of DCC in the hippocampus induced similar impairment of long-term potentiation (LTP) and fear memory extinction as observed in SPS mice. The impairment of fear memory extinction in SPS mice was improved by inhibiting the function of hippocampal DCC using a neutralizing antibody. Mechanistic studies have shown that knocking down or inhibiting µ-calpain in hippocampal neurons increased DCC expression and induced impairment of fear memory extinction. Additionally, SPS-triggered impairment of hippocampal LTP and fear memory extinction could be rescued through activation of the Rac1-Pak1 signaling pathway. Our study provides evidence that calpain-mediated regulation of DCC controls hippocampal LTP and fear memory extinction in SPS mice, which likely through activation of the Rac1-Pak1 signaling pathway.

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OBJECTIVE: This study used network analysis to investigate the cross-sectional and longitudinal network between PTSD symptoms within mother-adolescent dyads at 12 and 18 months after the 2008 Wenchuan earthquake. METHODS: The sample was from the Wenchuan Earthquake Adolescent Health Cohort. 399 mother-adolescent dyads completed the Posttraumatic Stress Disorder Self-Rating Scale at 12 and 18 months after the earthquake. We assessed central symptoms (those with the most significant influence on other symptoms) and bridge symptoms (symptoms connecting different communities) in contemporary networks (i.e., cross-sectional networks). Subsequently, cross-lagged panel network analyses (CLPN) were performed to estimate longitudinal relationships among symptoms between dyads. RESULTS: In the contemporary networks, symptoms such as "intrusive thoughts" of both dyads and "flashbacks" of adolescents were central, indicating that they are crucial in maintaining the network of PTSD symptoms. Additional symptoms such as maternal "difficulty in concentration" and dyads' "pessimism and disappointment" should also be considered because of their central roles. Moreover, the temporary network did not directly replicate the contemporary networks, with adolescents' "nightmares" at 12 months having a high influence on other PTSD symptoms at 18 months. LIMITATIONS: Self-reported tools other than clinical diagnoses were used to collect data. CONCLUSIONS: These symptom-level associations at cross-sectional and longitudinal networks extend our understanding of PTSD symptoms among mother-adolescent dyads by pointing to specific key symptoms of PTSD that may drive the co-occurrence of PTSD among dyads. Recognizing these symptoms is imperative for the development of targeted interventions and treatments aimed at addressing comorbid PTSD in mother-adolescent dyads.

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OBJECTIVES: South Korea operates a complete enumeration surveillance of coronavirus disease 2019 (COVID-19). Online mental health survey links were distributed to all COVID-19 confirmed patients within three days of confirmation of infection. This study evaluates the trend of depressive symptoms, anxiety symptoms, post-traumatic stress symptoms, somatic symptoms, and suicidal ideation of COVID-19 confirmed cases across the pandemic from January 2020 to July 2022. METHODS: A total of 99,055 responses were analyzed. Validated questionnaires were used to assess depressive symptoms (Patient Health Questionnaire-9), anxiety symptoms (Generalized Anxiety Disorder-7), post-traumatic stress symptoms (Primary Care Post Traumatic Stress Disorder screen), somatic symptoms (Patient Health Questionnaire-15), and suicidal ideation (P4 suicidality screener). Log-binomial regression was used to estimate prevalence ratio across 11 quarters (Q) of the year (2020Q1 to 2022Q3). Stratified analysis was conducted by sex to compare risk between males and females when adjusted prevalence was high. RESULTS: Compared to 2022Q1 (January-March), all symptoms had their highest prevalence ratio during 2020Q1 to 2020Q3 (January-September). The difference in adjusted symptom prevalence between males and females was nonsignificant during high-risk periods. CONCLUSIONS: Adverse mental health symptoms were most prevalent during the early pandemic, with a nonsignificant difference in prevalence observed between males and females. Greater attention should be given to individuals who experienced COVID-19 infection during the early stages of the pandemic.

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Introduction: This study examined the prevalence and correlates of probable mental health disorders, including psychological distress, somatization, depression, anxiety, phobic anxiety (PHO), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and insomnia among Chinese primary health care (PHC) physicians and nurses amid the post-pandemic period in 2022. Method: Region-stratified sampling was conducted to recruit a national sample of 4,246 respondents from 31 July 2022 to 12 August 2022. A total of 692 primary healthcare institutions were identified in 30 provincial-level administrative regions of China. An online questionnaire was used for assessing probable mental health disorders using Symptoms Checklist-90-Revised (SCL-90-R) and PTSD Checklist for DSM-5 (PCL-5), and sleeping problems using Insomnia Severity Index (ISI). Data on demographics and work were also collected. Bivariate analysis and multiple logistic regression were conducted to identify significant correlates of probable mental health disorders. Results: A total of 4,246 valid questionnaires were identified. Results showed that relative to the prevalence of probable mental health disorders among health care workers at the early stage of the pandemic in China, there was an overall decreased prevalence except for somatization, PHO, and OCD among the current PHC physicians and nurses. Multiple logistic regressions showed that significant risk factors of common probable mental health disorders, namely psychological distress, SOM, DEP, ANX, PHO, OCD, PTSD, and insomnia, were female gender, multimorbidity, history of psychiatric disorders, quarantine experience, never asking anyone for help, and overtime work. Conclusion: Attention should be given to preexisting psychiatric and multimorbid conditions, social support, and work-related stressors. Regular assessment and psychological interventions are needed to enhance the mental health of PHC professionals even after public health crisis.

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BACKGROUND: In China, parents who have lost their only child are referred to as Shidu parents (SDPs). This study aimed to investigate the prevalence and risk factors of post-traumatic stress disorder (PTSD) and investigate the influence of depressive and anxiety symptoms on the development of PTSD. METHOD: Four hundred and thirty-six SDPs completed assessments of PTSD (Structured Clinical Interview for DSM-IV Disorders, SCID-IV; The Clinician-Administered PTSD Scale-IV, CAPS-IV), depression (Hamilton depression scale), and anxiety (Hamilton Anxiety Scale) via in-person interviews. Logistic regression and hierarchical multiple linear regression analyses were used to explore the association of demographic characteristics, depression, and anxiety symptoms with PTSD. RESULTS: The prevalence of PTSD in SDPs was 14.45%. The comorbidity of depression and anxiety symptoms was 87.30% in the SDPs with PTSD. The logistic regression model, which included factors of gender, age, education, depression, and anxiety, which contributed to the development of PTSD, was significant [χ² (11) = 122.47, p < 0.001]. The hierarchical multiple linear regression analysis indicated that female gender and the severity of comorbidities (depression and anxiety) were positively associated with the severity of PTSD. CONCLUSION: This study found that the severity of depression and anxiety was closely related to the severity of PTSD, supporting that SDPs are highly prone to the co-occurrence of PTSD, depression, and anxiety after bereavement. Our findings may provide more insights into the development of individualized interventions for parents who have experienced the loss of their only child.

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Background: Post-intensive care syndrome (PICS) affects many critical care survivors and family members. Nevertheless, the relationship between PICS-relevant domains in cardiac arrest (CA) survivors and psychological distress in their family members (henceforth, PICS-F) remains underexplored. Methods: We enrolled consecutive CA patients admitted between 16 August 2021 and 28 June 2023 to an academic medical center, along with their close family members, in prospective studies. Survivors' PICS domains were: physical dependence (Physical Self-Maintenance Scale, PSMS), cognitive impairments (Modified Telephone Interview for Cognitive Status, TICS-M), and post-traumatic stress disorder (PTSS) symptoms (PTSD Checklist-PCL 5), as well as PICS-F (PCL-5 Total Score). Hierarchical multivariate linear regressions examined associations between PICS-F and survivors' PICS domains. Results: Of 74 dyads (n = 148), survivors had a mean (SD) age of 56 ± 16 years, with 61% being male and with a median hospital stay of 28 days. Family members (43% spouses) were slightly younger (52 ± 14 years), predominantly female (72%), and of minority race/ethnicity (62%). A high prevalence of PICS assessed 28.5 days (interquartile range 10-63) post-CA was observed in survivors (78% physical dependence, 54% cognitive impairment, 30% PTSS) and in family members (30% PTSS). Survivor PTSS was significantly associated with family member distress (ß = 0.3, p = 0.02), independent of physical dependence (ß = 0.0, p = 0.9), cognitive impairment (ß = -0.1, p = 0.5), family member characteristics, and duration of hospitalization. Conclusions: Both CA survivors and their family members showed substantial evidence of likely PICS. Survivor PTSS is notably associated with family member distress, highlighting the need for dyadic interventions to enhance psychosocial outcomes.

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Background: The relationship between trauma-related negative cognitions and post-traumatic stress disorder (PTSD) symptoms has been studied frequently. Several studies found a mediating effect of trauma-related negative cognitions on symptom reduction in studies on different psychotherapeutic treatments, however, this relationship has never been studied in imagery rescripting (ImRs) or eye movement desensitization and reprocessing (EMDR).Objective: To analyse the role of trauma-related negative cognitions in the treatment of PTSD due to childhood trauma with EMDR and ImRs.Method: N = 155 patients with PTSD due to childhood trauma aged between 18 and 65 (M = 38.54) participated in a randomized clinical trial and were treated with either EMDR or ImRs in Australia, Germany, and the Netherlands between October 2014 and June 2019. We analysed the relationship between PTSD symptoms (Clinician-administered PTSD Scale for DSM-5, CAPS-5 and Impact of Event Scale revised; IES-R, completed twice for index trauma and for all other traumas) and trauma-related negative cognitions (Post-Traumatic Cognitions Inventory, PTCI) using Granger Causality analyses with linear mixed models on person-centered variables. Assessments were conducted pre-treatment, post-treatment (12 sessions in 6 weeks), eight weeks post-treatment, and one year after the pre-treatment assessment.Results: Changes in negative cognitions (PTCI) preceded changes in PTSD symptoms (unidirectional) as measured by the CAPS and the IES-R for index trauma. For the IES-R related to all other traumas, a unidirectional relationship was found in which changes in PTSD symptoms preceded changes in negative cognitions. No moderating effect of treatment was found. On the level of PTCI subscales only changes in cognitions about oneself preceeded changes in PTSD symptoms.Conclusions: The results support the idea of a general role of trauma-related negative cognitions in the treatment of PTSD. The analyses should be replicated with a higher frequency of assessments.

We studied the role of trauma-related negative cognitions in the treatment of post-traumatic stress disorder (PTSD) with either EMDR or ImRs.Within-person changes in trauma-related negative cognitions preceded changes in PTSD symptoms, except for self-reported PTSD symptoms of all other trauma's than the index trauma, where the opposite relationship was found.We found no moderation by treatment condition, this supports the idea of a general role of trauma-related negative cognitions in the treatment of post-traumatic stress disorder.

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Background: Autistic traits (AT) seem to be particularly frequent among patients with borderline personality disorder (BPD). Moreover, the autism spectrum is considered a vulnerability factor for the development of post-traumatic stress disorder (PTSD) symptoms, increasing the vulnerability of BPD subjects toward the development of a stress-related disorder. Aim: The study aimed to investigate the association between AT and trauma-related symptoms in a clinical sample of patients with BPD. Methods: A total of 48 patients with a clinical diagnosis of BPD and 52 healthy control (HC) subjects were recruited and assessed with the Adult Autism Subthreshold Spectrum Self-Report (AdAS Spectrum) questionnaire and the Trauma and Loss Spectrum-Self-Report questionnaire (TALS-SR). The BPD group was divided into two subgroups: BPD with a symptomatological diagnosis of PTSD (pBPD = 25) and BPD not diagnosed with PTSD (No-pBPD = 23). Results: The clinical sample scored significantly higher in almost all AdAS domains. Moreover, pBPD groups reported higher AdAS and TALS-SR scores in the total and in various domains than the No-pBPD group, which scored higher in several domains than HC. AdAS Restricted interests and rumination domain scores were positive predictors of BPD presence independently from PTSD, while Inflexibility and adherence to routine domain was a negative predictor. Finally, AdAS Hyper/hyporeactivity to sensory stimuli domain was a positive predictor only for inclusion in the pBPD group. Conclusion: Our study confirmed the existence of a statistically significant relationship between the autism spectrum and BPD, while BPD subjects diagnosed with PTSD seem to show a higher autism spectrum burden.

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BACKGROUND: Life with end-stage organ failure is accompanied by an accumulation of traumatic medical or surgical experiences. Despite recovery after solid organ transplantation (SOT), many children and adolescents develop post-traumatic stress symptoms (PTSS). PTSS remain underappreciated as a major comorbidity in SOT programs, despite their association with decreased quality of life. METHODS: We conducted a retrospective, cross-sectional study of 86 pediatric SOT recipients (17 heart, 44 kidney, and 25 liver) to evaluate potential determinants of PTSS. Trauma symptoms were measured by the Child Trauma Screening Questionnaire (CTSQ). Demographic, baseline, and contemporaneous factors were tested for independent association with CTSQ scores. RESULTS: The median post-transplant CTSQ score was 2 (IQR 1-4), and 22% were identified as high risk (score ≥5) for PTSD. Higher CTSQ scores were independently associated with the number of ICU days within the previous 12 months, the number of medications (complexity), and involvement with foster care in the primary model (R2 [adj.] = 0.26). The addition of the Family Impact Module improved the overall model (R2 [adj.] = 0.33), wherein higher family functioning was independently associated with lower CTSQ scores. An exploratory analysis of pre-transplant patients (n = 34) found a median pre-transplant CTSQ of 2 (IQR 1-6), suggesting that PTSS are onset before transplant and persist afterward. CONCLUSIONS: PTSS are highly prevalent in the SOT population. Risk factors include recent adverse medical experiences and complexity, whereas family stability may be protective. Additional research is needed to improve early ascertainment and support for patients at high risk of developing PTSS throughout their transplant journey.

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INTRODUCTION: The Syrian refugee crisis has led to significant population displacement, with many seeking refuge and asylum in Nordic countries. While these countries offer safety and stability, the resettlement process combined with the refugees' own traumatic experiences can exacerbate existing or precipitate new mental health issues. AIM: This systematic review aims to comprehensively analyse the literature on mental health problems among Syrian refugees resettled in Nordic countries, exploring their prevalence and associated factors. METHODS: A comprehensive literature search was conducted following PRISMA guidelines, utilizing databases including Web of Science, PubMed, MEDLINE, and Cochrane. The included studies focused on adult Syrian refugees or asylum seekers aged 18 and above, residing within Nordic countries, and investigated various mental health problems between March 2011 and January 2024, conducted in various Nordic countries. RESULTS: Studies revealed high prevalence rates of PTSD (26%-45%), depression (40%-45%), and anxiety (30%-32%). Factors contributing to mental health problems included pre- and post-migration trauma, perceived discrimination, and socio-demographic variables. Pre-migration trauma exposure, such as witnessing violent events, was linked to trauma centrality and emotional suppression. Post-migration stressors like discrimination and financial strain, along with socio-demographic factors like gender and age, were associated with mental health issues. Specifically, female and older refugees reported higher levels of anxiety, depression, and low future expectations. CONCLUSION: The findings underscore the urgent need for comprehensive mental health assessment and services for Syrian refugees in Nordic countries. Addressing trauma, discrimination, and socio-economic challenges is crucial for improving their well-being and facilitating successful integration into host countries.

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Post-traumatic stress disorder (PTSD) is a mental disorder resulting from traumatic events which are characterized primarily by anxiety and depressive disorder. In this study, we determine the role of gut bacteria in PTSD. PTSD-like symptoms were produced by single prolonged stress (SPS). SPS animals showed increased levels of anxiety as measured by the elevated plus maze test, while depressive behaviour was confirmed using sucrose preference, force swim, and tail suspension tests. Gut dysbiosis was confirmed in PTSD animals by next-generation sequencing of 16 s RNA of faecal samples, while these animals also showed increased intestinal permeability and altered intestinal ultrastructure. Probiotic treatment increases beneficial microbiota, improves intestinal health and reduces PTSD-associated anxiety and depression. We also found a decrease in cortical BDNF levels in PTSD animals, which was reversed after probiotic administration. Here, we establish the link between gut dysbiosis and PTSD and show that probiotic treatment may improve the outcome of PTSD like symptoms in mice.

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Introduction: In this study, mental and physical illnesses, types of traumatic events, frequency of recurrence and sociodemographic characteristics of patients with Posttraumatic Stress Disorder (PTSD) were examined. Methods: The study included the files of 179 patients over the age of 18 who were admitted to the psychiatry outpatient clinic between 01.12.2010 and 31.01.2023 and diagnosed with PTSD. The data was obtained from the hospital automation system and national database. Results: Of the 44 patients diagnosed with a single comorbid mental illness, 45.5% had mixed anxiety and depressive disorder and 36.4% had a depressive disorder. The rate of patients with comorbid mental illness in PTSD was 51.4%, and chronic physical illness was observed in 59.8%. In our study, sexual trauma and domestic violence had the highest recurrence rates among traumatic events (80%). Conclusion: Comorbid mental and physical illnesses are common in PTSD. The lack of adequate examination time and an appropriate therapeutic environment causes this diagnosis to be missed by clinicians and prevents patients from getting an ideal health service. In order to prevent recurrences of sexual traumas and domestic violence, the competent authorities must make practices of protecting socially disadvantaged groups more effective and act in accordance with international conventions.

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Post-traumatic stress disorder (PTSD) is a neuropsychiatric disorder that may develop after experiencing traumatic events. Preclinical studies use various methods to induce PTSD-like models such as fear-conditioning, single-prolonged stress (SPS), restraint stress, and social defeat. Brain-derived neurotrophic factor (BDNF) is a crucial neurotrophin in mood regulation. Evidence shows BDNF changes in different neuropsychiatric disorders particularly PTSD. This review examined BDNF alterations in preclinical rodent models of PTSD where we demonstrated a wide range of paradoxical changes in BDNF. We found that the fear-conditioning model produced the most inconsistent alterations in BDNF, and suggest that conclusions drawn from these changes be approached with caution. We suggest that BDNF maladaptive changes in social defeat and restraint stress models may be related to the duration of stress, while the SPS model appears to have more consistent results. Ultimately, we propose that evaluating BDNF alterations in the process of treating PTSD symptoms may not be a reliable factor.

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Post-traumatic stress disorder (PTSD) stands as a pervasive psychiatric condition, exerting a profound impact on millions across the globe. Despite the availability of traditional therapeutic modalities, many individuals continue to grapple with suboptimal treatment outcomes, underscoring the urgent need for novel interventions. In recent years, stellate ganglion blocks (SGBs) have garnered attention as a promising avenue in the treatment landscape for PTSD, showcasing remarkable efficacy in ameliorating symptomatology and enhancing overall quality of life. This comprehensive review seeks to delve into the current landscape of research surrounding SGBs for PTSD, including proposed mechanisms of action, clinical efficacy across diverse patient populations, safety profile, and potential avenues for further exploration and refinement. By synthesizing the latest evidence and insights, this review aims to provide clinicians and researchers with a comprehensive understanding of the role of SGBs in PTSD management, ultimately informing clinical practice and guiding future research endeavors in this area of mental health intervention.

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Background: Post-traumatic stress disorder (PTSD) is one of the most important and common disorders caused by war trauma. The aim of this study was to determine the relationship between psychosocial factors and PTSD in war-torn immigrants in Mehran, Iran. Method: The present study was conducted by descriptive and correlational method. The data were collected from 245 people (121 women and 124 men) from war-torn immigrants 45 years and older who migrated from Mehran to Ilam during the Iran-Iraq war. The measuring tools were as follows: Post Traumatic Stress Disorder Scale, Multidimensional Scale of Perceived Social Support (MDPSS), Coping Strategies Scale (CSS-R), Multidimensional Health Locus of Control scale. Results: The prevalence rate of PTSD among war-torn immigrants in Mehran was 35.1 %. A significant negative correlation was observed between perceived social support and PTSD (p < .01). Coping strategies, including seeking social support, reappraisal/adaptation, problem-focused coping, and active coping, all showed significant negative correlations with PTSD (p < .01). Conversely, a significant positive correlation was found between avoidance coping strategies and self-control and PTSD (p < .01). In addition, there was a significant positive correlation between the external locus of control (believing in chance) and PTSD (P < 0.01) and significant negative correlation between internal locus of control and PTSD (P < .01). Conclusion: Weakness in social support, locus of control and also inappropriate coping strategies against war trauma were among the strong risk factors for PTSD. Therefore, social and behavioral interventions are recommended to increase social support, teaching problem-solving skills and strengthen individual control among war-torn immigrants to reduce the risk of developing PTSD.

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Transcranial magnetic stimulation (TMS) is a safe non-invasive treatment technique. We systematically reviewed randomised controlled trials (RCTs) applying TMS in obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) to analyse its therapeutic benefits and explore the relationship between cortical target and psychopathophysiology. We included 47 randomised controlled trials (35 for OCD) and found a 22.7 % symptom improvement for OCD and 29.4 % for PTSD. Eight cortical targets were investigated for OCD and four for PTSD, yielding similar results. Bilateral dlPFC-TMS exhibited the greatest symptom change (32.3 % for OCD, N = 4 studies; 35.7 % for PTSD, N = 1 studies), followed by right dlPFC-TMS (24.4 % for OCD, N = 8; 26.7 % for PTSD, N = 10), and left dlPFC-TMS (22.9 % for OCD, N = 6; 23.1 % for PTSD, N = 1). mPFC-TMS showed promising results, although evidence is limited (N = 2 studies each for OCD and PTSD) and findings for PTSD were conflicting. Despite clinical improvement, reviewed reports lacked a consistent and solid rationale for cortical target selection, revealing a gap in TMS research that complicates the interpretation of findings and hinders TMS development and optimisation. Future research should adopt a hypothesis-driven approach rather than relying solely on correlations from imaging studies, integrating neurobiological processes with affective, behavioural, and cognitive states, thereby doing justice to the complexity of human experience and mental illness.