Advancing PTSD Diagnosis, Treatment, and Dissemination of Trauma Care in Humanitarian Emergencies – A Proof-of-Concept Clinical Trial

Decentralised health systems in low- and middle-income countries impacted by humanitarian crises lack resources and a qualified workforce to attend to the overwhelming demand for mental health care in emergencies. Cross-cultural screening and diagnostic tools, alongside innovative treatment approaches that are safe, cost-effective, and scalable are needed. The primary aims of this study included (1) examining the clinical validity of a new screener, the Global Psychotrauma Screen (GPS), among refugees; (2) identifying candidate cognitive and electrophysiological diagnostic markers of combined clinical and subclinical PTSD; and (3) investigating the preliminary efficacy of a novel trauma-focused mobile App intervention via changes in clinical symptomatology, cognitive performance and electrophysiological brain activity. A non-randomised clinical trial was conducted with 70 African refugees in Australia. Participants completed clinical interviews, neuropsychological tests, quantitative electrophysiology (qEEG) recordings, and the seven-day App intervention from home. On the eighth day, participants returned to the lab to repeat all baseline assessments, followed by 1-, 3-, 6-, and 12-month interviews. The GPS demonstrated high sensitivity and specificity in detecting a probable diagnosis of PTSD, depression, and dissociative subtype. Baseline analyses indicated that the PTSD group had increased qEEG power across multiple brain regions, and faster rapid visual information processing. The intervention was associated with significant reductions in PTSD severity and related comorbidities, and changes in qEEG and cognitive performance. In conclusion, this study (1) indicated that the GPS may be a useful screening tool for refugees; (2) identified novel diagnostic and prognostic markers for clinical and subclinical PTSD, and (3) provided preliminary evidence for the efficacy of the proposed App in reducing PTSD severity and comorbid symptomatology. Randomised trials are recommended to further develop mobile-based screening, diagnostic and prognostic features, and determine the App’s cross-cultural efficacy in emergency settings

Mental health responses to COVID-19 around the world

Background: The mental health impact of the COVID-19 crisis may differ from previously studied stressful events in terms of psychological reactions, specific risk factors, and symptom severity across geographic regions worldwide.Objective: To assess the impact of COVID-19 on a wide range of mental health symptoms, to identify relevant risk factors, to identify the effect of COVID-19 country impact on mental health, and to evaluate regional differences in psychological responses to COVID-19 compared to other stressful events.Method: 7034 respondents (74% female) participated in the worldwide Global Psychotrauma Screen – Cross-Cultural responses to COVID-19 study (GPS-CCC), reporting on mental health symptoms related to COVID-19 (n = 1838) or other stressful events (n = 5196) from April to November 2020.Results: Events related to COVID-19 were associated with more mental health symptoms compared to other stressful events, especially symptoms of PTSD, anxiety, depression, insomnia, and dissociation. Lack of social support, psychiatric history, childhood trauma, additional stressful events in the past month, and low resilience predicted more mental health problems for COVID-19 and other stressful events. Higher COVID-19 country impact was associated with increased mental health impact of both COVID-19 and other stressful events. Analysis of differences across geographic regions revealed that in Latin America more mental health symptoms were reported for COVID-19 related events versus other stressful events, while the opposite pattern was seen in North America.Conclusions: The mental health impact of COVID-19-related stressors covers a wide range of symptoms and is more severe than that of other stressful events. This difference was especially apparent in Latin America. The findings underscore the need for global screening for a wide range of mental health problems as part of a public health approach, allowing for targeted prevention and intervention programs.publishedVersio

Mental health responses to COVID-19 around the world

Background: The mental health impact of the COVID-19 crisis may differ from previously studied stressful events in terms of psychological reactions, specific risk factors, and symptom severity across geographic regions worldwide.Objective: To assess the impact of COVID-19 on a wide range of mental health symptoms, to identify relevant risk factors, to identify the effect of COVID-19 country impact on mental health, and to evaluate regional differences in psychological responses to COVID-19 compared to other stressful events.Method: 7034 respondents (74% female) participated in the worldwide Global Psychotrauma Screen – Cross-Cultural responses to COVID-19 study (GPS-CCC), reporting on mental health symptoms related to COVID-19 (n = 1838) or other stressful events (n = 5196) from April to November 2020.Results: Events related to COVID-19 were associated with more mental health symptoms compared to other stressful events, especially symptoms of PTSD, anxiety, depression, insomnia, and dissociation. Lack of social support, psychiatric history, childhood trauma, additional stressful events in the past month, and low resilience predicted more mental health problems for COVID-19 and other stressful events. Higher COVID-19 country impact was associated with increased mental health impact of both COVID-19 and other stressful events. Analysis of differences across geographic regions revealed that in Latin America more mental health symptoms were reported for COVID-19 related events versus other stressful events, while the opposite pattern was seen in North America.Conclusions: The mental health impact of COVID-19-related stressors covers a wide range of symptoms and is more severe than that of other stressful events. This difference was especially apparent in Latin America. The findings underscore the need for global screening for a wide range of mental health problems as part of a public health approach, allowing for targeted prevention and intervention programs