Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks
Abstract Background Blast-explosion may cause traumatic brain injury (TBI), leading to post-concussion syndrome (PCS). In studies on military personnel, PCS symptoms are highly similar to those occurring in post-traumatic stress disorder (PTSD), questioning the overlap between these syndromes. In th...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-023-04943-1 |
| _version_ | 1797801320793505792 |
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| author | R. Saar-Ashkenazy S. Naparstek Y. Dizitzer N. Zimhoni A. Friedman I. Shelef H. Cohen H. Shalev L. Oxman V. Novack G. Ifergane |
| author_facet | R. Saar-Ashkenazy S. Naparstek Y. Dizitzer N. Zimhoni A. Friedman I. Shelef H. Cohen H. Shalev L. Oxman V. Novack G. Ifergane |
| author_sort | R. Saar-Ashkenazy |
| collection | DOAJ |
| description | Abstract Background Blast-explosion may cause traumatic brain injury (TBI), leading to post-concussion syndrome (PCS). In studies on military personnel, PCS symptoms are highly similar to those occurring in post-traumatic stress disorder (PTSD), questioning the overlap between these syndromes. In the current study we assessed PCS and PTSD in civilians following exposure to rocket attacks. We hypothesized that PCS symptomatology and brain connectivity will be associated with the objective physical exposure, while PTSD symptomatology will be associated with the subjective mental experience. Methods Two hundred eighty nine residents of explosion sites have participated in the current study. Participants completed self-report of PCS and PTSD. The association between objective and subjective factors of blast and clinical outcomes was assessed using multivariate analysis. White-matter (WM) alterations and cognitive abilities were assessed in a sub-group of participants (n = 46) and non-exposed controls (n = 16). Non-parametric analysis was used to compare connectivity and cognition between the groups. Results Blast-exposed individuals reported higher PTSD and PCS symptomatology. Among exposed individuals, those who were directly exposed to blast, reported higher levels of subjective feeling of danger and presented WM hypoconnectivity. Cognitive abilities did not differ between groups. Several risk factors for the development of PCS and PTSD were identified. Conclusions Civilians exposed to blast present higher PCS/PTSD symptomatology as well as WM hypoconnectivity. Although symptoms are sub-clinical, they might lead to the future development of a full-blown syndrome and should be considered carefully. The similarities between PCS and PTSD suggest that despite the different etiology, namely, the physical trauma in PCS and the emotional trauma in PTSD, these are not distinct syndromes, but rather represent a combined biopsychological disorder with a wide spectrum of behavioral, emotional, cognitive and neurological symptoms. |
| first_indexed | 2024-03-13T04:48:40Z |
| format | Article |
| id | doaj.art-a08e5c626b4346c19185627a4d78e548 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-03-13T04:48:40Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-a08e5c626b4346c19185627a4d78e5482023-06-18T11:21:24ZengBMCBMC Psychiatry1471-244X2023-06-0123111410.1186/s12888-023-04943-1Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacksR. Saar-Ashkenazy0S. Naparstek1Y. Dizitzer2N. Zimhoni3A. Friedman4I. Shelef5H. Cohen6H. Shalev7L. Oxman8V. Novack9G. Ifergane10Faculty of Social-Work, Ashkelon Academic CollegeDepartment of Psychology Ben-Gurion, University of the NegevClinical Research Center, Soroka University Medical CenterClinical Research Center, Soroka University Medical CenterDepartment of Cognitive-Neuroscience, Ben-Gurion University of the NegevZlotowski Center for Neuroscience, Ben-Gurion University of the NegevAnxiety and Stress Research Unit, Faculty of Health Sciences, Ministry of Health, Ben-Gurion University of the NegevDepartment of Psychiatry, Soroka University Medical CenterClinical Research Center, Soroka University Medical CenterClinical Research Center, Soroka University Medical CenterDepartment of Neurology, Soroka University Medical CenterAbstract Background Blast-explosion may cause traumatic brain injury (TBI), leading to post-concussion syndrome (PCS). In studies on military personnel, PCS symptoms are highly similar to those occurring in post-traumatic stress disorder (PTSD), questioning the overlap between these syndromes. In the current study we assessed PCS and PTSD in civilians following exposure to rocket attacks. We hypothesized that PCS symptomatology and brain connectivity will be associated with the objective physical exposure, while PTSD symptomatology will be associated with the subjective mental experience. Methods Two hundred eighty nine residents of explosion sites have participated in the current study. Participants completed self-report of PCS and PTSD. The association between objective and subjective factors of blast and clinical outcomes was assessed using multivariate analysis. White-matter (WM) alterations and cognitive abilities were assessed in a sub-group of participants (n = 46) and non-exposed controls (n = 16). Non-parametric analysis was used to compare connectivity and cognition between the groups. Results Blast-exposed individuals reported higher PTSD and PCS symptomatology. Among exposed individuals, those who were directly exposed to blast, reported higher levels of subjective feeling of danger and presented WM hypoconnectivity. Cognitive abilities did not differ between groups. Several risk factors for the development of PCS and PTSD were identified. Conclusions Civilians exposed to blast present higher PCS/PTSD symptomatology as well as WM hypoconnectivity. Although symptoms are sub-clinical, they might lead to the future development of a full-blown syndrome and should be considered carefully. The similarities between PCS and PTSD suggest that despite the different etiology, namely, the physical trauma in PCS and the emotional trauma in PTSD, these are not distinct syndromes, but rather represent a combined biopsychological disorder with a wide spectrum of behavioral, emotional, cognitive and neurological symptoms.https://doi.org/10.1186/s12888-023-04943-1BlastTBI/mTBIPCSPTSDDTI |
| spellingShingle | R. Saar-Ashkenazy S. Naparstek Y. Dizitzer N. Zimhoni A. Friedman I. Shelef H. Cohen H. Shalev L. Oxman V. Novack G. Ifergane Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks BMC Psychiatry Blast TBI/mTBI PCS PTSD DTI |
| title | Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks |
| title_full | Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks |
| title_fullStr | Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks |
| title_full_unstemmed | Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks |
| title_short | Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks |
| title_sort | neuro psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks |
| topic | Blast TBI/mTBI PCS PTSD DTI |
| url | https://doi.org/10.1186/s12888-023-04943-1 |
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