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Biomedical subjects

Jonathan I Bisson

Publications and source records attributed to Jonathan I Bisson.

13 recordsLinked to original sources
PubMed2006

Predicting post-traumatic stress disorder: validation of the Trauma Screening Questionnaire in victims of assault.

BACKGROUND: No accurate means of determining which individuals will develop post-traumatic stress disorder (PTSD) following a traumatic event has yet been identified. This study aimed to determine the validity of the Trauma Screening Questionnaire (TSQ) in predicting the development of PTSD following assault. METHOD: Five hundred and sixty-two individuals who presented to an emergency unit following assault completed the TSQ between 1 and 3 weeks later. The Davidson Trauma Scale (DTS) was completed by the same individuals at 1 month and 6 months following assault to determine the presence of PTSD. The predictive power of the TSQ was determined by statistical tests. RESULTS: The TSQ was an effective means of predicting future PTSD, with a sensitivity of 0.85, specificity 0.89, negative predictive value (NPV) 0.98 and efficiency 0.90. The positive predictive value (PPV) was lower (0.48), probably as a result of the relatively low prevalence of PTSD at 1 month (11%) and 6 months (8%) following the assault. CONCLUSIONS: This study suggests that the TSQ can be used between 1 and 3 weeks after assault to help identify individuals who will develop PTSD.

Adult↗
PubMed2006

Disseminating early interventions following trauma.

Dissemination of effective early interventions following trauma is necessary to ensure the provision of the best possible care in a timely manner. To achieve this, agreement from all key stakeholders is required regarding the messages to be disseminated and the means of dissemination. This article is based on a National Institute of Mental Health sponsored symposium on the dissemination of early interventions at the 21st annual meeting of the International Society for Traumatic Stress Studies in Toronto in 2005. The current knowledge base regarding the effectiveness and dissemination of early interventions (defined here as those that are begun within the first 3 months after exposure) following trauma for children, adolescents, and adults is considered.

Adolescent↗
PubMed2005

Neuroleptic malignant syndrome: diagnostic and therapeutic dilemmas.

Neuroleptic malignant syndrome (NMS) is a life threatening medical state complicating the use of antipsychotic medications and other drugs that affect the dopaminergic system on administration or withdrawal. The condition was recognised nearly half a century ago, shortly after the discovery of antipsychotic medications. However, there are still no systematic studies about NMS. There are no definitive guidelines on its treatment. Although early recognition is emphasised and usually possible, delayed diagnosis is not rare. We here report on a case of NMS complicated by renal failure, and possibly respiratory failure. The report underscores the seriousness of delayed diagnosis and puts forward a comprehensive management recommendation based on our experience and the existing literature.

Antipsychotic Agents↗
PubMed2004

Experience of incorporating a mental health service into patient care after operations for cancers of the head and neck.

The psychological needs of patients with cancer have been increasingly recognised. Those with cancers of the head and neck have previously been found to be at relatively high risk of developing mental health difficulties after diagnosis and treatment. To provide for their psychological needs a mental health liaison nurse was attached to the local maxillofacial surgery unit for a trial period of 18 months. Fifty-eight different patients out of a total possible 63 were seen on a total of 102 occasions. The main difficulties encountered were issues of adjustment. Ten patients required brief intervention and treatment as inpatients, and only two required treatment as outpatients. Most interventions were psychological and facilitated the normal adjustment process. Given the appreciable degree of psychopathology, we advocate a stepped care approach to deal with patients' mental health needs. Initial assessment, information, and support would be provided by ward-based staff with appropriate training and supervision. Patients who were identified as having more complex needs would be seen by a mental health liaison specialist.

Adaptation, Psychological↗
PubMed2004

Early cognitive-behavioural therapy for post-traumatic stress symptoms after physical injury. Randomised controlled trial.

BACKGROUND: Early single-session psychological interventions, including psychological debriefing following trauma, have not been shown to reduce psychological distress. Longer early psychological interventions have shown some promise. AIMS: To examine the efficacy of a four-session cognitive-behavioural intervention following physical injury. METHOD: A total of 152 patients attending an accident and emergency department displaying psychological distress following physical injury were randomised 1-3 weeks post-injury to a four-session cognitive-behavioural intervention that started 5-10 weeks after the injury or to no intervention and then followed up for 13 months. RESULTS: At 13 months, the total Impact of Event Scale score was significantly more reduced in the intervention group (adjusted mean difference=8.4,95% CI 2.4-14.36). Other differences were not statistically significant. CONCLUSIONS: A brief cognitive-behavioural intervention reduces symptoms of post-traumatic stress disorder in individuals with physical injury who display initial distress.

Accidents↗
PubMed2003

Single-session early psychological interventions following traumatic events.

Single-session early psychological interventions became widely advocated during the 1980s and 1990s as a way to prevent the development of psychological sequalae following traumatic events. There have now been 13 randomised controlled trials of single-session interventions within 1 month of a traumatic event. Notwithstanding their methodological shortcomings and clinical heterogeneity, the results are neutral overall in terms of clinical effectiveness. Possible explanations include a failure to encourage individuals' personal coping mechanisms and defence mechanisms and that insufficient time was allowed for habituation to intense exposure to occur. With the present evidence, the routine use of single-session interventions following traumatic events cannot be justified. This does not mean that there should be nothing offered, as many individuals involved in traumatic events clearly have emotional needs. Hopefully, future research will identify alternative forms of early intervention that prove useful to those individuals who would otherwise develop more significant psychological difficulties.

Humans↗
PubMed2003

Early psychosocial and pharmacological interventions after traumatic events.

1. There is no evidence to suggest that routine provision of single-session psychological interventions after traumatic events prevents the development of psychological sequelae. Some such evidence exists regarding multiple-session, cognitive-behavioral interventions. 2. There is no evidence to suggest that routine use of pharmacological agents prevents development of psychological sequelae in traumatized individuals. 3. Given the current evidence base, development of stepped-care programs focusing on education, screening, and treatment is warranted. 4. Currently, the main role of mental health professionals early on is to ensure emotionally supportive systems of care are in place, which will help identify individuals who appear most distressed so evidence-based interventions can be offered.

Antidepressive Agents↗