Biomedical subjects

Roger Schmidt

Publications and source records attributed to Roger Schmidt.

2 recordsLinked to original sources

PubMed2004

Posttraumatic Stress Disorder in patients with traumatic brain injury.

BACKGROUND: Severe traumatic stressors such as war, rape, or life-threatening accidents can result in a debilitating psychopathological development conceptualised as Posttraumatic Stress Disorder (PTSD). Pathological memory formation during an alarm response may set the precondition for PTSD to occur. If true, a lack of memory formation by extended unconsciousness in the course of the traumatic experience should preclude PTSD. METHODS: 46 patients from a neurological rehabilitation clinic were examined by means of questionnaires and structured clinical interviews. All patients had suffered a TBI due to an accident, but varied with respect to falling unconscious during the traumatic event. RESULTS: 27% of the sub-sample who were not unconscious for an extended period but only 3% (1 of 31 patients) who were unconscious for more than 12 hours as a result of the accident were diagnosed as having current PTSD (P <.02). Furthermore, intrusive memories proved to be far more frequent in patients who had not been unconscious. This was also the case for other re-experiencing symptoms and for psychological distress and physiological reactivity to reminders of the traumatic event. CONCLUSION: TBI and PTSD are not mutually exclusive. However, victims of accidents are unlikely to develop a PTSD if the impact to the head had resulted in an extended period of unconsciousness.

Accidents↗

PubMedDate not supplied

Conversion disorder revisited.

Conversion disorder is defined as a psychiatric illness whose symptoms or deficits, affecting voluntary motor or sensory function, cannot be explained by a neurological or general medical condition. Proposing a strategy in the search for the neural mechanisms underlying conversion disorder is a difficult task, partly because key features of the illness inherently lie on a continuum with other psychiatric disorders, such as depression and posttraumatic stress disorder. Recent brain imaging studies have revealed neural circuits involved in complex mental processes potentially related to conversion disorder. These studies are reviewed, together with neuroimaging work in conversion disorder and brain imaging studies that have enriched the conceptualization of memory and emotion in posttraumatic stress disorder and major depression. Analysis of this information from a symptom-based rather than a disease-category perspective leads to a brain-based cognitive model of conversion disorder. This model suggests that disconnected crosstalk between the individual subdivisions of the anterior cingulate and the prefrontal cortex might provide a neuroscientific basis for the psychodynamic dissociation hypothesis, traditionally the bedrock explanation of the relationship between internal conflict and physical deficit. The model also suggests novel research approaches, as well as opportunities for potential therapeutic interventions.

Brain↗