Event-related potentials in trauma-affected refugees

Size: px

Start display at page:

Download "Event-related potentials in trauma-affected refugees"

Oliver Mathews
5 years ago
Views:

1 Event-related potentials in trauma-affected refugees Hanieh Meteran, Bob Oranje, Birte Glenthøj, Erik Vindbjerg, Jessica Carlsson, MD, PhD, Competence Centre for Transcultural Psychiatry (CTP)

2 Today Background: What are event-related potentials (ERPs)? What is sensory gating? Why this study? Aims Methods: How did we do it? Results: What did we find? Reflections

3 Background: What are event-related potentials (ERPs)? EEG measured brain response Electrophysiological response to a stimulus (sensory, cognitive or motor event) A noninvasive way of evaluating brain functioning

4 Background: What are event-related potentials?

5 Background: What is sensory gating? Important function in healthy brain to sort out irrelevant information avoid overload psychosis / psychopathology Habituation necessary to avoid overload

6 Background: Testing sensory gating Prepulse inhibition (PPI) A weak prestimulus ms before a startling stimulus Reduces/gates the amplitude of startle response Deficits in schizophrenia spectrum P50 sensory gating Two accoustic clicks in rapid succesion (500 ms apart) In healthy subjects potential to the second click is reduced/gated Reduced in schizophrenia Habituation Habituation when repeated trials

7 Background: Why this study? Evidence of abnormalities in cognitive and information processing in PTSD accumulating over the years Far from being well-characterized Impaired P50 gating? References:Javanbakht et al.,biol. Mood Anxiety Disord. 2011, Karl et al., Biol. Psychol

8 Aims By means of electroencephalography (EEG) 1. To investigate information processing in traumaaffected refugees with PTSD using PPI and P50 2. To study a possible association with symptom severity. 8

9 Methods: Where and How? CTP a specialised out-patient facility Target group at CTP trauma-affected refugees with mental health problems Cross-sectional study 25 trauma-affected refugees with PTSD from CTP 20 healthy refugee controls

10 PTSD group Inclusion criteria Being a refugee or family-reunified to a refugee Being >= 18 years Speaking Danish, English, Arabic, Farsi, or Bosnian Fulfilling the criteria for the PTSD diagnosis according to the ICD-10 and DSM-5 research criteria Legally competent to provide informed consent

11 PTSD group Exclusion criteria Having an ICD-10 F2x (schizophrenia, schizotypal and delusional disorders) or bipolar diagnosis Having neurological disorders, substance abuse or dependency according to the ICD-10 criteria

12 Control group Healthy refugee controls Recruited from the community through network/advertisement Inclusion criteria Matching participants on age (+/- 5 years), gender, country of origin, Speaking Danish, English, Arabic, Farsi or Bosnian Legally competent to provide informed consent Exclusion criteria Same as for the PTSD group Having any current psychiatric illness

13 Day 1 at CTP Clinician-administered interviews 1. CAPS (Clinician-Administered PTSD scale) 2. CGI (Clinical Global Impression) 3. SCAN (Schedules for Clinical Assessment in Neuropsychiatry) Self-administered questionnaires 1. LEC (Life Event Checklist) 2. HTQ (Harvard Trauma Questionnaire)

14 Day 2 at Center for CSN Research (CNSR): Psychophysiological assessment 1. Hearing test (5 min) 2. Prepulse inhibition (PPI) of the startle reflex (25 min) paradigm 3. P50 suppression (21 min) paradigm 4. Selective attention (13 min) paradigm 5. Mismatch negativity (12 min) paradigm

15 Preliminary research findings

17 Total PTSD Control (n=45) (n=25) (n=20) N (%) N (%) N (%) Male 24 (53%) 13 (52%) 11 (55%) Country of origin Iran 12 (27%) 6 (24%) 6 (30%) Afghanistan 12 (27%) 7 (28%) 5 (25%) Iraq 10 (22%) 5 (20%) 5 (25%) Torture 14 (31%) 11 (44%) 3 (15%) Prison 13 (29%) 9 (36%) 4 (20%) Having lived in war 44 (98%) 25 (100%) 19 (95%) Soldier 11 (24%) 7 (28%) 4 (20%) Salary/ grant 20 (44%) 3 (12%) 17( 85%) PTSD (ICD-10) 25 (56%) 25 (100%) 0 (0%) Comorbid depression 20 (44%) 20 (80%) 0 (0%) Mean Mean Mean Age Years in Denmark

20 Results No significant differences between patients and controls in either PPI or P50 suppression Patients do not show habituation, where controls do

21 Reflections Even in this raw small sample a difference was found Look further into consequences and association with symptoms New interventions?

22 Thank you for your attention! Thanks to all participants! CTP-NET.DK HREGION Psykiatri

Treatment of trauma-affected refugees with venlafaxine versus sertraline combined with psychotherapy - a randomised study

Sonne et al. BMC Psychiatry (2016) 16:383 DOI 10.1186/s12888-016-1081-5 RESEARCH ARTICLE Treatment of trauma-affected refugees with venlafaxine versus sertraline combined with psychotherapy - a randomised