A Double-Blinded, Randomized, Placebo-Controlled Sub-Dissociative Dose Ketamine Pilot Study in the Treatment of Acute Depression and Suicidality in a Military Emergency Department Setting

Background: Rates of completed suicide in the military have increased. Options are limited for acute relief of depression and suicidal ideation. Traditional treatments' effects take weeks to months. A novel, rapid, therapeutic target has emerged with the N-methyl-D-aspartate antagonist ketamine. Previous studies suggest that a single dose of intravenous (IV) ketamine rapidly alleviates depression and suicidality.

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Improving Outcomes Following Extremity Trauma : The Need for a Multidisciplinary Approach

Extremity injuries contribute a significant amount to the overall disability of combat-injured soldiers. Tracking patient outcomes allows military health care providers to gain a better understanding of the disability associated with various injury patterns. Only recently have orthopedic surgeons begun to collect functional outcome measures, and perhaps even more importantly, have begun to collect patient-reported outcomes. There is a growing body of evidence demonstrating the importance of a multidisciplinary approach to optimize outcomes in patients following severe extremity trauma.

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Changes in Modus Operandi of Islamic State (IS) revisited

The recent attacks in Europe, carried out by Al-Qaeda (e.g. Paris, January 2015) and IS inspired or affiliated individuals and groups (e.g. Paris, November 2015, Brussels, March 2016), have increased concerns about possible future terrorist attacks by violent jihadist individuals and groups in EU Member States. This report presents an overview of the terrorist threat as perceived by the organisation and its main stakeholders, based on available information and expert knowledge.

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Biological profiling of plasma neuropeptide Y in relation to posttraumatic stress symptoms in two combat cohorts

Military personnel have an increased risk of developing stressrelated mental health problems after deployment to a combat zone [1]. In order to decrease the risk of developing stress-related disorders, biological vulnerability and protective factors should be identified. Neuropeptide Y (NPY) is a peptide transmitter that is associated with modulation of the stress response. Previous studies reported reduced NPY levels in the cerebrospinal fluid (CSF) of patients with posttraumatic stress disorder (PTSD) [2].

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Oxytocin administration enhances insula responses during social reward processing in post-traumatic stress disorder

Rationale: Post-traumatic stress disorder (PTSD) is a debilitating psychiatric condition that can develop after experiencing a traumatic event. Although effective treatment is available, including exposure therapy or cognitive behavioural therapy, about 30% of patients with PTSD do not respond to these treatments. Therefore, currently available treatments need to be improved. Intranasal administration of the neuropeptide oxytocin is a promising candidate for medication-enhanced psychotherapy (MEP), as oxytocin has been shown to increase sensitivity for social reward.

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Repeated intranasal oxytocin administration as early preventive intervention for PTSD : A randomized controlled trial.

As posttraumatic stress disorder (PTSD) develops in approximately 10% of trauma-exposed individuals, there is an urgent need for effective preventive interventions for PTSD [1]. Oxytocin administration was previously found to beneficially influence neurobiological and socio-emotional factors associated with increased PTSD risk [e.g. 2, 3]. Therefore, we hypothesized that intranasal oxytocin administration early post-trauma in trauma-exposed individuals could prevent PTSD development .

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Memory consolidation reconfigures neural pathways involved in the suppression of emotional memories

The ability to suppress unwanted emotional memories is crucial for human mental health. Through consolidation over time, emotional memories often become resistant to change. However, how consolidation impacts the effectiveness of emotional memory suppression is still unknown. Using event-related fMRI while concurrently recording skin conductance, we investigated the neurobiological processes underlying the suppression of aversive memories before and after overnight consolidation.

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Is there a vulnerability paradox in PTSD? : Pitfalls in cross-national comparisons of epidemiological data

Dückers et al analyse the relationship between prevalence estimates of trauma exposure and post-traumatic stress disorder (PTSD) in published data-sets from 24 countries, and between PTSD and vulnerability (based on a country vulnerability index developed in the 2013 World Risk report). The findings are substantially counterintuitive; countries with low vulnerability have higher life-time rates of PTSD, meaning that countries with low vulnerability and high trauma exposure have the highest rates of lifetime PTSD.

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PTSD symptom trajectories in disaster volunteers : The role of self-efficacy, social acknowledgement, and tasks carried out

Millions of volunteers respond after disasters, with a 24% to 46% risk of developing posttraumatic stress disorder (PTSD). It is unclear which symptom trajectories develop and how they differ between core (volunteering before the disaster) and noncore volunteers (joining after the disaster) and which factors predict trajectories. Symptoms of PTSD were assessed at 6-, 12-, and 18-months postearthquake in 449 volunteers in Indonesia.

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