Browsing by Author "Zohar, Joseph"
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- ItemEscitalopram in the prevention of posttraumatic stress disorder : a pilot randomized controlled trial(BioMed Central, 2015-02) Suliman, Sharain; Seedat, Soraya; Pingo, Janine; Sutherland, Taryn; Zohar, Joseph; Stein, Dan J.Background: A small literature suggests that pharmacotherapy may be useful in the prophylaxis of posttraumatic stress disorder in patients presenting with major trauma. There is relatively little data, however, on the use of selective serotonin reuptake inhibitors (SSRIs) in this context. Methods: 24 week, double-blind placebo controlled study. 31 participants presenting immediately after trauma, and meeting diagnostic criteria for full or partial acute stress disorder were randomized to treatment with 10–20 mg of escitalopram or placebo daily for 24 weeks. 2 participants were excluded from the analysis due to early drop out, leaving 29 participants (escitalopram = 12, placebo = 17) for inclusion in an intent- to- treat analysis. Participants were followed up until 56 weeks, and assessed with the Clinician Administered PTSD Scale (CAPS). A mixed model repeated measures analysis of variance (RMANOVA) was undertaken to determine the efficacy of the intervention on the CAPS score. Results: There was a significant reduction in CAPS score over the course of treatment (F(7, 142) = 41. 58, p < 0.001) in both the escitalopram and placebo groups, with a greater reduction in CAPS score in the placebo group F(7, 142) = 2.12, p = 0.045. There were improvements on all secondary measures, including the Clinical Global Impressions scale, and scales assessing depression, anxiety and disability. Only functional disability outcomes (F(7, 141) = 2.13, p = .04), were significantly different between treatment and placebo groups. In the sample as a whole, improvement in scores were maintained at the 52 week follow-up. Side effects were comparable between the groups. Conclusions: These data are consistent with other recent work indicating that the SSRIs may not be efficacious in the prevention of PTSD. Nevertheless, the small sample size and baseline differences between groups limit the explanatory power of the study. Although a consideration of the possibility of medication prophylaxis in PTSD remains important, both from conceptual and clinical perspectives, caution is needed with regards to the use of SSRIs until their efficacy can be proven.
- ItemPreventing problematic internet use during the COVID-19 pandemic : consensus guidance(Elsevier Inc, 2020-07) Király, Orsolya; Potenza, Marc N.; Stein, Dan J.; King, Daniel L.; Hodgins, David C.; Saunders, John B.; Griffiths, Mark D.; Gjoneska, Biljana; Billieux, Joël; Brand, Matthias; Abbott, Max W.; Chamberlain, Samuel R.; Corazza, Ornella; Burkauskas, Julius; Sales, Célia M. D.; Montag, Christian; Lochner, Christine; Grünblatt, Edna; Wegmann, Elisa; Martinotti, Giovanni; Lee, Hae Kook; Rumpf, Hans-Jürgen; Castro-Calvo, Jesús; Rahimi-Movaghar, Afarin; Higuchi, Susumu; Menchon, Jose M.; Zohar, Joseph; Pellegrini, Luca; Walitza, Susanne; Fineberg, Naomi A.; Demetrovics, ZsoltAs a response to the COVID-19 pandemic, many governments have introduced steps such as spatial distancing and "staying at home" to curb its spread and impact. The fear resulting from the disease, the 'lockdown' situation, high levels of uncertainty regarding the future, and financial insecurity raise the level of stress, anxiety, and depression experienced by people all around the world. Psychoactive substances and other reinforcing behaviors (e.g., gambling, video gaming, watching pornography) are often used to reduce stress and anxiety and/or to alleviate depressed mood. The tendency to use such substances and engage in such behaviors in an excessive manner as putative coping strategies in crises like the COVID-19 pandemic is considerable. Moreover, the importance of information and communications technology (ICT) is even higher in the present crisis than usual. ICT has been crucial in keeping parts of the economy going, allowing large groups of people to work and study from home, enhancing social connectedness, providing greatly needed entertainment, etc. Although for the vast majority ICT use is adaptive and should not be pathologized, a subgroup of vulnerable individuals are at risk of developing problematic usage patterns. The present consensus guidance discusses these risks and makes some practical recommendations that may help diminish them.