Dados do Trabalho

Título

POST-TRAUMATIC STRESS DISORDER AND SLEEP DISTURBANCES AFTER KIDNAPPING OF A BUS ON THE RIO-NITEROI BRIDGE: A CASE SERIES REPORT

Introdução

Post-traumatic stress disorder (PTSD) is the most common mental disorder resulting from a severe traumatic event, and can only be diagnosed after 30 days of the stressful event. Currently, there are few data in the literature comparing sleep alterations that occur in the period before and after these 30 days, in the same individuals.

Objetivo

The aim of this study was to describe possible sleep disorders and psychiatric symptoms and to study the possible relationships between them in individuals who collectively experience a traumatic event. In addition, it intends to contribute to broadening and deepening knowledge on the subject, adding new data on the relationship between acute stress disorder, PTSD and sleep.

Métodos

Ten victims were assessed a few days after the bus was hijacked on the Rio-Niterói bridge. They were residents of São Gonçalo/RJ, a historic population that was repeatedly exposed to all kinds of violence. Follow-up lasted between one and sixteen months. A sociodemographic profile was drawn and a periodic assessment of quality of life, mental health and sleep was performed (using the PCL-5, SF-36, THQ, BDI-II, BAI, ESE, PSQI and SCID-5-CV), in addition to the polysomnography.

Resultados

All participants had at least one sleep complaint at the first assessment, with insomnia and nightmares the most prevalent complaints. Four participants (female) had acute stress disorder (ASD). Two of these progressed to PTSD and 3 reported bizarre or trauma-related visual hallucinations within the first month. Overall, 4 participants developed PTSD and 7 required pharmacotherapy to treat PTSD, mood disorder, generalized anxiety disorder, and alcohol use disorder. The absence of anxiety symptoms a few days after the trauma, early psychiatric intervention and rapid correction of sleep disturbances were related to the non-development of severe mental disorders. Patients with a high number of traumatic events during their lifetime, a weakened social support network, long-term insomnia and nightmares, abusive use of alcohol, smoking, psychiatric comorbidities, poor adherence to early treatment, inadequate sleep hygiene or poor sleep quality had worse evolution.

Conclusões

The results of this study suggest that, in patients with ASD or PTSD, it is important to recognize possible protective and risk factors to initiate early psychiatric and sleep treatment and prevent chronification and worsening of the psychiatric condition.

Palavras -chave

Post-traumatic stress disorder. Acute stress disorder. Sleep. Polysomnography.