Browsing by Author "Suliman, Sharain"

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    Assessing post-traumatic responses among South African adolescents : a comparison of different methods
    (2002) Suliman, Sharain; Kaminer, Debbie
    The present study compares the use of standardised diagnostic clinical interviews, self-report scales, and unstructured interviews, to determine if these different methods of assessment elicit the same or similar information with regards to trauma exposure, post-traumatic stress disorder, and depression in adolescents. A sample of Grade ll learners was drawn from two schools in the Northern Suburbs of Cape T own. The total sample comprised of 58 learners between the ages of 16 and 18 years. Each participant was administered a demographic questionnaire, a clinical diagnostic interview, two self-report scales, and an unstructured interview. The diagnostic interview used was the Schedule for Affective Disorders and Schizophrenia for School-Aged Children - Present and Lifetime version (K-SADS-PL), and the self- report scales used were the Child and Adolescent Trauma Survey (CATS) and the Children's Depression Inventory (CD1). The demographic questionnaire and qualitative interview were devised for the study. The McNemar Chi-Square statistic was used to determine differences between the interview and self-report methods of assessment, and a content analysis of the qualitative interview was conducted. Additionally, a Receiver Operating Characteristic analysis was used to establish a CATS score, indicating a high risk of PTSD, that was more sensitive to the sample. The results indicate that even though clinical interviews and self-report scales appear to produce different information, if appropriate cut-off points are used, self-report scales can be used as a screening device to reduce the number of clinical interviews required, thus contributing to a more efficient use of resources. They also indicate that unstructured qualitative interviews can elicit useful information about post- traumatic responses that is not captured by the DSM IV criteria.
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    Escitalopram in the prevention of posttraumatic stress disorder: a pilot randomized controlled trial
    (BioMed Central, 2015-02-19) 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. Trial registration: Clinical Trials NCT00300313