Post‐traumatic stress disorder: evolving conceptualization and evidence, and future research directions

World Psychiatry, Год журнала: 2025, Номер 24(1), С. 52 - 80

Опубликована: Янв. 15, 2025

The understanding of responses to traumatic events has been greatly influenced by the introduction diagnosis post‐traumatic stress disorder (PTSD). In this paper we review initial versions diagnostic criteria for condition and associated epidemiological findings, including sociocultural differences. We consider evidence reactions occurring in multiple contexts not previously defined as traumatic, implications that these observations have diagnosis. More recent developments such DSM‐5 dissociative subtype ICD‐11 complex PTSD are reviewed, adding there several distinct phenotypes. describe psychological foundations PTSD, involving disturbances memory well identity. A broader focus on identity may be able accommodate group communal influences experience trauma impact resource loss. then summarize current concerning biological with a particular genetic neuroimaging studies. Whereas progress prevention disappointing, is now an extensive supporting efficacy variety treatments established trauma‐focused interventions – cognitive behavior therapy (TF‐CBT) eye movement desensitization reprocessing (EMDR) non‐trauma‐focused therapies, which also include some emerging identity‐based approaches present‐centered compassion‐focused therapies. Additionally, promising neither nor pharmacological, or combine pharmacological approach, 3,4‐methylenedioxymethamphetamine (MDMA)‐assisted psychotherapy. advances priority areas adapting resource‐limited settings across cultural contexts, community‐based approaches. conclude identifying future directions work mental health.

Язык: Английский

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Alleviating anxiety and taming trauma: Novel pharmacotherapeutics for anxiety disorders and posttraumatic stress disorder

Neuropharmacology, Год журнала: 2023, Номер 226, С. 109418 - 109418

Опубликована: Янв. 6, 2023

Psychiatric disorders associated with psychological trauma, stress and anxiety are a highly prevalent increasing cause of morbidity worldwide. Current therapeutic approaches, including medication, effective in alleviating symptoms posttraumatic disorder (PTSD), at least some individuals, but have unwanted side-effects do not resolve underlying pathophysiology. After period stagnation, there is renewed enthusiasm from public, academic commercial parties designing developing drug treatments for these disorders. Here, we aim to provide snapshot the current state this field that written neuropharmacologists, also practicing clinicians interested lay-reader. introducing currently available treatments, summarize recent/ongoing clinical assessment novel medicines PTSD, grouped according primary neurochemical targets their potential produce acute and/or enduring effects. The evaluation putative targeting monoamine (including psychedelics), GABA, glutamate, cannabinoid, cholinergic neuropeptide systems, amongst others, discussed. We emphasize importance clinically assessing new medications based on firm understanding neurobiology stemming rapid advances being made neuroscience. This includes harnessing neuroplasticity bring about lasting beneficial changes brain rather than – as many transient attenuation symptoms, exemplified by combining psychotropic/cognitive enhancing drugs psychotherapeutic approaches. conclude noting other emerging trends promising phase development.

Язык: Английский

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Metabolic and Inflammatory Response in Post-Traumatic Stress Disorder (PTSD): A Systematic Review on Peripheral Neuroimmune Biomarkers

International Journal of Environmental Research and Public Health, Год журнала: 2023, Номер 20(4), С. 2937 - 2937

Опубликована: Фев. 8, 2023

Several heterogeneous pathophysiology pathways have been hypothesized for being involved in the onset and course of Post-Traumatic Stress Disorder (PTSD). This systematic review aims to summarize current evidence on role inflammation immunological dysregulations PTSD, investigating possible peripheral biomarkers linked neuroimmune response stress. A total 44 studies dysregulated inflammatory metabolic subjects with PTSD respect controls were included. Eligibility criteria included full-text publications English language, human adult samples, involving both a clinical diagnosis healthy control group. The research was focused specific blood biomarkers, namely IL-1β, TNF-α, IL-6 INF-γ, as well potential harmful reduced antioxidant activity (involving catalase, superoxide dismutase glutathione peroxidase). inflammatory-altered tryptophan metabolism also explored. results showed conflicting data pro-inflammatory cytokines individuals lack study regarding other mediators investigated. present suggests need further samples clarify pathogenesis define biomarkers.

Язык: Английский

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Next generation bioelectronic medicine: making the case for non-invasive closed-loop autonomic neuromodulation

Bioelectronic Medicine, Год журнала: 2025, Номер 11(1)

Опубликована: Янв. 20, 2025

Abstract The field of bioelectronic medicine has advanced rapidly from rudimentary electrical therapies to cutting-edge closed-loop systems that integrate real-time physiological monitoring with adaptive neuromodulation. Early innovations, such as cardiac pacemakers and deep brain stimulation, paved the way for these sophisticated technologies. This review traces historical technological progression medicine, culminating in emerging potential devices multiple disorders body. We emphasize both invasive techniques, implantable brain, spinal cord autonomic regulation, while we introduce new prospects non-invasive neuromodulation, including focused ultrasound newly developed neurography enabling precise detection titration inflammatory immune responses. case neuromodulation (incorporating splenic stimulation) is presented through its applications conditions sepsis chronic inflammation, illustrating capacity revolutionize personalized healthcare. Today, or have yet be dynamically modulate nervous system function by responding molecular signals; it represents a transformative approach therapeutic interventions major opportunity which may advance. Knowledge gaps remain likely contribute lack available closed loop systems, namely, (1) significant exogenous endogenous noise must filtered out, (2) drift signal due temporal change disease severity and/or therapy induced neuroplasticity, (3) confounding effects (e.g., concurrent medications dysregulate functions). Leveraging continuous feedback adjustments overcome many barriers, next generation stand at forefront precision offering avenues individualized treatment.

Язык: Английский

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The flow cytometric analysis of depression focusing on modern-type depression and hikikomori: Exploring the link between subtypes of depression and immunological imbalances

Dialogues in Clinical Neuroscience, Год журнала: 2025, Номер 27(1), С. 13 - 25

Опубликована: Янв. 20, 2025

Introduction Depression includes different phenotypes. Modern-type depression (MTD) is a gateway disorder to pathological social withdrawal, known as hikikomori. Adverse childhood experiences (ACEs) are also important aetiologies of depression. Recently, immune imbalance has been proposed biological basis We hypothesised that peripheral immunological characteristics may be involved in subtyping

Язык: Английский

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Mouse model of post-traumatic stress disorder negatively impacts cardiac homeostasis

Journal of Molecular and Cellular Cardiology, Год журнала: 2025, Номер 201, С. 32 - 43

Опубликована: Фев. 18, 2025

Post-traumatic stress disorder (PTSD) is a disabling psychological characterized by chronic symptoms of intrusiveness, avoidance, and hyperarousal after traumatic event. Retrospective studies have indicated PTSD increases the risk for cardiovascular disease (CVD) including arrhythmia, hypertension, myocardial infarction. The goal this study was to: 1) use murine model cued fear conditioning (inescapable foot shock, IFS) to develop scoring method distinguish PTSD-like phenotype, 2) system characterize cardiac phenotype function in mice with extreme behaviors. We compared 3 groups, controls, non-responders (NR), at 2 time points [4-weeks 8-weeks post-IFS] compare left ventricular structure function. Assessment showed both male female had increased isovolumetric relaxation post-IFS, whereas only females demonstrated E/e', atrial diameter, decreased ejection fraction control mice. Female also interstitial fibrosis through picrosirius red staining expression fibrotic genes Col3a1 Lox. Overall, our data that displaying behavioral characteristics associated present sex-dependent diastolic dysfunction likely due, least part, an activation fibrosis.

Язык: Английский

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The emerging role of the gut microbiome in posttraumatic stress disorder

Brain Behavior and Immunity, Год журнала: 2023, Номер 114, С. 360 - 370

Опубликована: Сен. 7, 2023

Язык: Английский

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Dietary glutamate enhances intestinal immunity by modulating microbiota and Th17/Treg balance-related immune signaling in piglets after lipopolysaccharide challenge

Food Research International, Год журнала: 2023, Номер 166, С. 112597 - 112597

Опубликована: Фев. 18, 2023

Язык: Английский

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Effects of genetically predicted posttraumatic stress disorder on autoimmune phenotypes

Translational Psychiatry, Год журнала: 2024, Номер 14(1)

Опубликована: Апрель 1, 2024

Observational studies suggest that posttraumatic stress disorder (PTSD) increases risk for various autoimmune diseases. Insights into shared biology and causal relationships between these diseases may inform intervention approaches to PTSD co-morbid conditions. We investigated the genetic contributions PTSD, 18 diseases, 3 immune/inflammatory biomarkers. Univariate MiXeR was used contrast architectures of phenotypes. Genetic correlations were estimated using linkage disequilibrium score regression. Bi-directional, two-sample Mendelian randomization (MR) performed independent, genome-wide significant single nucleotide polymorphisms; inverse variance weighted median MR estimates evaluated. Sensitivity analyses uncorrelated (MR PRESSO) correlated horizontal pleiotropy (CAUSE) also performed. considerably more polygenic (10,863 influential variants) than (median 255 variants). However, evidenced correlation with nine three inflammatory had putative effects on thyroid disease (p = 0.00009) C-reactive protein (CRP) 4.3 × 10-7). Inferences not substantially altered by sensitivity analyses. Additionally, PTSD-autoimmune association remained in multivariable analysis adjusted genetically predicted biomarkers as potential mechanistic pathway variables. No a effect (all p values > 0.05). Although models supported associations CRP, adequate explain CRP 0.18). In summary, our results overlap inflammation. has disease, consistent existing epidemiologic evidence. A previously reported is potentially confounded genetics. Together, highlight nuanced links disorders, associated signatures, importance targeting related pathways protect against disability.

Язык: Английский

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Validity of mental and physical stress models

Neuroscience & Biobehavioral Reviews, Год журнала: 2024, Номер 158, С. 105566 - 105566

Опубликована: Фев. 2, 2024

Язык: Английский

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