Navegando por Palavras-chave "Stress disorders, post-traumatic"

Agora exibindo 1 - 2 de 2
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Psiconeuroendocrinologia do transtorno de estresse pós-traumático
    (Associação Brasileira de Psiquiatria - ABP, 2007-05-01) Ruiz, Juliana Elena [UNIFESP]; Barbosa Neto, Jair [UNIFESP]; Schoedl, Aline Ferri [UNIFESP]; Mello, Marcelo Feijó de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To review the literature on neurobiological findings related to hypothalamic-pituitary-adrenal axis dysfunctions associated with posttraumatic stress disorder. METHOD: The relevant scientific findings were described according to the date of publication and the characteristics of the studies: preclinical studies, studies on early life violence as a risk factor, and clinical findings related to patients diagnosed with posttraumatic stress disorder. RESULTS: A rich literature on hypothalamic-pituitary-adrenal axis dysfunctions and posttraumatic stress disorder was found. Neurobiological findings showed that posttraumatic stress disorder is associated with hypothalamic-pituitary-adrenal axis dysfunctions and other brain-related structures: prefrontal cortex, hippocampus, and amygdala. Posttraumatic stress disorder patients have low plasma levels of cortisol and present increased responsivity of glucocorticoid receptors, suggesting that the inhibition of negative feedback plays a significant role in the disorder pathology. Preclinical studies using animal models of maternal deprivation showed that depending on the moment the trauma occurred during the development, different hypothalamic-pituitary-adrenal axis dysfunctions were produced. Clinical studies showed that early life stress is related to the development of psychopathologies during adulthood. CONCLUSIONS: There is robust evidence of hypothalamic-pituitary-adrenal axis dysfunctions related to posttraumatic stress disorder, and the mechanisms underlying this association are being better understood.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Transtornos de humor e de ansiedade comórbidos em vítimas de violência com transtorno do estresse pós-traumático
    (Associação Brasileira de Psiquiatria - ABP, 2009-10-01) Quarantini, Lucas de Castro [UNIFESP]; Netto, Liana R.; Andrade-Nascimento, Monica; Almeida, Amanda Cristina Galvão Oliveira de [UNIFESP]; Sampaio, Aline Santos; Miranda-Scippa, Ângela Marisa de Aquino [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Koenen, Karestan C; Universidade Federal da Bahia Hospital-Escola Serviço Psiquiátrico; Harvard School of Public Health Department of Society, Human Development, and Health; Universidade Estadual de Feira de Santana Departamento de Saúde; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Harvard School of Public Health Department of Epidemiology
    OBJECTIVE: To review studies that have evaluated the comorbidity between posttraumatic stress disorder and mood disorders, as well as between posttraumatic stress disorder and other anxiety disorders. METHOD: We searched Medline for studies, published in English through April, 2009, using the following keywords: posttraumatic stress disorder, PTSD, mood disorder, major depressive disorder, major depression, bipolar disorder, dysthymia, anxiety disorder, generalized anxiety disorder, agoraphobia, obsessive-compulsive disorder, panic disorder, social phobia, and comorbidity. RESULTS: Major depression is one of the most frequent comorbid conditions in posttraumatic stress disorder individuals, but individuals with posttraumatic stress disorder are also more likely to present with bipolar disorder, other anxiety disorders and suicidal behaviors. These comorbid conditions are associated with greater clinical severity, functional impairment, and impaired quality of life in already compromised individuals with posttraumatic stress disorder. Depression symptoms also mediate the association between posttraumatic stress disorder and severity of pain among patients with chronic pain. CONCLUSION: Available studies suggest that individuals with posttraumatic stress disorder are at increased risk of developing affective disorders compared with trauma-exposed individuals who do not develop posttraumatic stress disorder. Conversely, pre-existing affective disorders increase a person's vulnerability to the posttraumatic stress disorder--inducing effects of traumatic events. Also, common genetic vulnerabilities can help to explain these comorbidity patterns. However, because the studies addressing this issue are few in number, heterogeneous and based on a limited sample, more studies are needed in order to adequately evaluate these comorbidities, as well as their clinical and therapeutic implications.