创伤后应激障碍简述

2004-12底发生的印度洋海啸令全世界震惊和悲痛。随着救援工作的推进，人们关注的焦点逐渐从遇难者转向幸存者，据相关报道显示，至少800名泰国幸存者患上了后海啸恐惧症，他们担心海啸还会卷土重来；一些幸存者为同伴相继死去而自己却生存下来感到负罪，甚至想要自杀；还有许多人脑海中不时出现灾情场面，或是仿佛听到海啸警报声；     

急性应激障碍向创伤后应激障碍转化模型的建立

目的建立小鼠急性应激障碍(ASD)向创伤后应激障碍(PTSD)转化的模型。方法雄性C57BL/6J小鼠(6-8周龄)采用电击刺激(0.8 m A,每次10 s,每天15次,3 d)造模,造模后24 h和28 d后测量焦虑、回避、再体验症状。通过行为轮廓法(behavior profile),分离出在急性期和慢性期患病的小鼠。结果在电击应激后24 h,应激组小鼠表现出明显的回避行为(P=0.0012)、在电击环境中的僵直行为(P<0.01)和明显的焦虑行为(P=0.002)。在电击后28天,应激组小鼠同对照组相比仍然表现出显著的焦虑行为(P=0.0889)、回避行为(P<0.01)和在电击环境中的僵直行为(P=0.0138)。通过行为轮廓法,以对照组各项行为学数据的平均值±0.5标准差为界限,定义在三项行为学测试中,均超过或低于界限的小鼠为患病小鼠。通过筛选,在应激后24 h对照组小鼠有1只患病,模型组有15只患病,患病率分别为4%和57.69%。在应激后28 d,对照组小鼠患病2只,应激组患病8只,患病率分别为8%和30.77%,应激组小鼠的创伤后应激障碍患病率同临床数据相似。其中应激组在急性期和慢性期均患病的小鼠有6只,急性应激障碍向创伤后应激障碍的转化率为40%。结论成功建立了小鼠急性应激障碍向创伤后应激障碍转化的模型,可用于相关机制研究和药物筛选。     

急性应激障碍向创伤后应激障碍发展小鼠模型的制备

目的 制备急性应激障碍(ASD)向创伤后应激障碍(PTSD)发展的小鼠模型,为应激障碍机制研究和防治药物评价提供动物模型.方法 雄性C57BL/6J小鼠,每日足底电击,电流0.8 mA,每次持续10 s,间隔时间10 s,重复15次,连续电击3 d,同时设正常对照组.急性期行为学实验于足底电击后第1～第3天进行;慢性期...     

创伤后应激障碍

创伤后应激障碍（PTSD）是对异乎寻常的威胁性、灾难性事件的延迟和（或）持久的反应。如自然灾害和人为灾害：地震、严重事故、目睹他人惨死、身受酷刑。等等。几乎所有经历这类事件的人都会感到巨大的痛苦。创伤性事件是PTSD诊断的必要条件。但不是PTSD发生的充分条件，虽然大多数人在经历创伤性事件后都会出现程度不等的症状，研究表明只有部分人最终成为PTSD患者。     

创伤后应激障碍的护理方法探讨

目的探讨创伤后应激障碍患者的护理措施。方法针对患者出现的应激障碍,进行家属教育、生活护理、心理护理等干预。结果通过随访发现患者的应激障碍得到很大改善,甚至已经消除,效果明显。结论应用相关护理措施,能够消除患者紧张心理,疗效满意。     

创伤后应激障碍的表现与干预治疗

<正>在现实生活中,人们难免会遭遇一些诸如地震、火灾、严重事故、被犯罪侵害等创伤性事件。当人们经历此类事件时,常常会出现严重的生理和心理上的问题,导致社会功能丧失,严重者甚至走向自杀,这便是创伤后应激障碍。由于创伤后应激障碍会带来延迟性、持续性的心身障碍,故应及时对创伤后应激障碍进行干预和治疗,以便尽早缓解症状,恢复     

中国不同人群创伤后应激障碍相关研究现状

<正>创伤后应激障碍(Post traumatic stress disorder,PTSD)是指在强烈的精神创伤后发生的一系列心理、生理的应激反应(stress reaction)所表现出的一系列临床综合征。其临床表现以再度体验创伤为特征,并伴有情绪的易激惹和回避行为。PTSD最初仅被认为是由战场经历引起的,现在已扩展为包     

Buspirone in the treatment of posttraumatic stress disorder

Three patients with a DSM-III-R diagnosis of posttraumatic stress disorder were successfully treated with buspirone in final maximum dosages ranging from 35-60 mg daily. The onset of clinical efficacy ranged from 5-29 days. Symptoms that improved included anxiety, insomnia, flashbacks, and depressed mood. Patients experienced no side effects. Serotonin partial agonist effects are a possible mechanism underlying buspirone's efficacy.     

Duloxetine in military posttraumatic stress disorder

The objective of this prospective study was to assess the efficacy and tolerability of duloxetine in the treatment of in military veterans with posttraumatic stress disorder (PTSD).Twenty subjects were enrolled in this 12-week, open-label trial. Diagnosis and symptom severity were assessed with the Clinician Administered PTSD Scale (CAPS). Depressive symptoms were assessed the Hamilton Depression Rating Scale. All subjects had a CAPS score of at least 60 at baseline. Subjects with lifetime history of psychotic disorders or bipolar illness were excluded. Fifteen participants completed 12 weeks of treatment, five dropped-out from the trial, 3 due to side effects. For patients who discontinued, missing values were estimated using "the last observation carried forward" method. Significant improvements were seen on: CAPS total and all subscales, depression and sleep measures. Most of the improvement was observed by week 2 of treatment. Nine participants (45%) were classified as responders, defined by 20% or greater improvement on CAPS total score. The mean daily dose of duloxetine was 81 mg. The most common side effects were constipation (20%) diarrhea (25%) and nausea (20%). Two subjects developed tachycardia, one withdrew from the trial due to this problem. Duloxetine had a fast onset of action and was effective in about half of the subjects, it was well tolerated in most subjects. These preliminary results in a difficult to treat population warrant the conduction of a double blind, placebo-controlled study of duloxetine in PTSD.     

Clinicians' views on treating posttraumatic stress disorder and substance use disorder

The dual diagnosis of posttraumatic stress disorder (PTSD) and substance use disorder (SUD) is reported to be both highly prevalent and highly challenging. In this study, 147 clinicians were surveyed on their degree of difficulty and gratification in working with each disorder (PTSD, SUD) and their combination; specific types of difficulties and gratifications; and personal and professional characteristics. The dual diagnosis was perceived as more difficult than either disorder alone; but, interestingly, gratification in the work was higher than its difficulty. Areas of greatest difficulty were clients' self-destructiveness, case management, and dependency; areas of greatest gratification were teaching new coping, developing expertise, and helping clients achieve abstinence. In general, difficulty and gratification appeared to be separate constructs, rather than simply opposites. Those finding the work most difficult were more likely to be in a mental health setting and to have no personal history of trauma. Clinical implications are discussed.     

5-羟色胺与创伤后应激障碍的研究进展

创伤后应激障碍(posttraumatic stress disorder,PTSD)是当机体遭受威胁生命或者强烈精神创伤后发生的疾病。近年来研究发现,5-羟色胺(5-HT)可能通过5-羟色胺转运体 (SERT)、5-HT受体(主要包括5-HT 1A 、5-HT1B、5-HT2A和5- HT2C受体),以及多巴胺、去甲肾上腺素等神经递质相互作用,参与PTSD的发生,该文就此进行综述。     

Psychostimulant treatment of combat-related posttraumatic stress disorder

The objective of this paper is to describe three cases of combat-related posttraumatic stress disorder (PTSD), largely refractory to standard medication treatment who responded well to psychostimulant treatment. Symptoms of PTSD potentially result from chronic, stress-induced dopaminergic dysfunction in the prefrontal cortex/basal ganglia system. Psychostimulants, by their relative propensity to enhance dopamine (DA) activity within these brain regions, may have particular value in targeting this dysfunction. Evidence of dopaminergic dysfunction following chronic stress is reviewed and possible mechanism of action of psychostimulants is explored. Psychostimulants appeared to be well tolerated and beneficial in the treatment of the cases of combat-related PTSD reported. General applicability of the use of psychostimulants in combat- and non-combat-related PTSD awaits further study. The potential implications of these findings in further delineating pathophysiology and treatment in PTSD deserve further exploration.     

High prevalence of obsessive-compulsive disorder among posttraumatic stress disorder patients

Posttraumatic obsessions have been reported in a few studies and case series. However, the magnitude of this phenomenon is still unknown. In the current study we systematically evaluated the prevalence of OCD in a sample of combat and terror related PTSD patients. Out of 44 referrals, 43% of the participants had PTSD with no OCD and 41% were diagnosed also with OCD. Six percent had sub-threshold OC symptoms. No difference was found between PTSD and PTSD-OCD participants' characteristics (including demographics, trauma-related factors, and other psychiatric co-morbidity). The surprisingly high number of OCD found in the current study suggests that PTSD-OCD might be underdiagnosed, signifies the importance of direct assessment of OCD in patients with PTSD, and raise questions regarding the underlying mechanism of post-traumatic OCD.