Sautter Frederic J, Bissette Garth, Wiley Justin, Manguno-Mire Gina, Schoenbachler Benjamin, Myers Leann, Johnson Janet E, Cerbone Arleen, Malaspina Dolores
Department of Psychiatry and Neurology, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.
Biol Psychiatry. 2003 Dec 15;54(12):1382-8. doi: 10.1016/s0006-3223(03)00571-7.
Recent studies have reported a high comorbidity between posttraumatic stress disorder (PTSD) and psychotic symptoms, and it has been hypothesized that PTSD with comorbid psychosis is a severe form of PTSD. Few studies have examined the neurobiology of PTSD with comorbid psychosis. If PTSD with secondary psychotic symptoms (PTSD-SP) is a severe form of PTSD, then it might be expected to show more extreme perturbations in the neuroendocrine patterns that characterize PTSD.
Patients with PTSD with secondary psychotic symptoms (PTSD-SP), PTSD without psychosis, and healthy comparison subjects were compared for differences in cerebrospinal fluid concentrations of corticotropin-releasing factor (CRF) and somatotropin-release-inhibiting hormone (SRIF).
The PTSD-SP subjects had significantly higher mean levels of CRF than either the PTSD or control subjects (p <.01). The three groups showed similar SRIF levels.
These data implicate abnormalities in the secretion of CRF with the production of secondary psychotic symptoms in PTSD. This finding supports the validity of PTSD-SP as a PTSD subtype and as a severe form of PTSD.
近期研究报告了创伤后应激障碍（PTSD）与精神病性症状之间存在高度共病现象，并且据推测，伴有共病性精神病的PTSD是一种严重形式的PTSD。很少有研究探讨伴有共病性精神病的PTSD的神经生物学机制。如果伴有继发性精神病性症状的PTSD（PTSD-SP）是一种严重形式的PTSD，那么可能预期它会在表征PTSD的神经内分泌模式中表现出更极端的紊乱。
比较伴有继发性精神病性症状的PTSD患者（PTSD-SP）、无精神病性症状的PTSD患者以及健康对照受试者脑脊液中促肾上腺皮质激素释放因子（CRF）和生长抑素释放抑制激素（SRIF）浓度的差异。
PTSD-SP受试者的CRF平均水平显著高于PTSD患者或对照受试者（p<.01）。三组的SRIF水平相似。
这些数据表明CRF分泌异常与PTSD中继发性精神病性症状的产生有关。这一发现支持了PTSD-SP作为PTSD亚型以及严重形式PTSD的有效性。
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