Zohar Joseph, Juven-Wetzler Alzbeta, Myers Vicki, Fostick Leah
Chaim Sheba Medical Center, Department of Psychiatry, Tel Hashomer 52621, Israel.
Curr Opin Psychiatry. 2008 Jan;21(1):74-7. doi: 10.1097/YCO.0b013e3282f269ee.
This review provides an update on contemporary perspectives on post-traumatic stress disorder and challenges myths about the disorder and its treatment. Post-traumatic stress disorder has recently attracted public attention because of the impact of international terrorism, although the vast majority of post-traumatic stress disorder cases actually relate to civilian events such as car accidents, rape and violent robbery. This disorder requires deeper understanding and consensus among professionals.
Advances have been made in elucidating the neurobiology of this disorder, partly by using an animal model of post-traumatic stress disorder. Recent studies have focused on memory processes and the therapeutic role played by plasticity of the hypothalamic-pituitary-adrenal axis, and how this fits (or does not fit) in with the current therapeutic interventions. Guidelines have been established by various bodies in an attempt to streamline treatment options.
Understanding of post-traumatic stress disorder is incomplete. Future research should attempt to determine what treatments given during the 'window of opportunity' - the time from exposure until post-traumatic stress disorder develops - are effective. Care should be taken not to interfere with spontaneous recovery.
本综述提供关于创伤后应激障碍当代观点的最新信息,并挑战有关该障碍及其治疗的误解。尽管绝大多数创伤后应激障碍病例实际上与诸如车祸、强奸和暴力抢劫等平民事件相关,但由于国际恐怖主义的影响,创伤后应激障碍最近引起了公众关注。这种障碍需要专业人员达成更深入的理解和共识。
在阐明该障碍的神经生物学方面已取得进展,部分是通过使用创伤后应激障碍动物模型。近期研究聚焦于记忆过程以及下丘脑 - 垂体 - 肾上腺轴可塑性所起的治疗作用,以及这如何(或不如何)与当前治疗干预相契合。各机构已制定指南以试图简化治疗选择。
对创伤后应激障碍的理解并不完整。未来研究应尝试确定在“机会窗口”(从暴露到创伤后应激障碍发生的时间段)给予何种治疗是有效的。应注意避免干扰自然恢复。