Sher L
Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY 10032, USA.
Minerva Pediatr. 2008 Dec;60(6):1393-9.
Post-traumatic stress disorder (PTSD) is a common psychiatric disorder which is frequently comorbid with major depressive disorder (MDD). It has been suggested that some or all individuals diagnosed with comorbid PTSD and MDD have a separate psychobiological condition that can be termed ''post-traumatic mood disorder'' (PTMD). The idea was based on the fact that a significant number of studies suggested that patients suffering from comorbid PTSD and MDD differed clinically and biologically from individuals with PTSD alone or MDD alone. Individuals with comorbid PTSD and MDD are characterized by greater severity of symptoms and the higher level of impairment in social and occupational functioning compared to individuals with PTSD alone or MDD alone. Neurobiological evidence supporting the concept of PTMD includes the findings from neuroendocrine challenge, cerebrospinal fluid, neuroimaging, sleep and other studies. It has been demonstrated that child abuse increases the risk for PTSD, MDD, and suicidal behavior in adolescents and adults. Many victims of childhood abuse develop comorbid PTSD and depression, i.e., they develop PTMD. PTMD is associated with suicidal behavior. The link between childhood abuse, suicidal behavior in adolescents and PTMD indicates that it is important to develop interventions to prevent PTMD in victims of child abuse; to develop measures to prevent suicidal behavior in adolescents with PTMD; and to study psychobiology of PTMD in order to develop treatments for PTMD. Priorities for intervening to reduce adolescent suicidal behavior lie with interventions focused upon the improved recognition, treatment and management of adolescents with psychiatric disorders including PTMD.
创伤后应激障碍（PTSD）是一种常见的精神障碍，常与重度抑郁症（MDD）共病。有人提出，部分或所有被诊断为PTSD与MDD共病的个体存在一种独立的心理生物学状况，可称为“创伤后情绪障碍”（PTMD）。这一观点基于大量研究表明，患有PTSD与MDD共病的患者在临床和生物学方面与仅患有PTSD或仅患有MDD的个体不同。与仅患有PTSD或仅患有MDD的个体相比，PTSD与MDD共病的个体症状更严重，社会和职业功能受损程度更高。支持PTMD概念的神经生物学证据包括神经内分泌激发试验、脑脊液、神经影像学、睡眠及其他研究的结果。研究表明，儿童期受虐会增加青少年和成年人患PTSD、MDD及自杀行为的风险。许多童年期受虐的受害者会发展为PTSD与抑郁症共病，即他们会患上PTMD。PTMD与自杀行为有关。童年期受虐、青少年自杀行为与PTMD之间的联系表明，开展干预措施以预防童年期受虐受害者患PTMD、制定措施预防患有PTMD的青少年的自杀行为以及研究PTMD的心理生物学以便开发PTMD的治疗方法非常重要。干预以减少青少年自杀行为的重点在于针对改善对包括PTMD在内的精神障碍青少年的识别、治疗和管理的干预措施。
