Shetty Vivek, Yamaguchi Masaki
Section of Oral and Maxillofacial Surgery, 23-009 UCLA School of Dentistry, University of California, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668, USA.
Oral Maxillofac Surg Clin North Am. 2010 May;22(2):269-78. doi: 10.1016/j.coms.2010.01.004.
After facial trauma, a distinct subset of patients goes on to develop mental health problems including recalcitrant psychopathology. Early identification of maladaptive stress reactions provides opportunities for initiating preemptive mental health interventions and hinges on the surgeon's ability to differentiate between transient distress and precursors of recalcitrant psychiatric sequelae. The comprehensive care of injured patients will benefit greatly from objective adjuncts and decision-making tools to complement the clinical evaluation. This article addresses meeting the need for practical, standardized, and reliable screening strategies through promising developments in the use of stress response biomarkers and biosensing technology. The systematic interrogation of differentially expressed stress response biomarkers in saliva now permits rapid assessment of the psychopathogical response to the stressor. Quantitative, point-of-use measurements of the traumatic stress response will greatly improve the nosology of posttraumatic stress disorders and help advance the screening, diagnosis, treatment, and prevention of mental health consequences of violence and trauma.
面部创伤后,有一部分特定患者会出现心理健康问题,包括顽固性精神病理学问题。早期识别适应不良的应激反应为启动预防性心理健康干预提供了机会,这取决于外科医生区分短暂痛苦和顽固性精神后遗症先兆的能力。受伤患者的综合护理将极大受益于客观辅助手段和决策工具,以补充临床评估。本文通过应激反应生物标志物和生物传感技术应用方面的有前景的进展,探讨了满足对实用、标准化和可靠筛查策略需求的问题。对唾液中差异表达的应激反应生物标志物进行系统检测,现在可以快速评估对应激源的精神病理反应。对创伤应激反应进行定量、即时测量将极大改善创伤后应激障碍的分类,并有助于推进对暴力和创伤所致心理健康后果的筛查、诊断、治疗及预防。