Limandri Barbara J
J Psychosoc Nurs Ment Health Serv. 2018 Aug 1;56(8):7-10. doi: 10.3928/02793695-20180723-02.
As a survival strategy, trauma arouses intensive neurobiological mechanisms that, if unchecked, contribute to severe chronic stress responses and disability. Although posttraumatic stress disorder can be considered a distinctive psychiatric disorder, it likely underlies many psychiatric disorders, including depression and mood, anxiety, substance use, and personality disorders. Psychiatric-mental health nurses need to carefully assess for trauma symptomatology in all patients and diverse populations, such as children; adolescents; immigrants; active and inactive military personnel; women; and lesbian, gay, bisexual, transgender, queer individuals. Pharmacotherapy should focus on priority of target symptoms with first-line medications including serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and adrenergic blocking agents. Serotonin antagonists (i.e., second-generation antipsychotic agents) and benzodiazepine drugs are contraindicated and should be used sparingly and with caution. Psychotherapy is an effective adjunct to pharmacotherapy in treating trauma-related conditions. [Journal of Psychosocial Nursing and Mental Health Services, 56(8), 7-10.].
作为一种生存策略，创伤会引发强烈的神经生物学机制，若不加以控制，会导致严重的慢性应激反应和残疾。尽管创伤后应激障碍可被视为一种独特的精神障碍，但它可能是许多精神障碍的潜在病因，包括抑郁症、情绪障碍、焦虑症、物质使用障碍和人格障碍。精神心理健康护士需要仔细评估所有患者及不同人群，如儿童、青少年、移民、现役和退役军人、女性以及女同性恋、男同性恋、双性恋、跨性别、酷儿群体中的创伤症状。药物治疗应关注目标症状的优先级，一线药物包括5-羟色胺再摄取抑制剂、5-羟色胺去甲肾上腺素再摄取抑制剂和肾上腺素能阻滞剂。5-羟色胺拮抗剂（即第二代抗精神病药物）和苯二氮䓬类药物为禁忌药，应谨慎使用且用量要少。心理治疗是治疗创伤相关病症时药物治疗的有效辅助手段。[《心理社会护理与精神卫生服务杂志》，56(8)，7 - 10。]
