Department of Psychiatry and Psychotherapy, Semmelweis University, Hungary; NAP-2-SE New Antidepressant Target Research Group, Semmelweis University, Hungary; International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, Russia.
Department of Psychiatry and Psychotherapy, Semmelweis University, Hungary; National Institute of Mental Health, Neurology and Neurosurgery - Nyiro Gyula Hospital, Hungary.
Eur Neuropsychopharmacol. 2022 Aug;61:17-29. doi: 10.1016/j.euroneuro.2022.05.010. Epub 2022 Jun 16.
A sharp increase in the prevalence of neuropsychiatric disorders, including major depression, anxiety, substance use disorders and posttraumatic stress disorder (PTSD) has occurred due to the traumatic nature of the persisting COVID-19 global pandemic. PTSD is estimated to occur in up to 25% of individuals following exposure to acute or chronic trauma, and the pandemic has inflicted both forms of trauma on much of the population through both direct physiological attack as well as an inherent upheaval to our sense of safety. However, despite significant advances in our ability to define and apprehend the effects of traumatic events, the neurobiology and neuroanatomical circuitry of PTSD, one of the most severe consequences of traumatic exposure, remains poorly understood. Furthermore, the current psychotherapies or pharmacological options for treatment have limited efficacy, durability, and low adherence rates. Consequently, there is a great need to better understand the neurobiology and neuroanatomy of PTSD and develop novel therapies that extend beyond the current limited treatments. This review summarizes the neurobiological and neuroanatomical underpinnings of PTSD and discusses the conventional and emerging psychotherapies, pharmacological and combined psychopharmacological therapies, including the use of psychedelic-assisted psychotherapies and neuromodulatory interventions, for the improved treatment of PTSD and the potential for their wider applications in other neuropsychiatric disorders resulting from traumatic exposure.
由于持续的 COVID-19 大流行具有创伤性，包括重度抑郁症、焦虑症、物质使用障碍和创伤后应激障碍（PTSD）在内的神经精神疾病的患病率急剧上升。据估计，在接触急性或慢性创伤后，多达 25%的人会出现 PTSD，大流行通过直接的生理攻击以及对我们安全感的固有颠覆，对大多数人造成了这两种形式的创伤。然而，尽管我们在定义和理解创伤性事件的影响方面取得了重大进展，但 PTSD（创伤暴露最严重的后果之一）的神经生物学和神经解剖学仍然知之甚少。此外，目前用于治疗的心理疗法或药物选择的疗效、持久性和低依从率有限。因此，我们非常有必要更好地了解 PTSD 的神经生物学和神经解剖学，并开发新的治疗方法，这些方法超越了目前有限的治疗方法。这篇综述总结了 PTSD 的神经生物学和神经解剖学基础，并讨论了传统和新兴的心理疗法、药理学和联合精神药理学疗法，包括使用迷幻药辅助心理疗法和神经调节干预，以改善 PTSD 的治疗效果，并探讨它们在其他因创伤性暴露而导致的神经精神疾病中的更广泛应用的潜力。
