Department of Psychiatry, NYU Grossman School of Medicine, New York.
Am J Psychiatry. 2024 Aug 1;181(8):705-719. doi: 10.1176/appi.ajp.20240536.
The recent worldwide surge of warfare and hostilities exposes increasingly large numbers of individuals to traumatic events, placing them at risk of developing posttraumatic stress disorder (PTSD) and challenging both clinicians and service delivery systems. This overview summarizes and updates the core knowledge of the genetic, molecular, and neural circuit features of the neurobiology of PTSD and advances in evidence-based psychotherapy, pharmacotherapy, neuromodulation, and digital treatments. While the complexity of the neurobiology and the biological and clinical heterogeneity of PTSD have challenged clinicians and researchers, there is an emerging consensus concerning the underlying mechanisms and approaches to diagnosis, treatment, and prevention of PTSD. This update addresses PTSD diagnosis, prevalence, course, risk factors, neurobiological mechanisms, current standard of care, and innovations in next-generation treatment and prevention strategies. It provides a comprehensive summary and concludes with areas of research for integrating advances in the neurobiology of the disorder with novel treatment and prevention targets.
最近全球范围内战争和敌对行动的激增使越来越多的人接触到创伤性事件，使他们面临患上创伤后应激障碍（PTSD）的风险，并对临床医生和服务提供系统提出了挑战。这篇综述总结和更新了 PTSD 的神经生物学中遗传、分子和神经回路特征的核心知识，以及基于证据的心理治疗、药物治疗、神经调节和数字治疗的进展。虽然 PTSD 的神经生物学的复杂性和生物学及临床异质性给临床医生和研究人员带来了挑战，但对于 PTSD 的潜在机制以及诊断、治疗和预防方法已经逐渐达成共识。本更新版介绍了 PTSD 的诊断、流行率、病程、风险因素、神经生物学机制、当前的标准治疗方法以及下一代治疗和预防策略的创新。它提供了一个全面的总结，并提出了将该疾病的神经生物学进展与新的治疗和预防靶点相结合的研究领域。
