Kim Jae-Min, Kang Hee-Ju, Kim Ju-Wan, Lee Ju-Yeon, Jang Hyunseok, Kim Jung-Chul, Kim Sung-Wan, Shin Il-Seon
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
J Anxiety Disord. 2024 Dec;108:102943. doi: 10.1016/j.janxdis.2024.102943. Epub 2024 Nov 12.
This longitudinal study explored the intricate relationships between serum Brain-Derived Neurotrophic Factor (sBDNF) levels, exposure to childhood adversities, and the subsequent development of Post-Traumatic Stress Disorder (PTSD), distinguishing between earlier- and delayed-onset forms over a two-year follow-up period in individuals sustaining physical injuries. We recruited patients presenting with moderate to severe physical injuries at a trauma center, conducting baseline assessments of sBDNF levels and childhood adversities through the Adverse Childhood Experiences (ACE) questionnaire. Additionally, detailed socio-demographic and clinical data were compiled. The Clinician-Administered PTSD Scale for DSM-5 was employed to diagnose PTSD at 3, 6, 12, and 24 months post-injury. Binary and multinomial logistic regression analyses were applied to elucidate the interactions between sBDNF levels, childhood adversities, and PTSD onset patterns. Among 895 participants, PTSD was diagnosed in 107 individuals (11.9 %), with 76 (8.4 %) exhibiting symptoms indicative of earlier-onset PTSD and 31 (3.5 %) demonstrating delayed-onset PTSD. Significantly, lower sBDNF levels were associated with a higher risk of earlier-onset PTSD specifically in the context of childhood adversities. This association was not observed in individuals without childhood adversities or in those with delayed-onset PTSD. The findings suggest a complex and critical interplay between neurobiological factors, specifically sBDNF levels, and early life adversities in influencing the timing of PTSD onset, potentially deepening the understanding of PTSD etiology.
这项纵向研究探讨了血清脑源性神经营养因子（sBDNF）水平、童年逆境暴露与创伤后应激障碍（PTSD）后续发展之间的复杂关系，在为期两年的随访期内，区分身体受伤个体中早发性和迟发性PTSD的形式。我们在一家创伤中心招募了中度至重度身体受伤的患者，通过儿童期不良经历（ACE）问卷对sBDNF水平和童年逆境进行基线评估。此外，还收集了详细的社会人口统计学和临床数据。使用针对《精神疾病诊断与统计手册》第5版的临床医生管理的PTSD量表，在受伤后3、6、12和24个月诊断PTSD。应用二元和多项逻辑回归分析来阐明sBDNF水平、童年逆境和PTSD发病模式之间的相互作用。在895名参与者中，107人（11.9%）被诊断为PTSD，其中76人（8.4%）表现出早发性PTSD的症状，31人（3.5%）表现出迟发性PTSD。值得注意的是，较低的sBDNF水平与童年逆境背景下早发性PTSD的较高风险相关。在没有童年逆境的个体或迟发性PTSD患者中未观察到这种关联。研究结果表明，神经生物学因素，特别是sBDNF水平，与早期生活逆境在影响PTSD发病时间方面存在复杂而关键的相互作用，这可能会加深对PTSD病因的理解。
