Sugden Steven G, Merlo Gia
Department of Psychiatry, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States.
Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States.
Front Neurosci. 2024 Dec 3;18:1488841. doi: 10.3389/fnins.2024.1488841. eCollection 2024.
Posttraumatic stress disorder is part of a spectrum of psychological symptoms that are frequently linked with a single defining traumatic experience. Symptoms can vary over the lifespan in intensity based on additional life stressors, individual stability, and connectedness to purpose. Historically, treatment has centered on psychotropic agents and individual and group therapy to increase the individual's window of tolerance, improve emotional dysregulation, and strengthen relationships. Unfortunately, there is a growing segment of individuals with posttraumatic stress disorder who do not respond to these traditional treatments, perhaps because they do not address the multidirectional relationships between chronic cortisol, changes in the brain gut microbiota system, neuroinflammation, and posttraumatic symptoms. We will review the literature and explain how trauma impacts the neuroendocrine and neuroimmunology within the brain, how these processes influence the brain gut microbiota system, and provide a mechanism for the development of posttraumatic stress disorder symptoms. Finally, we will show how the lifestyle psychiatry model provides symptom amelioration.
创伤后应激障碍是一系列心理症状的一部分，这些症状通常与单一明确的创伤经历相关联。症状的强度会因额外的生活压力源、个体稳定性以及与目标的关联性而在整个生命周期中有所不同。从历史上看，治疗主要集中在精神药物以及个体和团体治疗上，以扩大个体的耐受范围、改善情绪失调并加强人际关系。不幸的是，越来越多的创伤后应激障碍患者对这些传统治疗没有反应，这可能是因为它们没有解决慢性皮质醇、脑-肠微生物群系统变化、神经炎症和创伤后症状之间的多向关系。我们将回顾文献，并解释创伤如何影响大脑内的神经内分泌和神经免疫学，这些过程如何影响脑-肠微生物群系统，并为创伤后应激障碍症状的发展提供一种机制。最后，我们将展示生活方式精神病学模型如何减轻症状。
