Posttraumatic stress disorder is a complex phenomenon, and it is necessary to evaluate for any co-existing psychiatric illness in the patient. The medial prefrontal cortex (inhibitory control over the emotional reactivity of amygdala) appears to be smaller and less responsive in patients with PTSD. The size of the hippocampus is reduced, and the amygdala(processing emotions and modulating fear response) is overly reactive in individuals with PTSD. Īlso, PTSD is associated with the change in the neurophysiology and anatomy of the brain. Plasma neuropeptide Y concentration is also reduced. Serotonin concentration is also decreased in dorsal/median raphe, which likely changes the dynamic between the amygdala and the hippocampus. There is a decrease in GABA activity and an increase in the glutamate, which fosters dissociation and derealization. Also, some studies have shown altered functioning of other neurotransmitter systems such as GABA, glutamate, serotonin, neuropeptide Y, and other endogenous opioids in patients with PTSD. CRF stimulates the release of norepinephrine by the anterior cingulate cortex, which leads to an increased sympathetic response, which manifests as increased heart rate, blood pressure, increased arousal, and startle response. Individuals with PTSD have shown to have normal to low levels of cortisol and elevated levels of corticotropin-releasing factor (CRF) despite their ongoing stress. The pathophysiology of posttraumatic stress disorder involves alterations in the neurotransmitter and neurohormonal functioning. For a patient to be diagnosed as PTSD, the duration of the symptoms must be more than one month. However, the symptoms of PTSD overlap with acute stress disorder. There is a significant impairment in social, occupational, and other areas of functioning. Furthermore, problems with sleep and concentration, irritability, increased reactivity, increased startle response, hypervigilance, avoidance of traumatic triggers also occur. The symptoms of PTSD include persistently re-experiencing the traumatic event, intrusive thoughts, nightmares, flashbacks, dissociation(detachment from oneself or reality), and intense negative emotional (sadness, guilt) and physiological reaction on being exposed to the traumatic reminder. The Diagnostic and Statistical Manual of Mental Disorders(DSM-5) has included PTSD in the new category of Trauma- and Stress-related Disorders. Following the traumatic event, PTSD is common and is one of the serious health concerns that is associated with comorbidity, functional impairment, and increased mortality with suicidal ideations and attempts. Posttraumatic stress disorder (PTSD) is a syndrome that results from exposure to real or threatened death, serious injury, or sexual assault.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |