TY - JOUR
T1 - To Predict, Prevent, and Manage Post-Traumatic Stress Disorder (PTSD): A Review of Pathophysiology, Treatment, and Biomarkers
AU - Al Jowf, G.I.
AU - Ahmed, Z.T.
AU - Reijnders, R.A.
AU - de Nijs, L.
AU - Eijssen, L.M.T.
N1 - Funding Information:
Ghazi I. Al Jowf was supported by personal funding from King Faisal University, Employees Scholarship Program from the Saudi Arabian Government (no. 1026374049).
Publisher Copyright:
© 2023 by the authors.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Post-traumatic stress disorder (PTSD) can become a chronic and severely disabling condition resulting in a reduced quality of life and increased economic burden. The disorder is directly related to exposure to a traumatic event, e.g., a real or threatened injury, death, or sexual assault. Extensive research has been done on the neurobiological alterations underlying the disorder and its related phenotypes, revealing brain circuit disruption, neurotransmitter dysregulation, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Psychotherapy remains the first-line treatment option for PTSD given its good efficacy, although pharmacotherapy can also be used as a stand-alone or in combination with psychotherapy. In order to reduce the prevalence and burden of the disorder, multilevel models of prevention have been developed to detect the disorder as early as possible and to reduce morbidity in those with established diseases. Despite the clinical grounds of diagnosis, attention is increasing to the discovery of reliable biomarkers that can predict susceptibility, aid diagnosis, or monitor treatment. Several potential biomarkers have been linked with pathophysiological changes related to PTSD, encouraging further research to identify actionable targets. This review highlights the current literature regarding the pathophysiology, disease development models, treatment modalities, and preventive models from a public health perspective, and discusses the current state of biomarker research.
AB - Post-traumatic stress disorder (PTSD) can become a chronic and severely disabling condition resulting in a reduced quality of life and increased economic burden. The disorder is directly related to exposure to a traumatic event, e.g., a real or threatened injury, death, or sexual assault. Extensive research has been done on the neurobiological alterations underlying the disorder and its related phenotypes, revealing brain circuit disruption, neurotransmitter dysregulation, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Psychotherapy remains the first-line treatment option for PTSD given its good efficacy, although pharmacotherapy can also be used as a stand-alone or in combination with psychotherapy. In order to reduce the prevalence and burden of the disorder, multilevel models of prevention have been developed to detect the disorder as early as possible and to reduce morbidity in those with established diseases. Despite the clinical grounds of diagnosis, attention is increasing to the discovery of reliable biomarkers that can predict susceptibility, aid diagnosis, or monitor treatment. Several potential biomarkers have been linked with pathophysiological changes related to PTSD, encouraging further research to identify actionable targets. This review highlights the current literature regarding the pathophysiology, disease development models, treatment modalities, and preventive models from a public health perspective, and discusses the current state of biomarker research.
KW - stress
KW - traumatic stress
KW - PTSD
KW - behaviour changes
KW - pathophysiology
KW - public health
KW - biomarkers
KW - prevention
KW - treatment
KW - BENZODIAZEPINE-RECEPTOR BINDING
KW - CORTICOTROPIN-RELEASING-FACTOR
KW - NEUROPEPTIDE-Y CONCENTRATIONS
KW - RANDOMIZED CONTROLLED-TRIAL
KW - BDNF VAL66MET POLYMORPHISM
KW - COGNITIVE-BEHAVIOR THERAPY
KW - ANXIETY-LIKE BEHAVIOR
KW - DOUBLE-BLIND
KW - NEUROTROPHIC FACTOR
KW - PREFRONTAL CORTEX
U2 - 10.3390/ijms24065238
DO - 10.3390/ijms24065238
M3 - (Systematic) Review article
C2 - 36982313
SN - 1661-6596
VL - 24
JO - International Journal of Molecular Sciences
JF - International Journal of Molecular Sciences
IS - 6
M1 - 5238
ER -