To Predict, Prevent, and Manage Post-Traumatic Stress Disorder (PTSD): A Review of Pathophysiology, Treatment, and Biomarkers

Summary & key facts

This paper is a review of what scientists know about post-traumatic stress disorder, or PTSD. The authors looked at studies about how the brain and body change after trauma, how PTSD develops, which treatments work, and whether tests in blood, brain scans, or hormones can help predict or track the illness. They say talking therapies are the main treatment because they work well, medicines can help too, and that early detection and public-health prevention models are growing areas. The review also says some biological markers look promising, but none are yet reliable enough for everyday use.

Key facts:

• PTSD is a disorder that can follow a traumatic event like threatened injury, death, or sexual assault, and it can become long-lasting and disabling.
• Researchers have found repeated biological changes in people with PTSD, including altered brain circuits, disrupted brain chemicals, and problems in the stress hormone system called the hypothalamic-pituitary-adrenal axis.
• Talking therapies are still the first-choice treatment because they have good effectiveness, while medications can be used alone or together with therapy.
• Public-health approaches now include multilevel prevention models that try to spot PTSD early and reduce long-term harm.
• Scientists have identified several possible biological markers linked to PTSD-related changes, such as brain signals or hormone differences, but these markers are not yet reliable enough to be used routinely in clinics.
• The review calls for more research to turn the promising biological findings into practical tools that could predict who is at risk, help diagnose PTSD earlier, or show whether treatments are working.

Abstract

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.

Topics

Anesthesia and Neurotoxicity Research Posttraumatic Stress Disorder Research Stress Responses and Cortisol

Categories

Behavioral Neuroscience Life Sciences Neuroscience

Tags

Biochemistry Bioinformatics Biology Biomarker Chemistry Clinical psychology Disease Intensive care medicine Internal medicine Medicine Psychiatry Psychology Traumatic stress

Conditions & symptoms

Anxiety Depression PTSD Anxiety or worry Feeling disconnected from others Poor sleep