Posttraumatic stress disorder depression

Lee HJ, Lee MS, Kang RH, et al. Influence of the serotonin transporter promoter gene polymorphism on susceptibility to posttraumatic stress disorder. Depress Anxiety 2005 21 135-9. 

Strawn, J.R., Geracioti Jr., T.D., 2008. Noradrenergic dysfunction and the psychopharmacology of posttraumatic stress disorder. Depress. Anxiety 25,260-271. 

Data from American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC American Psychiatric Association, 2000 429-484 and Ballenger JC, Davidson JRT, Lecrubier Y, etai Consensus statement update on posttraumatic stress disorder from the International Consensus Croup on Depression and Anxiety. J (Tin Psychiatry 2004 65(Suppi l) 55-62. 

Mental disorders, for example, multiple subtypes of anxiety, chronic fatigue syndrome, depression, sometimes together with chronic pain, posttraumatic stress disorders (PTSD), and schizophrenia... 

Grossman R, Yehuda R, New A, Schmeidler J, Silverman J, Mitropoulous V, Sta Maria N, Bgolier J, Siever L (2003) Dexamethasone suppression test findings in subjects with personality disorders associations with posttraumatic stress disorder and major depression. Am J Psychiatry 160 1291-1298... 

Yehuda R, Teicher MH, Trestman RL, Levengood RA, Siever LJ (1996b) Cortisol regulation in posttraumatic stress disorder and major depression a chronobiological analysis. Biol Psychiatry 40 79-88... 

CRF, depression and 2Lnxiety. Endocrinology 160 1—12. Bremner, J.D., Innis, R.B., Southwick, S.M., Staib, L., Zoghbi, S., and Charney, D.S. (2000a) Decreased benzodiazepine receptor binding in prefrontal cortex in combat-related posttraumatic stress disorder. Am J Psychiatry 157 1120—1126. 

Solomon, Z. and Bleich, A. (1998) Comorhidity of posttraumatic stress disorder and depression in israeli veterans. CHS Spectrums 3(7) (Suppl 2) 15-21. 

Synergy within the serotoninergic system. Boosting serotonin neurotransmission has proved to be useful not only in treatment-resistant depression, but for treatment resistance within the whole family of serotonin spectrum disorders, such as obsessive-compulsive disorder, panic disorder, social phobia, posttraumatic stress disorder, and bulimia. 

Posttraumatic stress disorder (PTSD) is another anxiety disorder that can be characterized by attacks of anxiety or panic, but it is notably different from panic disorder or social phobia in that the initial anxiety or panic attack is in response to a real threat (being raped, for example) and subsequent attacks are usually linked to memories, thoughts, or flashbacks of the original trauma. The lifetime incidence of PTSD is about 1%. Patients have disturbed sleep and frequent sleep complaints. Comorbidities with other psychiatric disorders, especially depression and drug and alcohol abuse, are the rule rather than the exception. The DSM-IV diagnostic criteria are given in Table 9—11. 

FIGURE 9-8. Shown here are the variety of therapeutic options for treating posttraumatic stress disorder (PTSD). Combination treatments for PTSD are very poorly documented but very frequently used. The PTSD combinations are similar to those for depression and for panic disorder. 

The original finding was significantly smaller overall hippocampal volume in schizophrenia. Many studies have confirmed this original finding and have demonstrated it at the initial stage of the illness. While less prominent when compared to neurodegenerative illnesses, the volume difference is comparable to major depression and posttraumatic stress disorder. 

Clinicians will readily recognize in Table 3.7 the experiences reported by many of their patients when receiving treatment for depression or other related psychiatric disorders. By looking at the Function affected column, it is possible to understand why some medications (say, SSRIs) are effective in variable degrees in several conditions associated with serotonin dysfunction (depression, OCD, social anxiety disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, and bulimia nervosa). 

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