Posttraumatic stress disorder functioning

McFall ME, Veith RC, Murburg MM (1992) Basal sympathoadrenal function in posttraumatic stress disorder. Biol Psychiatry 31 1050-1056... 

Perry, B.D. (1994) Neurobiological sequelae of childhood trauma PTSD in children. In Murburg, M.M., ed.. Catecholamine Function in Posttraumatic Stress Disorder Emerging Concepts. Washington DC American Psychiatric Press, pp. 235—255. 

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). 

Lawford BR, Young RM, Noble EP, et al. D2 dopamine receptor gene polymorphism paroxetine and social functioning in posttraumatic stress disorder. Eur Neuropsychopharmacol 2003 13 313-20. 

Nutt, D.J. and Malizia, A.L. 2004. Structural and functional brain changes in posttraumatic stress disorder. J. Clin. Psychiatry, 65 Suppl 1 11-17. 

PTSD compares with depression in the level of disability it imposes on patients with the disorder. Individuals fail to realize their potentials for career development, marriage, and education. Decreased productivity leads to a financial loss of more than 3 billion per year. This figure does not include economic loss associated with the failure of patients with PTSD to achieve their educational or career goals. Women in a health care maintenance organization with high scores on the Posttraumatic Stress Disorder Checklist had more than twice the adjusted total annual median cost ( 1,283) of care (i.e., outpatient, specialty care, primary care, pharmacy and mental health care costs) than those with a low score ( 609). Treatment with effective pharmacotherapy can improve the QOL of these patients. Sertraline and fluoxetine improved measures of social and occupational functioning as well as the perception of improved QOL in patients with PTSD. - ... 

Taber KH, Rauch SL, Lanius RA, Hurley RA. Functional magnetic resonance imaging Applications to posttraumatic stress disorder. J Neuropsychiatry Clin Neurosci 2003 15 125-129. 

Paroxetine is a selective serotonin reuptake inhibitor that blocks reuptake of serotonin, enhancing serotonergic function. It is used to treat panic disorder or social anxiety disorder (except Pexeva), as defined in the DSM-IV major depressive disorder, as defined in DSM-111 (immediate release) orDSM-lV (controlled release). Immediate release only for obsessive-compulsive disorder (OCD) generalized anxiety disorder (GAD) (except Pexeva) posttraumatic stress disorder (PTSD), as defined in the DSM-IV (except Pexeva). 

Positron emission tomography (PET) is another imaging technique that employs radioactive tracers to image brain activity. PET can detect and map the presence of glucose, neurotransmitters, and a dozen other chemicals critical to brain function. Subtle changes in brain structure or function that correlate to diseases have been used to distinguish brain chemistry changes associated with Alzheimer s disease, schizophrenia, alcoholism, anxiety disorders, and posttraumatic stress disorder. PET can also be used to detect emotional responses and perceptions of emotion. 

Psychiatrists prescribe antipsychotics to treat mental illnesses that cause patients to experience marked breaks with reality (psychosis). The most common of such disorders is schizophrenia, which is a chronic, disabling, persistent, and severe brain disease that sigpiificantly impairs brain functioning and affects 1 percent of the world s population, including 3 million people in the United States alone. Antipsychotic medications are referred to as typical or atypical. Psychiatrists prescribe anxiolytics (antianxiety medications) to treat anxiety disorders, which include panic disorder, generalized anxiety disorder, specific phobias, obsessive-compulsive disorder, social anxiety disorder, and posttraumatic stress disorder. Psychiatrists prescribe antidepressants and mood stabilizers to treat the symptoms of mood disorders, the most common and severe of which are major depression and bipolar disorder. 

Bremner, J.D., Elzinga, B., Schmahl, C., et al., 2008. Structural and functional plasticity of the human brain in posttraumatic stress disorder. Prog. Brain Res. 167,171-186. 

Brown, V.M., LaBar, K.S., Haswell, C.C., et al., 2014. Altered resting-state functional connectivity of basolateral and centromedial amygdala complexes in posttraumatic stress disorder. Neuropsychopharmacology 39, 351-359. 

Gilbertson, M.W., Paulus, L.A., Williston, S.K., et al, 2006. Neurocognitive function in monozygotic twins discordant for combat exposure relationship to posttraumatic stress disorder. J. Abnorm. Psychol. 115, 484-495. 

Shin, L.M., Wright C.I., Cannistraro, P. A., et al., 2005. A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder. Arch. Gen. Psychiatry 62, 273-281. 

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