目的:通过meta分析全面评估认知行为疗法(CBT)在治疗创伤后应激障碍(PTSD)的效果。方法:系统检索PubMed、Web of Science、PsycINFO、中国知网(CNKI)、万方数据库、维普数据库,筛选相关随机对照试验(RCTs),以标准化评定量表评估PTSD症...目的:通过meta分析全面评估认知行为疗法(CBT)在治疗创伤后应激障碍(PTSD)的效果。方法:系统检索PubMed、Web of Science、PsycINFO、中国知网(CNKI)、万方数据库、维普数据库,筛选相关随机对照试验(RCTs),以标准化评定量表评估PTSD症状的减轻程度为主要结局指标。对纳入的研究进行了数据提取、质量评估和meta分析,检索时限为2005年1月-2024年10月。Meta分析采用Review Manager Software 5.4完成。结果:共纳入21项研究(总样本量1 683例)。Meta分析结果显示,CBT在减轻PTSD症状方面显著优于对照组,(SMD=-0.25,95%CI:-0.43~-0.06,P<0.05)。亚组分析探讨了研究区域、样本量和创伤来源等因素对结果的影响,为CBT在不同情境下的应用提供了参考。结论:CBT在缓解成年人PTSD症状方面具有良好疗效。展开更多
Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with...Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder.In addition,the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment.Evidence suggests that this condition is a multisystem disorder that affects many biological systems,raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder.We performed a PubMed search for microRNAs(miRNAs)in post-traumatic stress disorder(PTSD)that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023.These included four studies with whole blood,seven with peripheral blood mononuclear cells,four with plasma extracellular vesicles/exosomes,and one with serum exosomes.One of these studies had also used whole plasma.Two studies were excluded as they did not involve microRNA biomarkers.Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat,and only two were from recently traumatized adult subjects.In measuring miRNA expression levels,many of the studies had used microarray miRNA analysis,miRNA Seq analysis,or NanoString panels.Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls.The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood;miR-193a-5p,-7113-5p,-125a,-181c,and-671-5p in peripheral blood mononuclear cells;miR-10b-5p,-203a-3p,-4488,-502-3p,-874-3p,-5100,and-7641 in plasma extracellular vesicles/exosomes;and miR-18a-3p and-7-1-5p in blood plasma.Several important limitations identified in the studies need to be taken into account in future studies.Further studies are warranted with war veterans and recently traumatized children,adolescents,and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.展开更多
创伤后应激障碍(post-traumatic stress disorder, PTSD)是指个体在经历严重的心理创伤后产生的一种延迟性和持续性精神障碍,其发病机制尚不明确,临床缺乏安全有效、快捷便利的治疗手段。记忆的增强和记忆消退的减弱是PTSD发生的主要原...创伤后应激障碍(post-traumatic stress disorder, PTSD)是指个体在经历严重的心理创伤后产生的一种延迟性和持续性精神障碍,其发病机制尚不明确,临床缺乏安全有效、快捷便利的治疗手段。记忆的增强和记忆消退的减弱是PTSD发生的主要原因,因此对于PTSD的防治,针对记忆形成不同阶段进行干预可能有效。氯胺酮作为N-甲基-D-天冬氨酸受体拮抗剂具有良好的抗焦虑、抗抑郁的作用,有望成为新的PTSD治疗药物。本文将综述氯胺酮对记忆形成不同阶段的影响,为PTSD的防治提供新的研究思路和方向。Post-traumatic stress disorder (PTSD) is a delayed and persistent mental disorder that occurs after an individual experiences severe psychological trauma, and its pathogenesis is still unclear. There is a lack of safe, effective, fast and convenient clinical treatments. The enhancement of memory and the weakening of memory fading are the main reasons for the occurrence of PTSD, so for the prevention and treatment of PTSD, interventions targeting different stages of memory formation may be effective. Ketamine, as an N-methyl-D-aspartate receptor antagonist with good anxiolytic and antidepressant effects, is expected to be a new therapeutic drug for PTSD. In this paper, we will review the effects of ketamine on different stages of memory formation to provide new research ideas and directions for the prevention and treatment of PTSD.展开更多
文摘Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder.In addition,the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment.Evidence suggests that this condition is a multisystem disorder that affects many biological systems,raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder.We performed a PubMed search for microRNAs(miRNAs)in post-traumatic stress disorder(PTSD)that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023.These included four studies with whole blood,seven with peripheral blood mononuclear cells,four with plasma extracellular vesicles/exosomes,and one with serum exosomes.One of these studies had also used whole plasma.Two studies were excluded as they did not involve microRNA biomarkers.Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat,and only two were from recently traumatized adult subjects.In measuring miRNA expression levels,many of the studies had used microarray miRNA analysis,miRNA Seq analysis,or NanoString panels.Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls.The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood;miR-193a-5p,-7113-5p,-125a,-181c,and-671-5p in peripheral blood mononuclear cells;miR-10b-5p,-203a-3p,-4488,-502-3p,-874-3p,-5100,and-7641 in plasma extracellular vesicles/exosomes;and miR-18a-3p and-7-1-5p in blood plasma.Several important limitations identified in the studies need to be taken into account in future studies.Further studies are warranted with war veterans and recently traumatized children,adolescents,and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.
文摘创伤后应激障碍(post-traumatic stress disorder, PTSD)是指个体在经历严重的心理创伤后产生的一种延迟性和持续性精神障碍,其发病机制尚不明确,临床缺乏安全有效、快捷便利的治疗手段。记忆的增强和记忆消退的减弱是PTSD发生的主要原因,因此对于PTSD的防治,针对记忆形成不同阶段进行干预可能有效。氯胺酮作为N-甲基-D-天冬氨酸受体拮抗剂具有良好的抗焦虑、抗抑郁的作用,有望成为新的PTSD治疗药物。本文将综述氯胺酮对记忆形成不同阶段的影响,为PTSD的防治提供新的研究思路和方向。Post-traumatic stress disorder (PTSD) is a delayed and persistent mental disorder that occurs after an individual experiences severe psychological trauma, and its pathogenesis is still unclear. There is a lack of safe, effective, fast and convenient clinical treatments. The enhancement of memory and the weakening of memory fading are the main reasons for the occurrence of PTSD, so for the prevention and treatment of PTSD, interventions targeting different stages of memory formation may be effective. Ketamine, as an N-methyl-D-aspartate receptor antagonist with good anxiolytic and antidepressant effects, is expected to be a new therapeutic drug for PTSD. In this paper, we will review the effects of ketamine on different stages of memory formation to provide new research ideas and directions for the prevention and treatment of PTSD.
