EPIDEMIOLOGY, PATHOPHYSIOLOGY AND TREATMENT OF POSTTRAUMATIC STRESS DISORDER. Review

Abstract

Relevance. Posttraumatic stress disorder (PTSD) occurs in people who have suffered a traumatic event (during war, natural disaster, domestic violence, etc.) sometimes even many years after the injury, causing changes in psychological and behavioral levels. Objective is to consider current data on the prevalence, pathophysiology and therapy of patients with PTSD. Methods. Analysis of data presented by PubMed by keywords "posttraumatic stress", "prevalence", "pathophysiology", "psychotherapy", "psychopharmacology". Results. PTSD is observed in 5-10% of the population, twice as often in women than in men, among children PTSD is found in 10%, in girls 4 times more often than in boys. During the war, PTSD is most often associated with stressful events such as bombing, homelessness, sieges, and combat. The highest prevalence of PTSD was among widows and widowers, divorcees, the unemployed and retirees. Hereditary sources of PTSD risk are shown on the basis of general genomic and epigenomic associations, transcriptomic and neuroimaging studies. Changes in the amygdala, islet, hippocampus, anterior cingulate cortex, and prefrontal cortex demonstrate that emotional dysregulation in PTSD occurs due to complications in the large neural network. Methods of non-pharmacological therapy of PTSD are presented and the effectiveness of drugs of different groups (antidepressants; antipsychotics; drugs that affect sympathetic activity, endocannabinoid system, etc.) is described. Conclusions. Posttraumatic stress disorder is a common disorder that is often undiagnosed, leading to significant psychological and behavioral disorders, increasing the risk of suicide. The review presents modern ideas about its pathophysiology and treatment options.