Psychological trauma, posttraumatic stress disorder and trauma-related depression: A mini-review

作者：Shikai Wang, Min Feng, Fang Yu, Liang Lv, Sun Gui-lan, Shengliang Yang, Ping Guo, Shan-Fei Cheng, Mincai Qian, Huanxin Chen · 发表于：World Journal of Psychiatry · 年份：2023 · DOI：10.5498/wjp.v13.i6.331 · 被引用次数：75 · 研究领域：Posttraumatic Stress Disorder Research、Migration, Health and Trauma、Child Abuse and Trauma

Childhood maltreatment is the most important preventable risk factor for psychiatric disorders.Maltreated individuals typically develop psychiatric disorders at an earlier age, have a more pernicious course, more comorbidities, greater symptom severity, and respond less favorably to treatments than non-maltreated individuals with the same primary DSM-5 diagnosis.Furthermore, maltreated individuals have alterations in stress-susceptible brain regions, hypothalamic-pituitary-adrenal response, and inflammatory marker levels not discernible in their non-maltreated counterparts.Hence, maltreated and non-maltreated individuals with the same primary DSM-5 diagnoses appear to be clinically and neurobiologically distinct.The failure to embody this distinction in DSM-5 has interfered with our ability to discover novel treatments, to recommend currently available treatments most likely to be efficacious, and has been a largely unrecognized confound that has thwarted our ability to identify the biological basis for major psychiatric disorders.Incorporating this distinction into DSM will help transform this sign and symptom-based classification system to a more etiologically informed nosology.We discuss several diagnostic alternatives and recommend the inclusion of a Developmental Trauma Disorder diagnosis for severely dysregulated individuals, of all ages, with numerous comorbidities, who experienced interpersonal victimization and disruptions in attachment, such as emotional maltreatmen...