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      Neurobiological studies of trauma-related psychopathology: a public health perspective Translated title: Estudios neurobiológicos de la psicopatología relacionada con el trauma: una perspectiva de salud pública Translated title: 创伤精神病理学的神经生物学研究:公共卫生观点

      editorial
      a , b , a , b , a , b
      European Journal of Psychotraumatology
      Taylor & Francis
      Trauma, post-traumatic stress disorder (PTSD), neurobiology, translational neuroscience, neuroimaging, public health, intervention, trauma, trastorno de estrés postraumático (TEPT), neurobiología, neurociencia traslacional, neuroimagen, salud pública, intervención, 创伤创伤后应激障碍(PTSD), 神经生物学, 转化神经科学, 神经影像学公共卫生干预, • The societal burden of trauma- and stress-related psychiatric disorders is enormous. • Our knowledge of the neurobiology of psychiatric disorders is gradually increasing.• We highlight the translational potential of neurobiological work and its relevance to the public health burden. • Improved understanding of the neurobiology may lead to interventions with better treatment outcomes.

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          ABSTRACT

          The societal burden of psychiatric disorders that result after exposure to psychological trauma is enormous. The study of trauma-related disorders using neurobiological and public health approaches is often disjointed. It is critical to emphasize the translational potential of neurobiological work and its relevance to the public health burden of psychological trauma. Applying a public health model to traumatology that includes primary, secondary, and tertiary levels, we highlight ways in which advancing the field of neurobiology can pave the way for scalable interventions that can improve outcomes and help to address the public health problem.

           

          La carga social de los trastornos psiquiátricos que resultan después de la exposición al trauma psicológico es enorme. El estudio de los trastornos relacionados con el trauma que utilizan enfoques neurobiológicos y de salud pública a menudo es inconexo. Es fundamental enfatizar el potencial de traslación del trabajo neurobiológico y su relevancia para la carga en la salud pública del trauma psicológico. Aplicando un modelo de salud pública al trauma psicológico que incluye niveles primario, secundario y terciario, destacamos formas en las que avanzar en el campo de la neurobiología puede allanar el camino para intervenciones escalonadas que puedan mejorar los resultados y ayudar a abordar el problema de salud pública.

           

          暴露于心理创伤后导致的精神疾病带来巨大的社会负担。使用神经生物学和公共卫生方法对创伤相关疾病的研究通常是脱节的。强调神经生物学工作的转化潜力及其与心理创伤的公共卫生负担的相关性至关重要。使用公共卫生模型应用于包括初级、二级和三级水平的创伤学,我们强调了推进神经生物学领域可以为扩展干预措施铺平道路,这些干预措施可以改善结果并帮助解决公共卫生问题。

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          Most cited references28

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          The resilience framework as a strategy to combat stress-related disorders

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            Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial.

            Few pharmacotherapies have demonstrated sufficient efficacy in the treatment of posttraumatic stress disorder (PTSD), a chronic and disabling condition. To test the efficacy and safety of a single intravenous subanesthetic dose of ketamine for the treatment of PTSD and associated depressive symptoms in patients with chronic PTSD. Proof-of-concept, randomized, double-blind, crossover trial comparing ketamine with an active placebo control, midazolam, conducted at a single site (Icahn School of Medicine at Mount Sinai, New York, New York). Forty-one patients with chronic PTSD related to a range of trauma exposures were recruited via advertisements. Intravenous infusion of ketamine hydrochloride (0.5 mg/kg) and midazolam (0.045 mg/kg). The primary outcome measure was change in PTSD symptom severity, measured using the Impact of Event Scale-Revised. Secondary outcome measures included the Montgomery-Asberg Depression Rating Scale, the Clinical Global Impression-Severity and -Improvement scales, and adverse effect measures, including the Clinician-Administered Dissociative States Scale, the Brief Psychiatric Rating Scale, and the Young Mania Rating Scale. Ketamine infusion was associated with significant and rapid reduction in PTSD symptom severity, compared with midazolam, when assessed 24 hours after infusion (mean difference in Impact of Event Scale-Revised score, 12.7 [95% CI, 2.5-22.8]; P = .02). Greater reduction of PTSD symptoms following treatment with ketamine was evident in both crossover and first-period analyses, and remained significant after adjusting for baseline and 24-hour depressive symptom severity. Ketamine was also associated with reduction in comorbid depressive symptoms and with improvement in overall clinical presentation. Ketamine was generally well tolerated without clinically significant persistent dissociative symptoms. This study provides the first evidence for rapid reduction in symptom severity following ketamine infusion in patients with chronic PTSD. If replicated, these findings may lead to novel approaches to the pharmacologic treatment of patients with this disabling condition. clinicaltrials.gov Identifier: NCT00749203.
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              Subcallosal cingulate deep brain stimulation for treatment-resistant depression: a multisite, randomised, sham-controlled trial

              Deep brain stimulation (DBS) of the subcallosal cingulate white matter has shown promise as an intervention for patients with chronic, unremitting depression. To test the safety and efficacy of DBS for treatment-resistant depression, a prospective, randomised, sham-controlled trial was conducted.
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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                ZEPT
                zept20
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8066
                2018
                20 December 2018
                : 9
                : 1
                : 1556554
                Affiliations
                [a ]Clinical Neurosciences Division National Center for PTSD, United States Department of Veterans Affairs , West Haven, CT, USA
                [b ]Department of Psychiatry, Yale University School of Medicine , New Haven, CT, USA
                Author notes
                CONTACT Teddy J. Akiki teddy.akiki@ 123456yale.edu Clinical Neurosciences Division, National Center for PTSD, United States Department of Veterans Affairs , West Haven, CT, USA
                Author information
                http://orcid.org/0000-0003-1988-9201
                http://orcid.org/0000-0002-8985-9975
                http://orcid.org/0000-0001-5783-6181
                Article
                1556554
                10.1080/20008198.2018.1556554
                6319465
                9e77890a-5ea8-4b06-bfd0-25f9f31b80c0
                This work was authored as part of the Contributors’ official duties as Employees of the United States Government and is therefore a work of the United States Government. In accordance with 17 USC. 105, no copyright protection is available for such works under US Law.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 October 2018
                : 23 November 2018
                : 28 November 2018
                Page count
                References: 31, Pages: 5
                Categories
                Editorial

                Clinical Psychology & Psychiatry
                trauma,post-traumatic stress disorder (ptsd),neurobiology,translational neuroscience,neuroimaging,public health,intervention,trastorno de estrés postraumático (tept),neurobiología,neurociencia traslacional,neuroimagen,salud pública,intervención,创伤创伤后应激障碍(ptsd),神经生物学,转化神经科学,神经影像学公共卫生干预,• the societal burden of trauma- and stress-related psychiatric disorders is enormous. • our knowledge of the neurobiology of psychiatric disorders is gradually increasing.• we highlight the translational potential of neurobiological work and its relevance to the public health burden. • improved understanding of the neurobiology may lead to interventions with better treatment outcomes.

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