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혈장 세로토닌과 외상후 스트레스 장애:월남전 참전 재향군인을 대상으로

Plasma Serotonin Level of Vietnam War Veterans with Post-Traumatic Stress Disorder and Symptom Severity

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Objective:The objective of this study was to examine the relationship between plasma serotonin concentration and posttraumatic stress disorder (PTSD) symptoms in chronic PTSD patients who have been taking medication. Methods:Plasma serotonin level of 14 PTSD patients and a control group of 28 Vietnam War veterans was measured by HPLC (high performance liquid chromatography). The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD), and Hamiltion Anxiety Scale (HAS) were used to evaluate PTSD symptom severity. Results:Serotonin level was significantly higher in the PTSD group than in the control group (p=0.036, p=0.006, respectively). M-PTSD (p<0.001), CAPS (p<0.001), HRSD (p<0.001), and HAS (p<0.001) scale scores were significantly higher in the PTSD group than in the control group; however, the CES score failed to show a significant improvement (p=0.964). There were no significant differences between plasma serotonin and PTSD symptoms. Conclusion:In chronic PTSD patients who have been taking medications, we can not predict treatment effect and symptom severity by measuring only plasma serotonin levels. PTSD is a complicated disorder which may likely be related to a variety of neurotransmitter systems. Therefore, further research which investigate relationships with norepinephrine, dopamine, and other neurotransmitters as well as serotonin is needed to improve the treatment of PTSD.

Abstract

Objective:The objective of this study was to examine the relationship between plasma serotonin concentration and posttraumatic stress disorder (PTSD) symptoms in chronic PTSD patients who have been taking medication. Methods:Plasma serotonin level of 14 PTSD patients and a control group of 28 Vietnam War veterans was measured by HPLC (high performance liquid chromatography). The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD), and Hamiltion Anxiety Scale (HAS) were used to evaluate PTSD symptom severity. Results:Serotonin level was significantly higher in the PTSD group than in the control group (p=0.036, p=0.006, respectively). M-PTSD (p<0.001), CAPS (p<0.001), HRSD (p<0.001), and HAS (p<0.001) scale scores were significantly higher in the PTSD group than in the control group; however, the CES score failed to show a significant improvement (p=0.964). There were no significant differences between plasma serotonin and PTSD symptoms. Conclusion:In chronic PTSD patients who have been taking medications, we can not predict treatment effect and symptom severity by measuring only plasma serotonin levels. PTSD is a complicated disorder which may likely be related to a variety of neurotransmitter systems. Therefore, further research which investigate relationships with norepinephrine, dopamine, and other neurotransmitters as well as serotonin is needed to improve the treatment of PTSD.

참고문헌 (34)

  1. American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders-IV-TR" (2000), American Psychiatric Association
  2. Taylor S, "The structure of posttraumatic stress symptoms", J Abnorm Psychol, 107, pp.154~160 (1998)
  3. Keane TM, "Comorbidity in posttraumatic stress disorder: an analysis of community and clinical studies", J App Soc Psychol, 20, pp.1776~1788 (1990)
  4. Brady KT, "Posttraumatic stress disorder and comorbidity: recognizing the many faces of PTSD", J Clin Psychiatry, 58, pp.12~15 (1997)
  5. Van der Kolk BA, "The psychobiology of posttraumatic stress disorder", J Clin Psychiatry, 58, pp.16~24 (1997)
  6. Nesse RM, "Adrenergic function in patients with panic anxiety", Arch Gen Psychiatry, 41, pp.771~776 (1984)
  7. Geracioti TD Jr, "CSF norepinephrine concentrations in posttraumatic stress disorder", Am J Psychiatry, 158, pp.1227~1230 (2001)
  8. Hawk LW, "Urinary catecholamines and cortisol in recent-onset posttraumatic stress disorder after motor vehicle accident", Psychosom Med, 62, pp.423~434 (2000)
  9. Roth RH, "Stress and the mesocorticolimbic dopamine systems", Ann N Y Acad Sci, 537, pp.138~147 (1988)
  10. Hamner MB, "Elevated plasma dopamine in posttraumatic stress disorder: A preliminary report", Biol psychiatry, 33, pp.304~306 (1993)
  11. Southwick SM, "Noradrenergic and serotonergic function in posttraumatic stress disorder", Arch Gen Psychiatry, 54, pp.749~758 (1997)
  12. Davis LL, "Post-traumatic stress disorder and serotonin - new directions for research and treatment", J Psychiatry Neurosci, 22, pp.318~326 (1997)
  13. Markowitz PI, "Biological studies of impulsivity, aggression and suicidal behavior. In: Impulsivity and Aggression", pp.71~90 (1995), Wiley
  14. Friedman MJ, "Towards pharmacotherapy for posttraumatic stress disorder. In: Neurobiological and clinical consequences of stress", pp.465~481 (1995), Lippincott-Raven
  15. Spivak B, "Low platelet- poor plasma concentrations of serotonin in patients with combatrelated posttraumatic stress disorder", Biol Psychiatry, 45, pp.840~845 (1999)
  16. Davidson JRT, "Biological therapies for posttraumatic stress disorder - an overview", J Clin Psychiatry, 58, pp.29~32 (1997)
  17. Keane TM, "Clinical evaluation of a measure to assess combat exposure", Psychol Assessment 1, 1, pp.53~55 (1989)
  18. Keane TM, "Mississippi Scale for Combat- Related Posttraumatic Stress Disorder: Three studies in reliability and validity", J Consult Clin Psychol, 56, pp.85~90 (1988)
  19. Lee BY, "A reliability and validity study of a Clinician-Administered PTSD Scale", J Kor Neuropsychiatr Assoc, 38, pp.514~521 (1999)
  20. Hamilton M, "Rating Scale for Depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)
  21. Hamilton M, "The assessment of anxiety states by rating", Br J Med Psychol, 32, pp.50~55 (1959)
  22. Fichtner CG, "Post-traumatic stress disorderpathophysiological aspects and pharmacological approaches to treatment", CNS Drugs, 8, pp.293~322 (1997)
  23. Blardi P, "Serotonin and fluoxetine levels in plasma and platelets after fluoxetine treatment in depressive patients", J Clin Psychopharmacol, 22, pp.131~136 (2002)
  24. Adamec R, "Transmitter systems involved in neural plasticity underlying increased anxiety and defense implications for understanding anxiety following traumatic stress", Neurosci Biobehav Rev, 21, pp.755~756 (1997)
  25. Grillon C, "The psychobiological basis of posttraumatic stress disorder", Mol Psychiat, 1, pp.278~297 (1996)
  26. Lipper S, "Preliminary study of carbamazepine in posttraumatic stress disorder", Psychosomatics, 27, pp.849~854 (1986)
  27. Yehuda R, "Enhanced suppression of cortisol following dexamethasone administration in posttraumatic stress disorder", Am J Psychiatry, 150, pp.83~86 (1993)
  28. Southwick SM, "Abnormal noradrenergic function in PTSD", Arch Gen Psychiatry, 50, pp.266~274 (1993)
  29. Bremner JD, "Functional neuroanatomical correlates of stress on memory", Journal of Traumatic Stress, 8, pp.527~553 (1995)
  30. Rauch SL, "Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: a functional MRI study", Biol Psychiatry, 47, pp.769~776 (2000)
  31. Bleich A, "The role of serotonin in schizophrenia", Schizophr Bull, 14, pp.287~315 (1988)
  32. Murphy DL, "Brain serotonin neurotransmission: an overview and update with an emphasis on serotonin subsystem heterogeneity, multiple receptors, interactions with other neurotransmitter systems, and consequent implications for understanding the actions of serotonergic drugs", J Clin Psychiatry, 59, pp.4~12 (1998)
  33. Walderhaug E, "Lowering of serotonin by rapid tryptophan depletion increase impulsiveness in normal individual", Psychopharmacol, 164, pp.385~391 (2002)
  34. Cicin-Sain L, "Posttraumatic stress disorder and platelet serotonin measures", J Psychiatr Res, 34, pp.155~161 (2000)

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