혈장 세로토닌과 외상후 스트레스 장애:월남전 참전 재향군인을 대상으로
Plasma Serotonin Level of Vietnam War Veterans with Post-Traumatic Stress Disorder and Symptom Severity
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
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)
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders-IV-TR" (2000), American Psychiatric Association
- Taylor S, "The structure of posttraumatic stress symptoms", J Abnorm Psychol, 107, pp.154~160 (1998)
- Keane TM, "Comorbidity in posttraumatic stress disorder: an analysis of community and clinical studies", J App Soc Psychol, 20, pp.1776~1788 (1990)
- Brady KT, "Posttraumatic stress disorder and comorbidity: recognizing the many faces of PTSD", J Clin Psychiatry, 58, pp.12~15 (1997)
- Van der Kolk BA, "The psychobiology of posttraumatic stress disorder", J Clin Psychiatry, 58, pp.16~24 (1997)
- Nesse RM, "Adrenergic function in patients with panic anxiety", Arch Gen Psychiatry, 41, pp.771~776 (1984)
- Geracioti TD Jr, "CSF norepinephrine concentrations in posttraumatic stress disorder", Am J Psychiatry, 158, pp.1227~1230 (2001)
- Hawk LW, "Urinary catecholamines and cortisol in recent-onset posttraumatic stress disorder after motor vehicle accident", Psychosom Med, 62, pp.423~434 (2000)
- Roth RH, "Stress and the mesocorticolimbic dopamine systems", Ann N Y Acad Sci, 537, pp.138~147 (1988)
- Hamner MB, "Elevated plasma dopamine in posttraumatic stress disorder: A preliminary report", Biol psychiatry, 33, pp.304~306 (1993)
- Southwick SM, "Noradrenergic and serotonergic function in posttraumatic stress disorder", Arch Gen Psychiatry, 54, pp.749~758 (1997)
- Davis LL, "Post-traumatic stress disorder and serotonin - new directions for research and treatment", J Psychiatry Neurosci, 22, pp.318~326 (1997)
- Markowitz PI, "Biological studies of impulsivity, aggression and suicidal behavior. In: Impulsivity and Aggression", pp.71~90 (1995), Wiley
- Friedman MJ, "Towards pharmacotherapy for posttraumatic stress disorder. In: Neurobiological and clinical consequences of stress", pp.465~481 (1995), Lippincott-Raven
- Spivak B, "Low platelet- poor plasma concentrations of serotonin in patients with combatrelated posttraumatic stress disorder", Biol Psychiatry, 45, pp.840~845 (1999)
- Davidson JRT, "Biological therapies for posttraumatic stress disorder - an overview", J Clin Psychiatry, 58, pp.29~32 (1997)
- Keane TM, "Clinical evaluation of a measure to assess combat exposure", Psychol Assessment 1, 1, pp.53~55 (1989)
- 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)
- Lee BY, "A reliability and validity study of a Clinician-Administered PTSD Scale", J Kor Neuropsychiatr Assoc, 38, pp.514~521 (1999)
- Hamilton M, "Rating Scale for Depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)
- Hamilton M, "The assessment of anxiety states by rating", Br J Med Psychol, 32, pp.50~55 (1959)
- Fichtner CG, "Post-traumatic stress disorderpathophysiological aspects and pharmacological approaches to treatment", CNS Drugs, 8, pp.293~322 (1997)
- Blardi P, "Serotonin and fluoxetine levels in plasma and platelets after fluoxetine treatment in depressive patients", J Clin Psychopharmacol, 22, pp.131~136 (2002)
- 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)
- Grillon C, "The psychobiological basis of posttraumatic stress disorder", Mol Psychiat, 1, pp.278~297 (1996)
- Lipper S, "Preliminary study of carbamazepine in posttraumatic stress disorder", Psychosomatics, 27, pp.849~854 (1986)
- Yehuda R, "Enhanced suppression of cortisol following dexamethasone administration in posttraumatic stress disorder", Am J Psychiatry, 150, pp.83~86 (1993)
- Southwick SM, "Abnormal noradrenergic function in PTSD", Arch Gen Psychiatry, 50, pp.266~274 (1993)
- Bremner JD, "Functional neuroanatomical correlates of stress on memory", Journal of Traumatic Stress, 8, pp.527~553 (1995)
- Rauch SL, "Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: a functional MRI study", Biol Psychiatry, 47, pp.769~776 (2000)
- Bleich A, "The role of serotonin in schizophrenia", Schizophr Bull, 14, pp.287~315 (1988)
- 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)
- Walderhaug E, "Lowering of serotonin by rapid tryptophan depletion increase impulsiveness in normal individual", Psychopharmacol, 164, pp.385~391 (2002)
- Cicin-Sain L, "Posttraumatic stress disorder and platelet serotonin measures", J Psychiatr Res, 34, pp.155~161 (2000)
