engleski

Neurobiological approach to the manifestations of chronic posttraumatic stress disorder

Chronic posttraumatic stress disorder (PTSD) is accompa-nied by a variety of pathophysiologic syndrome and biologic alterations with consequential physical disturbances. Thirty-two male patients, Croatian soldiers serving in the war in Croatia in 1991-1992, mean age 34.1ą7.1 years, with a diagnosis of PTSD made by psychiatric examination and use of DSM-III and LASC-01 assessment scales, were included in the study. The patients underwent neuropsychologic and laboratory examinations to determine the possible organic lesions. Multi-dimensional neuropsychologic testing was performed to as-sess their cognitive function and possible presence of an orga-nic factor. Mental retardation exceeding the level of tolerance was found in as many as 21 patients, impaired memory in 19, considerably disturbed mnestic control in 30, and a tendency to confabulation in 15 patients. Other tests also pointed to the organic basis of the recorded mental abnormalities (attention, visuomotor coordination). Laboratory tests revealed the following disturbances: increa-sed blood glucose in three, increased cholesterol in seven, incre-ased triglycerides in den, decreased HDL in ten, increased LDL in six, increased leukocytes in 16, increased erythrocyte sedi-mentation rate in five and increased thrombin time in 18 pa-tients. Other laboratory abnormalities were also recorded. The following psychosomatic disorders were diagnosed: duodenal ulcer in two, gastritis in two, diabetes in three and arterial hypertension in 2 patients. Determination of cerebral circulation by the method of tran-scranial Doppler sonography showed functional disorders of cerebral hemodynamics in 16, spasms in 11 and hypoperfusion in fivee patients.A considerable proportion of unhealthy style of life was re-corded, including smoking in 30, alcohol abuse in 15, and ina-dequate exercise and overweight in ten patients. The study confirmed the relationship between psychic and physical mechanisms in the development of PTSD, and the presence of organic parameters of a damage to the nervous system, as well as of psychosomatic and organic damage to other body systems. This preliminary study pointed to the need of complex approach to a PTSD patient.

posttraumaric stress disorder; neurobiology

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