title: [Psychoneuroendocrinology of posttraumatic stress disorder].
abstract: OBJECTIVE
  To review the literature on neurobiological findings related to hypothalamic-pituitary-adrenal axis dysfunctions associated with posttraumatic stress disorder.
  
  
  METHODS
  The relevant scientific findings were described according to the date of publication and the characteristics of the studies: preclinical studies, studies on early life violence as a risk factor, and clinical findings related to patients diagnosed with posttraumatic stress disorder.
  
  
  RESULTS
  A rich literature on hypothalamic-pituitary-adrenal axis dysfunctions and posttraumatic stress disorder was found. Neurobiological findings showed that posttraumatic stress disorder is associated with hypothalamic-pituitary-adrenal axis dysfunctions and other brain-related structures: prefrontal cortex, hippocampus, and amygdala. Posttraumatic stress disorder patients have low plasma levels of cortisol and present increased responsivity of glucocorticoid receptors, suggesting that the inhibition of negative feedback plays a significant role in the disorder pathology. Preclinical studies using animal models of maternal deprivation showed that depending on the moment the trauma occurred during the development, different hypothalamic-pituitary-adrenal axis dysfunctions were produced. Clinical studies showed that early life stress is related to the development of psychopathologies during adulthood.
  
  
  CONCLUSIONS
  There is robust evidence of hypothalamic-pituitary-adrenal axis dysfunctions related to posttraumatic stress disorder, and the mechanisms underlying this association are being better understood.
authors.affiliation: Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Juliana Elena
authors.initials: JE
authors.lastname: Ruiz
authors.forename: Jair
authors.initials: J
authors.lastname: Barbosa Neto
authors.forename: Aline Ferri
authors.initials: AF
authors.lastname: Schoedl
authors.forename: Marcelo Feijo
authors.initials: MF
authors.lastname: Mello
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000679:Amygdala / Q000473:pathology / Q000503:physiopathology; D000818:Animals; D003346:Corticotropin-Releasing Hormone / Q000378:metabolism; D019548:Crime Victims / Q000523:psychology*; D019317:Evidence-Based Medicine; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology* / Q000523:psychology; D017741:Survivors; D014754:Violence / Q000523:psychology*
chemical_list: D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone