[Psychoneuroendocrinology of posttraumatic stress disorder].
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.
Ruiz
Juliana Elena
JE
Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Barbosa Neto
Jair
J
Schoedl
Aline Ferri
AF
Mello
Marcelo Feijo
MF
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*
D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone