title: Review of somatic symptoms in post-traumatic stress disorder.
abstract: Post-traumatic stress disorder (PTSD) is associated with both (1) 'ill-defined' or 'medically unexplained' somatic syndromes, e.g. unexplained dizziness, tinnitus and blurry vision, and syndromes that can be classified as somatoform disorders (DSM-IV-TR); and (2) a range of medical conditions, with a preponderance of cardiovascular, respiratory, musculoskeletal, neurological, and gastrointestinal disorders, diabetes, chronic pain, sleep disorders and other immune-mediated disorders in various studies. Frequently reported medical co-morbidities with PTSD across various studies include cardiovascular disease, especially hypertension, and immune-mediated disorders. PTSD is associated with limbic instability and alterations in both the hypothalamic- pituitary-adrenal and sympatho-adrenal medullary axes, which affect neuroendocrine and immune functions, have central nervous system effects resulting in pseudo-neurological symptoms and disorders of sleep-wake regulation, and result in autonomic nervous system dysregulation. Hypervigilance, a central feature of PTSD, can lead to 'local sleep' or regional arousal states, when the patient is partially asleep and partially awake, and manifests as complex motor and/or verbal behaviours in a partially conscious state. The few studies of the effects of standard PTSD treatments (medications, CBT) on PTSD-associated somatic syndromes report a reduction in the severity of ill-defined and autonomically mediated somatic symptoms, self-reported physical health problems, and some chronic pain syndromes.
authors: Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada. magupta@uwo.ca
authors: Madhulika A
authors: MA
authors: Gupta
mesh_terms: D000313:Adrenal Medulla / Q000503:physiopathology*; D001007:Anxiety / Q000209:etiology / Q000503:physiopathology; D002986:Clinical Trials as Topic; D015928:Cognitive Behavioral Therapy / Q000379:methods; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004244:Dizziness / Q000209:etiology / Q000523:psychology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D007107:Immune System / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012893:Sleep Wake Disorders / Q000209:etiology / Q000503:physiopathology; D013001:Somatoform Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014012:Tinnitus / Q000209:etiology / Q000523:psychology; D014786:Vision Disorders / Q000209:etiology / Q000523:psychology
chemical_list: D011619:Psychotropic Drugs