TY - JOUR
T1 - New insights into secondary prevention in post-traumatic stress disorder
AU - Zohar, Joseph
AU - Juven-Wetzler, Alzbeta
AU - Sonnino, Rachel
AU - Cwikel-Hamzany, Shlomit
AU - Balaban, Evgenya
AU - Cohen, Hagit
PY - 2011/1/1
Y1 - 2011/1/1
N2 - Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies.
AB - Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies.
KW - Animal model
KW - Cortisol
KW - HPA axis
KW - Post-traumatic stress disorder
KW - Prevention
KW - Spontaneous recovery
UR - http://www.scopus.com/inward/record.url?scp=82255162414&partnerID=8YFLogxK
U2 - 10.31887/dcns.2011.13.2/jzohar
DO - 10.31887/dcns.2011.13.2/jzohar
M3 - Article
AN - SCOPUS:82255162414
SN - 1294-8322
VL - 13
SP - 301
EP - 309
JO - Dialogues in Clinical Neuroscience
JF - Dialogues in Clinical Neuroscience
IS - 3
ER -