Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic...Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal(HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder(OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyperresponsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally,abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.展开更多
Purpose: To identify, analyze and synthetize the scientific evidences that support Early Life Stress (ELS) diagnosis using the Childhood Trauma Questionnaire (CTQ), since it assumes the use of psychoactive substances ...Purpose: To identify, analyze and synthetize the scientific evidences that support Early Life Stress (ELS) diagnosis using the Childhood Trauma Questionnaire (CTQ), since it assumes the use of psychoactive substances later in adolescence and adulthood. Individuals that experienced some form of childhood stress may present, in adulthood, consequences that manifest into mental disorders such as problematic use of psychoactive substances. Methods: An integrative review of the literature on the subject in the databases: PubMed, Web of Science, LILACS and Psycinfo, regards studies that have been indexed in the last ten years (2003-2014). Combination of controlled and uncontrolled factors in the use and abuse of psychoactive substances, CTQ and ELS adapted to each database. Findings: The alcohol was the most used drug by the participating subjects of these research;mostly, the use of psychoactive drugs, started when they were still in adolescence;ELS and the later use of psychoactive drugs can be found more frequently in female;the lack of internal resources for dealing with stress in adulthood after ELS occurrence may have as a consequence the use of psychoactive drugs as a coping mechanism. Conclusions: It was possible to identify scientific evidences that support the ELS diagnosis, measured by the CTQ, as a determining factor for the use and abuse of alcohol and/or other psychoactive drugs in adolescence and adulthood. Implications: Investigate the ELS as a strategy to improve the therapeutic project of patients in nursing care, which will be built based on scientific evidence, so it can be more effective.展开更多
Background: Early life stress is a significant public health problem associated with increased rates of psychiatric disorders, especially those related to drug abuse. Objective: To identify the prevalence of early lif...Background: Early life stress is a significant public health problem associated with increased rates of psychiatric disorders, especially those related to drug abuse. Objective: To identify the prevalence of early life stress in drug users, to compare the intensity of trauma in alcohol and crack users, and to relate the power of injury to the severity of drug dependence. Method: Cross-sectional analytical study with a sample of 105 alcohol and crack users treated by an outpatient service. The instruments for data collection were sociodemographic data questionnaire, the Mini-International Neuropsychiatric Interview, and the Severity of Dependence Scale. The categorical variables association was analyzed using the Chi-squared test, considering p Results: High prevalence of early stress and severity of dependence were identified, with higher rates among crack users. The early stress revealed in the Alcohol group high rates of emotional (88.7%) and physical (94.3%) neglect and in the Crack group significant frequency of physical (61.5%) emotional abuse (51.9%), sexual (46.2%), and emotional (78.8%) and physical (90.4%) neglect. Crack users are 2.6 times more likely to have been emotionally abused, and 2.1 times more likely to have been sexually abused during childhood when compared to the alcohol group. Conclusion: Early stress was prevalent with significant intensity in drug users, and evaluation of this problem is essential for a better understanding of these disorders.展开更多
文摘Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal(HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder(OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyperresponsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally,abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.
文摘Purpose: To identify, analyze and synthetize the scientific evidences that support Early Life Stress (ELS) diagnosis using the Childhood Trauma Questionnaire (CTQ), since it assumes the use of psychoactive substances later in adolescence and adulthood. Individuals that experienced some form of childhood stress may present, in adulthood, consequences that manifest into mental disorders such as problematic use of psychoactive substances. Methods: An integrative review of the literature on the subject in the databases: PubMed, Web of Science, LILACS and Psycinfo, regards studies that have been indexed in the last ten years (2003-2014). Combination of controlled and uncontrolled factors in the use and abuse of psychoactive substances, CTQ and ELS adapted to each database. Findings: The alcohol was the most used drug by the participating subjects of these research;mostly, the use of psychoactive drugs, started when they were still in adolescence;ELS and the later use of psychoactive drugs can be found more frequently in female;the lack of internal resources for dealing with stress in adulthood after ELS occurrence may have as a consequence the use of psychoactive drugs as a coping mechanism. Conclusions: It was possible to identify scientific evidences that support the ELS diagnosis, measured by the CTQ, as a determining factor for the use and abuse of alcohol and/or other psychoactive drugs in adolescence and adulthood. Implications: Investigate the ELS as a strategy to improve the therapeutic project of patients in nursing care, which will be built based on scientific evidence, so it can be more effective.
文摘Background: Early life stress is a significant public health problem associated with increased rates of psychiatric disorders, especially those related to drug abuse. Objective: To identify the prevalence of early life stress in drug users, to compare the intensity of trauma in alcohol and crack users, and to relate the power of injury to the severity of drug dependence. Method: Cross-sectional analytical study with a sample of 105 alcohol and crack users treated by an outpatient service. The instruments for data collection were sociodemographic data questionnaire, the Mini-International Neuropsychiatric Interview, and the Severity of Dependence Scale. The categorical variables association was analyzed using the Chi-squared test, considering p Results: High prevalence of early stress and severity of dependence were identified, with higher rates among crack users. The early stress revealed in the Alcohol group high rates of emotional (88.7%) and physical (94.3%) neglect and in the Crack group significant frequency of physical (61.5%) emotional abuse (51.9%), sexual (46.2%), and emotional (78.8%) and physical (90.4%) neglect. Crack users are 2.6 times more likely to have been emotionally abused, and 2.1 times more likely to have been sexually abused during childhood when compared to the alcohol group. Conclusion: Early stress was prevalent with significant intensity in drug users, and evaluation of this problem is essential for a better understanding of these disorders.
