Evidence map›Paper›PMID 28168596›Full record

ReviewCurrent psychiatry reports2017

The Need to Take a Staging Approach to the Biological Mechanisms of PTSD and its Treatment.

Alexander Cowell McFarlane, Eleanor Lawrence-Wood, Miranda Van Hooff, Gin S Malhi, Rachel Yehuda

Abstract readReview
PubMed Publisher
In one paragraph

Review in Current psychiatry reports, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  7. Exercise and PTSD.Current topics in behavioral neurosciences · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alexander Cowell McFarlaneCentre for Traumatic Stress Studies, The University of Adelaide, Level 2, 122 Frome Street, Adelaide, 5000, South Australia. alexander.mcfarlane@adelaide.edu.au.
Eleanor Lawrence-WoodCentre for Traumatic Stress Studies, The University of Adelaide, Level 2, 122 Frome Street, Adelaide, 5000, South Australia.
Miranda Van HooffCentre for Traumatic Stress Studies, The University of Adelaide, Level 2, 122 Frome Street, Adelaide, 5000, South Australia.
Gin S MalhiDepartment of Psychiatry, Sydney Medical School, The University of Sydney, Edward Ford Building (A27), Fisher Road, University of Sydney, New South Wales, 2006, Australia.
Rachel YehudaTraumatic Stress Studies Division, Mount Sinai School of Medicine, James J Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY, 110468, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Despite the substantial body of neurobiological research, no specific drug target has been developed to treat PTSD and there are substantial limitations with the available interventions. We propose that advances are likely to depend on the development of better classification of the heterogeneity of PTSD using a staging approach of disease. A primary rationale for staging is to highlight the probability that distinct therapeutic approaches need to be utilised according to the degree of biological progression of the disorder. Prospective studies, particularly of military populations, provide substantial evidence about the emerging biological abnormalities that precede the full-blown disorder. These need to be targeted with tailored interventions to prevent disease progression. Equally, the neurobiology of chronic unremitting PTSD needs to be differentiated from the acute disorder which emerges across a spectrum of severity, and this range of presentations correspondingly needs to be addressed with differing therapeutic strategies. The staging approach also needs to take account of the range of somatic pathological outcomes that are being identified as a consequence of traumatic stress exposure. PTSD should be conceptualised as a systemic disorder underpinned a range of biological dysregulation, including metabolic and altered immune function, reflected in the increased rates of cardiovascular and autoimmune disease. The effectiveness of novel treatments needs to be judged across their effectiveness in addressing the spectrum of trauma-related pathology.

Indexed as

Acute DiseaseCombat DisordersComorbidityDisease ProgressionHumansInflammationLongitudinal StudiesMilitary PersonnelProspective StudiesPsychophysiologyRisk FactorsStress Disorders, Post-TraumaticDelayed onsetDuration of illnessInflammationLongitudinal courseMedical comorbidityNeurobiologyPTSDStagingSubsyndromalTreatment

Identifiers

PMID28168596

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.