All studies suggest that PTSD continues to affect a significant portion of the population, with notable variations between genders and age groups. This difference is more pronounced at certain ages, such as middle age, where women may experience more severe symptoms between the ages of 51-55 and men between the ages of 41-45.
Post-traumatic stress disorder (PTSD) is a mental health condition that can arise after exposure to traumatic events, such as serious accidents, violence or natural disasters.
It is characterized by a combination of symptoms that include intrusive thoughts about the event, a constant feeling of hyperalertness, avoidance of situations or places associated with the trauma, and negative changes in mood and cognition.
For some individuals, these symptoms become persistent and seriously affect quality of life.
It is estimated that approximately 5.6% of adults who experience trauma will develop PTSD over the course of their lives, with the highest rates seen in people exposed to high levels of trauma, such as war survivors and victims of physical assault.a.
In addition to the emotional and psychological impact, PTSD represents a significant economic burden due to the costs associated with treatment and lost productivity. This condition often persists throughout life and requires effective interventions to improve the quality of life of patients.
Advanced research has contributed to a deeper understanding of the biology of PTSD. Preclinical studies focused on the brain’s fear system have revealed how alterations in specific regions, such as the amygdala, ventromedial prefrontal cortex and anterior cingulate cortex, can lead to emotional dysregulation.
For example, the amygdala, which is crucial for processing fear responses, may be hyperactive in PTSD, while the prefrontal cortex, responsible for regulating these responses, may be less active.
In addition, neuroendocrine studies have indicated alterations in the hypothalamic-pituitary-adrenal (HPA) axis, which regulates stress, and in the functioning of glucocorticoids, hormones involved in the stress response.
From a genetic perspective, hereditary factors are known to play a significant role in the risk of developing PTSD.
Large genome-wide association studies (GWAS) have revealed that PTSD is highly polygenic, that is, influenced by a large number of genes.
Research projects such as the Psychiatric Genomic Consortium for PTSD (PGC-PTSD) and the VA Million Veteran Program (MVP) have identified 16 genetic risk loci, although these findings are not yet consistent across different data sets. This suggests that even larger and more comprehensive studies are needed.
Recently, it has been discovered that genes located on the X chromosome, which is important for sex determination, may play a relevant role, especially considering the gender differences in the prevalence of PTSD.
Women have a significantly higher prevalence of PTSD compared to men, with studies indicating rates of 5.2% for women and 1.8% for men in the United States.
This difference is more pronounced in some age groups, such as middle age, where women may experience more severe symptoms. However, among young adults (18–24 years) and older people (over 55 years), gender differences tend to be less pronounced.
In another study, data collected from previous Danish and Nordic studies on PTSD or trauma were analyzed. The final sample consisted of 6,548 participants, 2,768 (42.3%) men and 3,780 (57.7%) women. PTSD was measured using the Harvard Trauma Questionnaire, Part IV (HTQ-IV).
Men and women differed in the distribution of PTSD across the lifetime. The highest prevalence of PTSD was observed in the early 40s for men and in the early 50s for women, while the lowest prevalence for both sexes was in the early 70s.
Women had an overall prevalence of PTSD twice as high as men. However, at some ages, the female-to-male ratio was nearly 3:1. The highest female-to-male ratio was found for young people aged 21 to 25.
Prevalence chart of PTSD in adults. Based on diagnostic interview data from the National Comorbidity Survey Replication (NCS-R).
Globally, the prevalence of PTSD varies depending on cultural and social factors and the type of traumatic event. For example, in the United States, lifetime prevalence rates are 6.8%, while in Brazil they range from 2.1% to 4.3%, depending on the period considered.
In addition to discoveries about prevalence and genetic factors, recent studies have made significant advances in identifying 95 genetic loci associated with PTSD, 80 of which are novel. These genes are related to processes such as stress regulation, neural development, synaptic function and immune response.
For example, genes such as GRIA1 and GRM8 are involved in neurotransmitter signaling, while FOXP2 is related to neuronal orientation and development.
These findings provide new insights into the biological systems that underlie PTSD, paving the way for the development of more effective treatments.
PTSD is also frequently associated with other mental health conditions, such as depression and attention deficit disorder, and physical conditions, such as cardiovascular disease and obesity. However, studies on these interactions are still limited.
As researchers continue to explore the genetics and neurobiology of PTSD, it is expected that new therapeutic targets will be identified, enabling more accurate diagnoses and personalized treatments.
These advances highlight the complexity of PTSD, its interplay with genetic, biological and social factors, and the need for strategies tailored to individual patient characteristics. Continued research in this field is essential to address the challenges of diagnosing and treating this debilitating condition.
READ MORE:
National Institute of Mental Health. Post-Traumatic Stress Disorder (PTSD).
The combined effect of gender and age on post traumatic stress disorder: do men and women show differences in the lifespan distribution of the disorder?
Daniel N Ditlevsen and Ask Elklit
Annals of General Psychiatry. volume 9, Article number: 32 (2010)
Genome-wide association analyses identify 95 risk loci and provide insights into the neurobiology of posttraumatic stress disorder
Nievergelt CM et al.
Nat Genet. 2024 May; 56 (5) :792-808.
doi: 10.1038/s41588-024-01707-9.
Abstract:
Posttraumatic stress disorder (PTSD) genetics are characterized by lower discoverability than most other psychiatric disorders. The contribution to biological understanding from previous genetic studies has thus been limited. We performed a multi-ancestry meta-analysis of genome-wide association studies across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases). We identified 95 genome-wide significant loci (80 novel). Convergent multi-omic approaches identified 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators (e.g., GRIA1, GRM8, CACNA1E), developmental, axon guidance, and transcription factors (e.g., FOXP2, EFNA5, DCC), synaptic structure and function genes (e.g., PCLO, NCAM1, PDE4B), and endocrine or immune regulators (e.g., ESR1, TRAF3, TANK). Additional top genes influence stress, immune, fear, and threat-related processes, previously hypothesized to underlie PTSD neurobiology. These findings strengthen our understanding of neurobiological systems relevant to PTSD pathophysiology, while also opening new areas for investigation.
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