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Horm Metab Res 2007; 39(6): 413-419
DOI: 10.1055/s-2007-981461
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© Georg Thieme Verlag KG Stuttgart · New York

Post-traumatic Stress Disorder in Children and Adolescents: From Sigmund Freud's “Trauma” to Psychopathology and the (Dys)metabolic Syndrome

P. Pervanidou 1 , G. P. Chrousos 1
  • 1First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, Athens, Greece
Further Information

Publication History

received 21. 11. 2006

accepted 3. 4. 2007

Publication Date:
18 June 2007 (online)

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Abstract

Post-traumatic Stress Disorder (PTSD) is an anxiety syndrome that develops after exposure to traumatic life events. Symptoms include re-experience of the initial trauma, avoidance of stimuli associated with the trauma and symptoms of excessive arousal. Neuroendocrine studies in adults with PTSD have demonstrated that basal cerebrospinal fluid (CSF) CRH levels are elevated and urinary cortisol levels are variable - low in the majority of cases - whereas other studies demonstrate no differences in urinary and plasma cortisol concentrations. Urinary catecholamine excretion is higher in PTSD patients than those of control subjects and other psychiatric disorders.

Children may differ from adults in their psychologic and physiologic responses to severe stressors. Also, exposure to stress during critical periods of development may have irreversible effects on behavioral maturation and may affect specific vulnerable brain areas, altering CNS development. Similar to findings in adult studies, PTSD in children is characterized by increased sympathetic nervous system (SNS) activity, as indicated by elevated norepinephrine levels in the periphery. High cortisol levels in urine or saliva have been reported in most studies of childhood PTSD, while prospective longitudinal studies concerning the natural history of neuroendocrine changes in pediatric PTSD after an acute stressor are limited. The identification of neurobiologic changes in response to early adverse experiences is of major importance for the prognosis, prevention, management, and treatment of children and adolescents at risk for or suffering from PTSD.

Key words

Child development - salivary cortisol - catecholamines - brain - behavior

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Correspondence

P. PervanidouMD 

First Department of Pediatrics Athens University Medical School

Aghia Sophia Children's Hospital

Thivon & Levadias Street

Athens

Greece

Phone: +30/210/683 39 36

Fax: +30/210/652 50 13

Email: ppervanid@med.uoa.gr