Mental disorders related to stress
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Mental Disorders Related to Stress
Prevalence and Impact of Stress-Related Mental Disorders
Stress-related mental disorders are prevalent across various settings, particularly in emergency situations such as armed conflicts, natural disasters, and industrial accidents. These conditions include a range of psychological reactions, with post-traumatic stress disorder (PTSD) being one of the most commonly studied. Epidemiological data indicate that PTSD and other stress-related disorders significantly impact both low- and middle-income countries (LAMICs) and high-income countries (HICs)1. The lifetime prevalence of PTSD among adult Americans is approximately 7.8%, with women being more frequently affected than men1.
Diagnostic Criteria and Classification
The classification of stress-related mental disorders has evolved, with significant updates in the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The ICD-11 has introduced a new grouping for disorders specifically associated with stress, which includes PTSD, complex PTSD, prolonged grief disorder, adjustment disorder, reactive attachment disorder, and disinhibited social engagement disorder2 6. These disorders are characterized by distinct clinical features and are directly linked to identifiable stressors2.
Pathophysiological Mechanisms
The pathophysiology of stress-related mental disorders involves complex interactions between genetic, environmental, and biological factors. Stress can influence hormone levels, immune responses, and neural circuits, contributing to the development of mental disorders such as anxiety, depression, and PTSD8. Genetic studies have identified specific variants, such as those in the PDE4B gene, which are associated with increased risk for anxiety and stress-related disorders4. Additionally, the brain-gut axis has been implicated in the pathogenesis of these conditions, highlighting the multifaceted nature of their underlying mechanisms8.
Treatment and Intervention Strategies
Effective management of stress-related mental disorders requires a multifaceted approach. Psychological interventions, such as cognitive-behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR), have shown efficacy in treating PTSD and other stress-related conditions1. Pharmacological treatments, including antidepressants, are also commonly used. Moreover, physical activity has been identified as a beneficial intervention for preventing and treating stress-related mental disorders, with evidence supporting its efficacy in reducing symptoms of depression and anxiety9.
Work-Related Stress and Mental Health
Work-related stress is a significant contributor to mental health disorders, including anxiety, depression, and burnout. The concept of allostasis and allostatic load provides a framework for understanding the impact of chronic work stress on mental health10. Effective strategies to mitigate work-related stress include legislative measures to limit psychosocial risks, as well as the development of internet-based programs for mental health promotion and prevention10.
Conclusion
Stress-related mental disorders are complex and multifaceted, involving a combination of genetic, environmental, and biological factors. Advances in diagnostic criteria and classification, along with a better understanding of pathophysiological mechanisms, have improved the clinical utility and applicability of these diagnoses. Effective treatment strategies, including psychological, pharmacological, and lifestyle interventions, are essential for managing these conditions. Addressing work-related stress and implementing preventive measures can further enhance mental health outcomes. Continued research is needed to refine diagnostic guidelines and develop comprehensive treatment approaches for stress-related mental disorders.
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Mental disorders and conditions specifically related to stress
Stress-related conditions are highly prevalent in emergency situations, with PTSD being the most prevalent and impacting individuals globally.
Proposals for mental disorders specifically associated with stress in the International Classification of Diseases-11
The ICD-11 Working Group has proposed changes to mental disorders specifically associated with stress, aiming to improve clinical utility and address concerns about their validity and treatment effectiveness in global health-care settings.
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Trauma and Stressor-Related Disorders are psychiatric conditions resulting from exposure to traumatic or stressful events, affecting individuals' psychological distress, social, professional, and other relevant areas of their lives.
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Anxiety and stress-related disorders are complex heritable phenotypes with genetic correlations to psychiatric traits, educational outcomes, obesity-related phenotypes, smoking, and reproductive success.
Observational StudyRigorous JournalHighly CitedStress-related physical and mental disorders: a new paradigm
A comprehensive stress assessment instrument integrating biological, psychological, social, economic, and spiritual parameters is needed to improve treatment options and multidimensional well-being interventions.
Disorders Specifically Associated With Stress in ICD-11
The ICD-11 has improved clinical utility and applicability for mental disorders specifically associated with stress, but more research is needed to evaluate assessments and diagnostic features.
Literature ReviewDisorders specifically associated with stress: A case-controlled field study for ICD-11 mental and behavioural disorders
ICD-11 diagnostic changes, such as the addition of Complex PTSD and Prolonged Grief Disorder, improve diagnostic decisions and clarify application, but require revisions to improve clarity.
Non-RCT
Large Human TrialRigorous JournalHighly Cited[A Review of Research Progress in the Pathophysiological Mechanism of Stress-related Mental Disorders].
Excessive stress can lead to stress-related mental disorders, with the brain-gut axis playing a crucial role in their pathogenesis.
Literature ReviewExercise as Treatment for “Stress-Related” Mental Disorders
Physical activity is effective in preventing and treating stress-related mental disorders, with potential benefits from physiological, psychological, and social mechanisms.
Systematic ReviewWork-related mental health: current state of the art (literature review)
Work-related stress is a significant issue, with no clear understanding of its mechanisms and stages, and internet-based programs show promise for promoting mental health.
Systematic Review