Treatment of Childhood Trauma: Pharmacological Approach

Traumatic experiences during childhood may lead to the development of several psychiatric diseases, including mood disorders, different forms of psychosis, and post-traumatic stress disorders. Psychiatric patients with a history of childhood trauma (CT) show increased severity of symptoms, worse outcome, and poor treatment response. These features might be due to neurobiological, endocrinological, and immunological alterations occurring as a consequence of early exposure to stressors and mediated by the hypothalamus–pituitary–adrenal (HPA) axis. Pharmacological approach for the management of CT is usually employed as one component of integrated treatments, including psychotherapeutic and psychosocial interventions. However, subjects with CT often show inadequate response to different classes of psychiatric medications, especially antidepressants and mood stabilizers. Since a higher degree of activation of the immune system has been consistently observed both in psychiatric patients and in subjects exposed to early stressors, future research should test if immunomodulatory interventions could improve the treatment of psychiatric patients with a history of CT.