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[儿童和青少年创伤后应激障碍的诊断与治疗。儿童和青少年精神创伤门诊的职责]

[Diagnosis and therapy of post-traumatic stress disorders in childhood and adolescence. Responsibilities of the child and adolescent psychiatric trauma outpatient clinic].

作者信息

Herpertz-Dahlmann B, Hahn F, Hempt A

机构信息

Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Aachen.

出版信息

Nervenarzt. 2005 May;76(5):546-56. doi: 10.1007/s00115-004-1819-z.

DOI:10.1007/s00115-004-1819-z
PMID:15480528
Abstract

This article presents an overview of the etiology, clinical characteristics, assessment, and treatment of PTSD in children and adolescents. Diagnostic criteria of DSM-IV and ICD-10 for PTSD in adults may not adequately describe this disorder especially in toddlers and preschool children, because specific PTSD symptoms may vary according to the developmental stage of the child. Prevalence of PTSD in adolescence is similar to that in adulthood. Children who exhibit high degrees of psychopathology before traumatic exposure, who are exposed to high levels of trauma for an extended period, or who directly experienced the event face a high risk to develop PTSD and other later adverse outcomes. Parental support and other social factors also emerge as strong predictors of differential risk among traumatized children. Cognitive-behavioral therapy is a well-assessed intervention strategy recommended for children and adolescents with PTSD while there are no controlled trials of pharmacological treatments. The outpatient clinic for traumatized children and adolescents of the University Clinic of Aachen is introduced and clinical characteristics of children seeking help are described. In addition, the social network and cooperating services are illustrated.

摘要

本文概述了儿童和青少年创伤后应激障碍(PTSD)的病因、临床特征、评估及治疗。成人PTSD的《精神疾病诊断与统计手册》第四版(DSM-IV)和《国际疾病分类》第十版(ICD-10)的诊断标准可能无法充分描述这种疾病,尤其是在幼儿和学龄前儿童中,因为特定的PTSD症状可能因儿童的发育阶段而异。青少年PTSD的患病率与成年人相似。在遭受创伤之前表现出高度精神病理学症状的儿童、长时间暴露于高水平创伤的儿童或直接经历该事件的儿童,面临着发展为PTSD及其他后期不良后果的高风险。父母的支持和其他社会因素也成为受创伤儿童中不同风险的有力预测因素。认知行为疗法是一种经过充分评估的干预策略,推荐用于患有PTSD的儿童和青少年,而目前尚无药物治疗的对照试验。介绍了亚琛大学诊所的受创伤儿童和青少年门诊,并描述了寻求帮助的儿童的临床特征。此外,还说明了社交网络和合作服务。

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