Morrison Anthony P
Epidemiol Psichiatr Soc. 2009 Oct-Dec;18(4):294-8.
This editorial reviews the relationship between childhood trauma and the development of psychosis in adulthood. There are numerous studies, including large, prospective studies, which clearly support a link between childhood adversity and experience of psychosis later in life. There is also evidence that there is a dose response relationship, and that childhood trauma is particularly associated with the experience of hallucinations and delusional ideas. It is possible that psychosis is a relatively understandable response to the experience of severe trauma, and recent cognitive models of psychosis can help to explain the underlying mechanisms in such a causal relationship. There are obvious treatment implications, which include the need to assess histories of childhood trauma in people with psychosis, the incorporation of trauma in shared understandings of psychosis with service users, the incorporation of change strategies in cognitive behaviour therapy for psychosis that are derived from evidence-based approaches to the treatment of trauma and PTSD, and the prevention of traumatisation by mental health services.
这篇社论回顾了童年创伤与成年期精神病发展之间的关系。有许多研究，包括大型前瞻性研究，明确支持童年逆境与晚年精神病体验之间的联系。也有证据表明存在剂量反应关系，且童年创伤尤其与幻觉和妄想观念的体验相关。精神病有可能是对严重创伤经历的一种相对容易理解的反应，最近的精神病认知模型有助于解释这种因果关系中的潜在机制。这有明显的治疗意义，包括需要评估精神病患者的童年创伤史，将创伤纳入与服务使用者对精神病的共同理解中，将源自基于证据的创伤和创伤后应激障碍治疗方法的改变策略纳入精神病的认知行为疗法中，以及预防心理健康服务造成的创伤。
