Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Child Psychiatry Hum Dev. 2010 Dec;41(6):624-40. doi: 10.1007/s10578-010-0192-3.
PTSD in children and adolescents differs from the adult disease. Therapeutic approaches involve both psychotherapy and psychopharmacotherapy.
The current paper aims at reviewing studies on psychopharmacological treatment of childhood and adolescent PTSD. Additionally, developmental frameworks for PTSD diagnosis and research along with an experimental model of quenching and kindling in the context of stress exposure are presented. We conducted an extensive literature search of reviews on psychopharmacotherapy as well as studies on psychopharmacological treatment for PTSD among children and adolescents. We used the database PubMed and focused on the time period of the last 10 years up to January 2009. Pertinent earlier papers were also included.There are a limited number of studies specifically assessing the psychopharmacological treatment of PTSD in children and adolescents. The vast majority of them lack verification in RCTs. Only the use of imipramine, divalproex sodium and sertraline were already evaluated in RCTs. Future studies should take into account developmental approaches to the diagnosis and treatment of PTSD in children and adolescents. In this context, different underlying neurobiological patterns, which are reflected in distinct clinical symptomatology, require a precise investigation and a symptom-orientated psychopharmacological approach.
儿童和青少年的创伤后应激障碍与成人疾病不同。治疗方法包括心理治疗和精神药理学治疗。
目前的论文旨在回顾儿童和青少年创伤后应激障碍的精神药理学治疗研究。此外,还介绍了 PTSD 诊断和研究的发展框架,以及应激暴露背景下的抑制和点燃的实验模型。我们对精神药理学治疗综述以及儿童和青少年创伤后应激障碍的精神药理学治疗研究进行了广泛的文献检索。我们使用了 PubMed 数据库,并将重点放在截至 2009 年 1 月的过去 10 年的时间范围内。同时也包括了相关的早期论文。
专门评估儿童和青少年创伤后应激障碍精神药理学治疗的研究数量有限。其中绝大多数研究都缺乏 RCT 的验证。只有丙咪嗪、丙戊酸钠和舍曲林的使用已经在 RCT 中进行了评估。未来的研究应考虑到儿童和青少年创伤后应激障碍的诊断和治疗的发展方法。在这种情况下,不同的潜在神经生物学模式,反映在不同的临床症状中,需要进行精确的调查和以症状为导向的精神药理学方法。