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老年人创伤后应激障碍:特征和治疗方法概述。

Posttraumatic stress disorder in older adults: an overview of characteristics and treatment approaches.

机构信息

Treatment Center for Torture Victims, Berlin, Germany.

出版信息

Int J Geriatr Psychiatry. 2012 Mar;27(3):230-9. doi: 10.1002/gps.2725. Epub 2011 Apr 28.

Abstract

OBJECTIVE

Posttraumatic stress disorder (PTSD) is a common and disabling condition following a traumatic event. Despite its high prevalence rates, relatively little is known about the manifestation and course of the disorder in older adults. Moreover, there has been little evaluation of the efficacy of psychotherapeutic treatment approaches for older patients.

DESIGN

This overview aims to summarize available data on the prevalence and symptoms of late-life PTSD and to review the current treatment approaches for older adults.

RESULTS

The course and severity of PTSD symptoms in older adults depend on the time the trauma occurred (early versus late life). In the case of acute traumatization, lower prevalence rates and symptom severities are generally observed in older than in younger populations. In the case of early-life traumatization, a decline in PTSD symptom severity can be observed over the life course. Research on treatment approaches has produced promising results, indicating that disorder-specific interventions (i.e., trauma confrontation and cognitive restructuring) can be effectively combined with an age-specific narrative life-review approach.

CONCLUSION

Given the limited empirical evidence, caution is warranted in generalizing the reported findings. Nevertheless, it is possible to draw a number of conclusions concerning the characteristics and treatment of PTSD in older adults. Further research is needed to better understand the various presentations of PTSD in late life and to validate and improve the effectiveness of available treatment approaches.

摘要

目的

创伤后应激障碍(PTSD)是创伤后常见且致残的一种疾病。尽管其发病率较高,但对于老年人中该障碍的表现和病程知之甚少。此外,对于老年患者的心理治疗方法的疗效评估也很少。

设计

本文旨在总结关于老年 PTSD 的患病率和症状的现有数据,并回顾目前针对老年人的治疗方法。

结果

老年人 PTSD 症状的病程和严重程度取决于创伤发生的时间(早期还是晚期)。在急性创伤的情况下,老年人的患病率和症状严重程度通常低于年轻人。在早期创伤的情况下,随着生命历程的发展,PTSD 症状的严重程度会下降。针对治疗方法的研究已取得可喜的成果,表明特定于疾病的干预措施(即创伤面对和认知重构)可以与特定于年龄的叙事生活回顾方法有效结合。

结论

鉴于有限的经验证据,在概括报告的发现时需谨慎。尽管如此,对于老年人 PTSD 的特征和治疗,仍可以得出一些结论。需要进一步研究以更好地了解晚年 PTSD 的各种表现,并验证和改善现有治疗方法的有效性。

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