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儿童期创伤和精神病患者的创伤后应激障碍:临床挑战和新兴治疗方法。

Childhood trauma and posttraumatic stress disorder in patients with psychosis: clinical challenges and emerging treatments.

机构信息

Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Curr Opin Psychiatry. 2011 Nov;24(6):514-8. doi: 10.1097/YCO.0b013e32834b56c8.

Abstract

PURPOSE OF REVIEW

To review the current literature on childhood trauma and emerging treatments for posttraumatic stress disorder (PTSD), one of its most prevalent consequences, in patients with psychotic disorders.

RECENT FINDINGS

Of patients with psychosis, 40-50% report either childhood sexual abuse or childhood physical abuse, and 11-46% fulfil a diagnosis of PTSD. About one-third of patients report childhood emotional abuse in the absence of other forms of childhood trauma. More robust evidence is mounting to support the role of childhood trauma in the aetiology of psychosis, but more research is needed to understand the underlying mechanisms. Patients with a history of childhood trauma and/or PTSD have a more severe clinical profile compared with those without these experiences, worse overall functioning, and lower remission rates. Research suggests that instruments assessing childhood trauma and PTSD developed for the general population are also appropriate for use among people with psychosis, and trauma-focussed treatments can be used safely and effectively in this group.

SUMMARY

Childhood trauma and its consequences are highly prevalent among patients with psychosis and severely affect the course and outcome. Treatment approaches appropriate for this population need to be further evaluated and implemented into routine practice.

摘要

目的综述

综述儿童创伤和新兴治疗方法的当前文献,创伤后应激障碍(PTSD)是精神病患者最常见的后果之一。

最新发现

精神病患者中有 40-50%报告有儿童性虐待或儿童身体虐待,11-46%符合 PTSD 的诊断。大约三分之一的患者在没有其他形式的儿童创伤的情况下报告有儿童情绪虐待。越来越多的证据支持儿童创伤在精神病发病机制中的作用,但需要更多的研究来了解潜在的机制。与没有这些经历的患者相比,有儿童创伤和/或 PTSD 病史的患者的临床特征更为严重,整体功能更差,缓解率更低。研究表明,为一般人群开发的评估儿童创伤和 PTSD 的工具也适用于精神病患者,并且针对创伤的治疗方法可以在该人群中安全有效地使用。

总结

儿童创伤及其后果在精神病患者中非常普遍,严重影响病程和结果。需要进一步评估适合该人群的治疗方法,并将其纳入常规治疗。

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