Department of child and adolescent psychiatry University Basel, Schanzenstrasse 13, CH-4056, Basel, Switzerland.
BMC Psychiatry. 2013 Jan 3;13:3. doi: 10.1186/1471-244X-13-3.
This article reviews the current debate on developmental trauma disorder (DTD) with respect to formalizing its diagnostic criteria. Victims of abuse, neglect, and maltreatment in childhood often develop a wide range of age-dependent psychopathologies with various mental comorbidities. The supporters of a formal DTD diagnosis argue that post-traumatic stress disorder (PTSD) does not cover all consequences of severe and complex traumatization in childhood.
Traumatized individuals are difficult to treat, but clinical experience has shown that they tend to benefit from specific trauma therapy. A main argument against inclusion of formal DTD criteria into existing diagnostic systems is that emphasis on the etiology of the disorder might force current diagnostic systems to deviate from their purely descriptive nature. Furthermore, comorbidities and biological aspects of the disorder may be underdiagnosed using the DTD criteria.
Here, we discuss arguments for and against the proposal of DTD criteria and address implications and consequences for the clinical practice.
本文就发育性创伤障碍（DTD）的诊断标准进行了综述。儿童时期遭受虐待、忽视和虐待的受害者经常会出现一系列与年龄相关的精神病理，伴有各种精神共病。DTD 诊断的支持者认为，创伤后应激障碍（PTSD）并不能涵盖儿童时期严重和复杂创伤的所有后果。
创伤患者的治疗难度较大，但临床经验表明，他们往往受益于特定的创伤治疗。反对将正式的 DTD 标准纳入现有诊断系统的一个主要论点是，对疾病病因的强调可能会迫使当前的诊断系统偏离其纯粹描述性的性质。此外，使用 DTD 标准可能会漏诊该疾病的共病和生物学方面。
本文讨论了支持和反对DTD 标准的论点，并探讨了对临床实践的影响和后果。
