[创伤后应激障碍：诊断、治疗与预防的当前见解]

[Posttraumatic stress disorder: current insights in diagnostics, treatment and prevention].

作者信息

Lok A, Frijling J L, van Zuiden M

机构信息

Academisch Medisch Centrum-Universiteit van Amsterdam, afd. Psychiatrie, Amsterdam.

出版信息

Ned Tijdschr Geneeskd. 2018;161:D1905.

Abstract

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may develop after traumatic events.- PTSD is one of the most prevalent psychiatric disorders in the Netherlands, with an estimated lifetime prevalence of 7%.- Recurrent re-experiencing of the traumatic event is the most characteristic PTSD symptom.- Recognition of PTSD may be hampered by the heterogeneous symptomatology, avoidance to talk about the trauma and highly frequent comorbid psychiatric and somatic comorbidity.- Feelings of guilt and shame may also influence reported trauma history.- First choice treatment for PTSD is trauma-focused psychotherapy, which may be combined with pharmacotherapy.- In case of severe acute posttraumatic stress symptoms after a recent trauma, it is recommended to start early trauma-focused psychotherapy.- Neurobiological findings are increasingly applied in novel interventions to improve the treatment and prevention of PTSD.

摘要

创伤后应激障碍（PTSD）是一种可能在创伤事件后出现的精神障碍。
PTSD是荷兰最常见的精神障碍之一，估计终生患病率为7%。
创伤事件的反复重现是PTSD最典型的症状。
PTSD症状的异质性、对谈论创伤的回避以及极高的精神和躯体共病率可能会妨碍对PTSD的识别。
内疚和羞耻感也可能影响所报告的创伤史。
PTSD的首选治疗方法是聚焦创伤的心理治疗，可与药物治疗相结合。
对于近期创伤后出现严重急性创伤后应激症状的情况，建议尽早开始聚焦创伤的心理治疗。
神经生物学研究结果越来越多地应用于新型干预措施，以改善PTSD的治疗和预防。