Fekih-Romdhane Feten, Ben Fadhel Sinda, Hakiri Abir, Cheour Majda
Hôpital Razi, service de psychiatrie Ibn Omrane, 1, rue des orangers, 2010 La Manouba, Tunisie; Université Tunis El Manar, faculté de médecine de Tunis, , Tunisie.
Hôpital Razi, service de psychiatrie Ibn Omrane, 1, rue des orangers, 2010 La Manouba, Tunisie; Université Tunis El Manar, faculté de médecine de Tunis, , Tunisie.
Presse Med. 2019 Mar;48(3 Pt 1):243-249. doi: 10.1016/j.lpm.2018.11.023. Epub 2019 Jan 31.
Childhood adversity rates would be higher in subjects at ultra-high risk of psychosis than in the general population. In addition to reference ideas, magical thoughts and social dysfunction, subjects at ultra-high risk of psychosis with a history of childhood trauma would experience more severe and specific symptoms. Childhood trauma, especially sexual abuse, was associated with the transition to psychosis. Several models have been cited to explain the link between trauma and the subsequent onset of psychosis or prepsychotic states: dysfunctional cognitive patterns, affective dysregulation, attachment styles, biological mechanisms, and epigenetic regulation. No methods of trauma assessment has been developed or validated in subjects at ultra-high risk of psychosis. Current interventions aim to prevent or reduce the adversities of childhood and improve their coping skills. Neuroleptic prescription is only recommended if there is a significant increase in prepsychotic symptoms.
与普通人群相比,精神病超高风险个体的童年逆境发生率更高。除了参照观念、奇幻思维和社交功能障碍外,有童年创伤史的精神病超高风险个体还会经历更严重、更具特异性的症状。童年创伤,尤其是性虐待,与向精神病的转变有关。已有几种模型被引用来解释创伤与精神病或精神病前期状态后续发作之间的联系:功能失调的认知模式、情感调节障碍、依恋风格、生物学机制和表观遗传调控。目前尚未开发或验证针对精神病超高风险个体的创伤评估方法。当前的干预措施旨在预防或减少童年逆境,并提高他们的应对技能。只有在精神病前期症状显著增加时,才建议使用抗精神病药物处方。