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一项关于青少年和成年人 ICD-11 复杂创伤后应激障碍(CPTSD)评估的系统评价。

A Systematic Review of the Assessment of ICD-11 Complex Post-Traumatic Stress Disorder (CPTSD) in Young People and Adults.

机构信息

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Adult Autism Service, Oxleas NHS Foundation Trust, Dartford, UK.

出版信息

Clin Psychol Psychother. 2024 May-Jun;31(3):e3012. doi: 10.1002/cpp.3012.

Abstract

Complex post-traumatic stress disorder (CPTSD) was introduced in the International Classification of Diseases (ICD) 11 in 2013 to simplify diagnosis and increase clinical utility. Given the recent ICD-11 conceptualisation, there is no standard approach for its assessment, and a review of research is necessary. This systematic review focuses on ICD-11 CPTSD assessment in young people aged 7 to 17 and adults aged 18 and above, examining measures, differentiating features and clinical considerations. Data from five databases are reviewed using a narrative synthesis approach and the quality of evidence is assessed and discussed. A total of 36 studies involving 5901 participants recruited from clinical settings and 1458 professionals with CPTSD assessment experience were included. Studies predominantly focused on adults, and the most used measure for assessment was the International Trauma Questionnaire. Papers focusing on differentiating features highlighted increased symptom severity, impairment and difficulties in individuals with CPTSD, compared to those with PTSD across various characteristics in both young people and adults. This review also identified the importance of a sensitive clinical approach with adaptations based on culture and age. Although gold-standard recommendations cannot be made, this paper offers tentative clinical practice recommendations and considerations regarding ICD-11 CPTSD assessment.

摘要

复杂创伤后应激障碍(CPTSD)于 2013 年在《国际疾病分类》(ICD)11 中引入,以简化诊断并提高临床实用性。鉴于最近 ICD-11 的概念化,其评估没有标准方法,因此需要进行研究综述。本系统综述重点关注 7 至 17 岁的年轻人和 18 岁及以上的成年人的 ICD-11 CPTSD 评估,检查评估工具、鉴别特征和临床注意事项。使用叙述性综合方法对来自五个数据库的数据进行了回顾,评估和讨论了证据质量。共有 36 项研究纳入了 5901 名来自临床环境的参与者和 1458 名具有 CPTSD 评估经验的专业人员。这些研究主要关注成年人,用于评估的最常用工具是国际创伤问卷。关注鉴别特征的论文强调,与 PTSD 相比,CPTSD 患者在年轻人和成年人的各种特征中,症状严重程度、障碍和困难程度更高。本综述还强调了在文化和年龄基础上进行敏感临床方法调整的重要性。尽管不能提出黄金标准建议,但本文提供了关于 ICD-11 CPTSD 评估的临时临床实践建议和注意事项。

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