Ebbinghaus R, Bauer M, Priebe S
Abteilung für Sozialpsychiatrie, Freie Universität Berlin.
Fortschr Neurol Psychiatr. 1996 Nov;64(11):433-43. doi: 10.1055/s-2007-996589.
PTSD is a frequent subject of empirical psychiatric research. There is, however, little knowledge about the efficacy of treatment methods. In this review, general therapeutic guidelines and common components of different psychotherapies are described. Approaches of behaviour, cognitive, psychodynamic and hypnotherapy are outlined. Controlled studies show the reduction of intrusive PTSD-symptoms in behaviour therapy. Effects of psychodynamic therapy on avoidance symptoms have been demonstrated in one study. Family and group therapy are described, their efficacy has not been empirically tested yet. The need to integrate different concepts and models is emphasized. Special guidelines in the treatment of victims of political persecution are summarized. In pharmacotherapy positive effects on partial PTSD-symptoms has been shown in particular for SSRI-antidepressants. Pharmacotherapy may be a useful addition to psychotherapy. Fixed guidelines for the treatment of PTSD can not be set up yet.
创伤后应激障碍(PTSD)是实证精神病学研究的常见主题。然而,对于治疗方法的疗效了解甚少。在本综述中,描述了一般治疗指南以及不同心理疗法的共同组成部分。概述了行为疗法、认知疗法、心理动力疗法和催眠疗法的方法。对照研究表明行为疗法可减轻创伤后应激障碍的侵入性症状。一项研究证明了心理动力疗法对回避症状的疗效。文中描述了家庭疗法和团体疗法,但尚未对其疗效进行实证检验。强调了整合不同概念和模型的必要性。总结了政治迫害受害者治疗的特殊指南。在药物治疗方面,特别是选择性5-羟色胺再摄取抑制剂(SSRI)类抗抑郁药已显示出对部分创伤后应激障碍症状有积极作用。药物治疗可能是心理治疗的有益补充。目前尚无法制定创伤后应激障碍治疗的固定指南。