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Posttraumatische Belastungsstörung

Auslöser und Folgeerscheinung vaskulärer Erkrankungen

Posttraumatic stress disorder

Trigger and consequence of vascular diseases

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Zusammenfassung

Die posttraumatische Belastungsstörung (PTBS) wurde bisher hauptsächlich mit Kriegstraumata, sexueller oder physischer Gewalteinwirkung in Verbindung gebracht. Tatsächlich kommt die PTBS jedoch auch häufig nach lebensbedrohlichen körperlichen Erkrankungen wie Herzinfarkt und Schlaganfall vor. Eine PTBS wird in der klinischen Praxis in diesem Kontext viel zu selten diagnostiziert, obwohl ein erheblicher Einfluss auf das klinische Outcome und die Mortalität nach vaskulären Ereignissen besteht. Zudem bildet die PTBS einen wichtigen Risikofaktor für die Entwicklung vaskulärer Erkrankungen. Diese Übersichtsarbeit erläutert den bidirektionalen Zusammenhang zwischen PTBS und vaskulären Ereignissen und fasst die bisherigen Forschungsergebnisse bezüglich Klinik, Prävalenz und Pathophysiologie zusammen.

Abstract

Posttraumatic stress disorder (PTSD) was previously thought to be a psychological reaction precipitated by exposure to war, sexual and physical violence; however, PTSD is also prevalent after life-threatening medical events, such as stroke and myocardial infarction. After such events PTSD is often underdiagnosed despite the fact that it is clearly associated with adverse clinical outcomes including recurrence of cardiac events and increased mortality. Moreover, PTSD increases the risk of vascular events. This review summarizes the bidirectional relationship between PTSD and vascular diseases and outlines current knowledge regarding clinical features, prevalence and the putative underlying pathophysiological mechanisms.

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Danksagung

Wir danken der Deutschen Forschungsgemeinschaft (GE 2576/3-1, K.G.; KR 2956/4-1, G.K.) und der CORONA-Stiftung (M. E.) für die Förderung.

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  1. Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    J. Schöner, G. Kronenberg & A. Heinz

  2. Klinik für Neurologie, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    J. Schöner, G. Kronenberg, M. Endres & K. Gertz

  3. Centrum für Schlaganfallforschung Berlin (CSB), Charité Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    J. Schöner, G. Kronenberg, M. Endres & K. Gertz

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Correspondence to G. Kronenberg.

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Schöner, J., Kronenberg, G., Heinz, A. et al. Posttraumatische Belastungsstörung. Nervenarzt 88, 234–246 (2017). https://doi.org/10.1007/s00115-016-0231-9

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