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Trauma und Psychose – Teil 2

Zur Assoziation frühkindlicher Traumatisierungen und Psychoserisiko in der Allgemeinbevölkerung

Trauma and psychosis—part 2 – On the association of early childhood maltreatment and risk of psychosis in general population

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Zusammenfassung

Epidemiologische Studien eignen sich in besonderer Weise, den potentiellen Zusammenhang von frühkindlichen Traumatisierungen und nachfolgender psychotischer Symptombildung zu untersuchen. Als primäres Outcome-Kriterium fungiert bei diesem Ansatz die Prävalenz von nicht-klinischen psychotischen Symptomen bei traumaexponierten Personen im Vergleich zu nicht traumatisierten Kontrollgruppen aus der Allgemeinbevölkerung. Mittlerweile existiert eine Fülle von methodisch guten epidemiologischen Studien, die diesen Zusammenhang für Populationen in der Kindheit, in der Adoleszenz und im Erwachsenenalter überzeugend belegen. Im Anschluss hieran stellen sich einerseits Fragen, über welche psychologischen, psychosozialen und neurobiologischen Mechanismen ein erhöhtes Psychoserisiko früher Traumatisierungen vermittelt werden kann, und andererseits Fragen, welche Faktoren den Übergang dieser mehrheitlich subklinischen psychotischen Symptome in klinisch relevante Formen psychotischer Störungen bestimmen. Sowohl theoretische Modelle als auch empirische Daten aus ersten Studien werden dargestellt.

Summary

Any association of early childhood maltreatment and later risk of psychosis may be favourably investigated by epidemiological studies in the general population. Primary outcome variable in these studies is the prevalence of subclinical psychotic symptoms (hallucinations, delusions) in early trauma-exposed groups compared to control groups without any significant trauma in childhood. A systematic literature search underlines a significant association of early childhood trauma and later non-clinical psychotic symptoms in representative samples of the general population both during childhood, adolescence and adulthood. Important questions deal with the issues, which psychological, psychosocial and neurobiological mechanisms may mediate the risk of early trauma in respect of later psychotic symptoms on the one side, and which factors may determine the transition from non-clinical psychotic symptoms to major psychotic disorders cared for within mental health services. Both theoretical models and first data derived from empirical studies will be presented.

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  1. Universitätsklinik für Psychiatrie, Medizinische Universität Graz, Auenbruggerplatz 31, 8036, Graz, Österreich

    Hans-Peter Kapfhammer

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Kapfhammer, HP. Trauma und Psychose – Teil 2. Neuropsychiatr 27, 21–37 (2013). https://doi.org/10.1007/s40211-012-0031-9

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