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Diagnostik und Therapie der posttraumatischen Belastungsstörung im Kindes- und Jugendalter

Aufgaben einer kinder- und jugendpsychiatrischen Traumaambulanz

Clinical assessment and therapy of post-traumatic stress disorder in childhood and adolescence

Responsibilities of an outpatient clinic for traumatized children

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Zusammenfassung

Die folgende Übersicht stellt spezifische Merkmale bei Entstehung, Symptomatik und Therapie der PTSD im Kindes- und Jugendalter dar. Traumatische Störungen im Klein-, Vorschul- und Grundschulalter werden durch die Klassifikationskriterien von DSM-IV und ICD-10 nur unzureichend abgebildet. Die Prävalenz im Jugendalter entspricht der bei Erwachsenen; Mädchen sind häufiger betroffen als Jungen. Risikofaktoren für eine PTSD im Kindes- und Jugendalter sind genetische Faktoren, prätraumatische psychiatrische Erkrankungen des Kindes und der Eltern, die Art, Schweregrad und Nähe zum Trauma sowie unzureichende elterliche und andere soziale Unterstützung. Bei der Untersuchung und Diagnostik ist auf ein kindgerechtes Vorgehen und Einbeziehung der Bezugspersonen zu achten. Kontrollierte Studien zeigen die Effektivität von kognitiv-behavioralen Therapieverfahren für das Kindes- und Jugendalter auf, während entsprechende pharmakologische Studien für diesen Altersbereich fehlen. Am Beispiel der Traumaambulanz für Kinder und Jugendliche des Universitätsklinikums Aachen werden Merkmale des Patientenklientels sowie die Prävalenz posttraumatischer psychischer Störungen beschrieben und notwendige Vernetzungsstrukturen aufgezeigt.

Summary

This article presents an overview of the etiology, clinical characteristics, assessment, and treatment of PTSD in children and adolescents. Diagnostic criteria of DSM-IV and ICD-10 for PTSD in adults may not adequately describe this disorder especially in toddlers and preschool children, because specific PTSD symptoms may vary according to the developmental stage of the child. Prevalence of PTSD in adolescence is similar to that in adulthood. Children who exhibit high degrees of psychopathology before traumatic exposure, who are exposed to high levels of trauma for an extended period, or who directly experienced the event face a high risk to develop PTSD and other later adverse outcomes. Parental support and other social factors also emerge as strong predictors of differential risk among traumatized children. Cognitive-behavioral therapy is a well-assessed intervention strategy recommended for children and adolescents with PTSD while there are no controlled trials of pharmacological treatments. The outpatient clinic for traumatized children and adolescents of the University Clinic of Aachen is introduced and clinical characteristics of children seeking help are described. In addition, the social network and cooperating services are illustrated.

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Authors and Affiliations

  1. Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Aachen

    B. Herpertz-Dahlmann, F. Hahn & A. Hempt

  2. Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Aachen, Neuenhofer Weg 21, 52074, Aachen, Deutschland

    B. Herpertz-Dahlmann

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  1. B. Herpertz-Dahlmann
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  2. F. Hahn
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  3. A. Hempt
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Correspondence to B. Herpertz-Dahlmann.

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Herrn Professor Dr. med. Dr. phil. Helmut Remschmidt, Marburg, zum 65. Geburtstag gewidmet.

Teile dieser Publikation beziehen sich auf einen Vortrag, den die Erstautorin am 09.01.2003 bei der Bundesärztekammer Köln gehalten hat.

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Herpertz-Dahlmann, B., Hahn, F. & Hempt, A. Diagnostik und Therapie der posttraumatischen Belastungsstörung im Kindes- und Jugendalter . Nervenarzt 76, 546–556 (2005). https://doi.org/10.1007/s00115-004-1819-z

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