Pediatric Drugs

, Volume 4, Issue 3, pp 159–170 | Cite as

Post-Traumatic Stress Disorder in Children and Adolescents

Epidemiology, Diagnosis and Treatment Options
Therapy In Practice

Abstract

Post-traumatic stress disorder (PTSD) is a common psychiatric condition in childhood and adolescence. Rates vary widely depending upon the type of trauma exposure. Interpersonal traumas, such as rape or physical abuse, are more likely to result in PTSD than exposure to natural or technological disaster.

Clinical presentations are exceedingly complex and children with PTSD are at increased risk of having comorbid psychiatric diagnoses. Because of its complexity and frequent occurrence with other disorders, assessment of PTSD necessitates a broad-based evaluation utilizing multiple informations and structured instruments specific to the symptoms of PTSD in youth. Cognitive-behavioral therapy (CBT) is the treatment of first choice.

Pharmacological agents for PTSD treatment have received little empirical investigation in childhood. Pharmacological treatment is used to target disabling symptoms of the disorder, which limit psychotherapy or life functioning, by helping children to tolerate working through distressful material in therapy and life. Pharmacological treatment should be based on a stepwise approach utilizing broad spectrum medications such as the selective serotonin reuptake inhibitors as first-line agents. Comorbid conditions should be identified and treated with appropriate medication or psychosocial interventions.

Treatment algorithms are provided to guide rational medication strategies for children and adolescents with PTSD, subsyndromal PTSD, and in PTSD that is comorbid with other psychiatric conditions of childhood. Reduction in even one debilitating symptom of PTSD can improve a child’s overall functioning across multiple domains.

Notes

Acknowledgements

Dr Donnelly serves as a consultant for Pfizer, Eli Lilly and Glaxo SmithKline pharmaceutical companies.

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Copyright information

© Adis International Limited 2002

Authors and Affiliations

  1. 1.Section of Child and Adolescent Psychiatry, Department of PsychiatryDartmouth-Hitchcock Medical CenterLebanonUSA
  2. 2.Division of Child and Adolescent PsychiatryDuke University Medical CenterDurhamUSA

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