Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma?
Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma?
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DOI：
10.5498/wjp.v8.i1.12
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发表时间：
2018-03-22
影响因子：
3.1
通讯作者：
Jelastopulu E
中科院分区：
文献类型：
--
作者：
Giourou E;Skokou M;Andrew SP;Alexopoulou K;Gourzis P;Jelastopulu E
复杂性创伤后应激障碍（复杂性PTSD）最近已被提议作为一个独特的临床实体在世界卫生组织国际疾病分类，第11版，由于出版，二十年后，其第一次启动。它被描述为目前PTSD定义的增强版本，具有PTSD的临床特征加上三个额外的症状群，即情绪失调，消极的自我认知和人际关系困难，因此类似于边缘型人格障碍（BPD）常见的临床特征。复杂性创伤后应激障碍与复杂性创伤有关，复杂性创伤由其威胁和诱捕背景定义，通常是人际性质的。在这篇文章中，我们回顾了目前的研究结果有关的创伤事件诱发上述疾病以及周围的生物学相关性，沿着他们的临床特点。此外，我们认为，除了目前不同的临床诊断（创伤后应激障碍;复杂的创伤后应激障碍; BPD），有一个集群的这些共病的疾病，遵循一个连续的创伤和生物严重性的一系列共同或相似的临床特征，并应予以治疗。需要更多的研究来证实或拒绝这一假设，特别是在临床方面，以及它们如何与临床实体的生物学背景相关联，支持从精神疾病的现象学分类转向更生物学验证的分类。
Complex posttraumatic stress disorder (Complex PTSD) has been recently proposed as a distinct clinical entity in the WHO International Classification of Diseases, 11th version, due to be published, two decades after its first initiation. It is described as an enhanced version of the current definition of PTSD, with clinical features of PTSD plus three additional clusters of symptoms namely emotional dysregulation, negative self-cognitions and interpersonal hardship, thus resembling the clinical features commonly encountered in borderline personality disorder (BPD). Complex PTSD is related to complex trauma which is defined by its threatening and entrapping context, generally interpersonal in nature. In this manuscript, we review the current findings related to traumatic events predisposing the above-mentioned disorders as well as the biological correlates surrounding them, along with their clinical features. Furthermore, we suggest that besides the present distinct clinical diagnoses (PTSD; Complex PTSD; BPD), there is a cluster of these comorbid disorders, that follow a continuum of trauma and biological severity on a spectrum of common or similar clinical features and should be treated as such. More studies are needed to confirm or reject this hypothesis, particularly in clinical terms and how they correlate to clinical entities’ biological background, endorsing a shift from the phenomenologically only classification of psychiatric disorders towards a more biologically validated classification.
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