Zusammenfassung
Die posttraumatische Belastungsstörung (PTBS) wurde schon vor Jahrzehnten insbesondere im Zusammenhang mit Kriegsereignissen beschrieben. Sie wird bis heute bei Menschen, die mit Krieg, Naturkatastrophen, Terrorismus, Unglücken oder schwerwiegenden persönlichen Schicksalsschlägen konfrontiert werden, beobachtet. Zahlreiche Einflussfaktoren begünstigen das Auftreten einer PTBS. Beispielsweise werden Männer häufiger mit traumatischen Situationen konfrontiert, Frauen hingegen entwickeln häufiger eine PTBS als Männer. Auch liegen mittlerweile interessante Ergebnisse für Zusammenhänge zwischen genetischen Faktoren und Umweltbedingungen vor. Die Persönlichkeitsvariablen Ängstlichkeit, Stressreaktivität, emotionale Labilität und Neigung zu Depressionen sind signifikant mit dem kurzen Allel der Promotorregion des Serotonin-Transporters assoziiert. Bei Menschen, die dieses Allel tragen, ist der Serotoninmetabolismus signifikant verringert, was zur Entstehung einer PTBS beiträgt. Ähnliche Untersuchungen werden in den kommenden Jahren zur Aufklärung dieser bislang nur wenig verstandenen Erkrankung beitragen.
Abstract
Posttraumatic stress disorder (PTSD) has been described since more than one century, especially following war and combat experiences. Until today it can be seen frequently in subjects which have encountered war, natural catastrophes, terrorism or other severe psychotraumas. In the past decades, operationalized diagnostic criteria have been established, which are currently described in the ICD-10 and DSM-IV manuals. Interesting findings on the interplay between genetic risk factors and life events have been published in the recent years. A polymorphism of the serotonin transporter promoter has been studied most comprehensively in this respect. The short allele of the promoter is significantly associated with the personality variables Anxiety, Stress reactivity, Emotional lability and Depression. In subjects carrying the short allele, serotonin metabolism is significantly decreased which contributes to the development of PTSD. In the coming years, similar studies will shed further light on the pathophysiology of this only poorly understood disorder.
Schlüsselwörter
Posttraumatische Belastungsstörung - PTBS - Geschichte - Diagnostik - Risikofaktoren - Epidemiologie - Pathophysiologie - Serotonin-Transporter-Polymorphismus - 5HTT Promoter
Key words
Posttraumatic stress disorder - PTSD - history - diagnosis - risk factors - epidemiology - pathophysiology - serotonin transporter polymorphism - 5HTT promoter
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Dr. Stephan Kamolz
Klinik und Poliklinik für Psychiatrie und Psychotherapie
Füchsleinstraße 15
97080 Würzburg
eMail: kamolz@mail.uni-wuerzburg.de
