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Nervenheilkunde 2006; 25(09): 709-716
DOI: 10.1055/s-0038-1626777
Originaler Artikel
Schattauer GmbH

Behandlung der posttraumatischen Belastungsstörung bei Kindern und Jugendlichen

Eine Übersicht empirischer WirksamkeitsstudienTreatment of posttraumatic stress disorder in children and adolescentsA review of treatment outcome studies
S. Kraft
1   Klinik für Kinder- und Jugendpsychiatrie, Universität Ulm (Leitung: Prof. Dr. Jörg Fegert)
,
R. Schepker
2   Zentrum für Psychiatrie Weissenau (Leitung: Prof. Dr. Renate Schepker)
,
L. Goldbeck
1   Klinik für Kinder- und Jugendpsychiatrie, Universität Ulm (Leitung: Prof. Dr. Jörg Fegert)
,
J. M. Fegert
1   Klinik für Kinder- und Jugendpsychiatrie, Universität Ulm (Leitung: Prof. Dr. Jörg Fegert)
› Author Affiliations
Further Information

Publication History

Publication Date:
19 January 2018 (online)

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Zusammenfassung

Auf der Basis einer systematischen Literaturrecherche wird der aktuelle Wissensstand zur Wirksamkeit psychotherapeutischer und pharmakotherapeutischer Behandlungsmethoden von posttraumatischen Belastungsstörungen im Kindes- und Jugendalter zusammengefasst und bewertet. Es konnten 19 kontrollierte und randomisierte klinische Studien zur Psychotherapie, jedoch keine zur Pharmakotherapie gefunden werden.

Die Wirksamkeit kognitiv-behavioraler Therapieprogramme ist inzwischen gut belegt, wobei die Einbeziehung eines Elternteils bzw. einer Pflegeperson in die Behandlung sich günstig auszuwirken scheint. Für Eye Movement Desensitization and Reprocessing (EMDR) und für multisystemische Familientherapie gibt es erste erfolgversprechende Studien, deren Ergebnisse allerdings wegen kleiner Fallzahlen und fehlender Replikation als vorläufig angesehen werden müssen. Kontrollierte klinische Studien zur Pharmakotherapie fehlen für das Kindes- und Jugendalter, sodass hierzu keinerlei gesicherte Erkenntnisse vorliegen. Zu fordern sind weitere klinische Studien an dieser zahlenmäßig relevanten und teilweise schwer beeinträchtigten Zielgruppe. Untersuchungen zur differenziellen Indikation verschiedener Therapieansätze und zur Wirksamkeit von Kombinationsbehandlungen, z.B. Psychotherapie plus Pharmakotherapie, stehen aus.

Summary

Based on a systematic literature search, the current state of knowledge on the efficacy of psychotherapeutic and pharmacologic treatment of posttraumatic stress disorders in children and adolescents is summarized and reviewed. Nineteen randomized controlled clinical trials were found for psychotherapy, and none for pharmacotherapy.

The efficacy of cognitive behavioral treatment programs has been substantiated, with the participation of a parent or caretaker in the treatment seeming to be beneficial. There are promising studies for Eye Movement Desensitization and Reprocessing (EMDR) and for Multisystemic Family Therapy. However, because of small sample sizes and lacking replication, their results have to be regarded as provisional. Up to now, there are no controlled clinical trials on pharmacological treatments for traumatized children and adolescents.

More studies on this numerically relevant and partly severely impaired group are to be claimed. Studies on differential indication of different treatment approaches and on the efficacy of combination treatments, as psychotherapy plus pharmacotherapy, are lacking.

Schlüsselwörter

Posttraumatische Belastungsstörung - Kinder und Jugendliche - Psychotherapie - Pharmakotherapie

Keywords

Posttraumatic stress disorder - children and adolescents - psychotherapy - pharmacotherapy
 

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