Психологические процессы, опосредующие связь между травмой развития и специфическими психотическими симптомами у взрослых: систематический обзор и метаанализ
Всемирная психиатрия. №1 2021
Психологические процессы, опосредующие связь между травмой развития и специфическими психотическими симптомами у взрослых: систематический обзор и метаанализ
Michael A.P. Bloomfield1-4, Tinya Chang1 , Maximillian J. Woodl2 , Laura M. Lyons2 , Zhen Cheng1 , Clarissa Bauer-Staeb1,5, Catherine Hobbs1,5, Sophie Bracke1 , Helen Kennerley6,7, Louise Isham7,8, Chris Brewin9 , Jo Billings10, Talya Greene10,11, Glyn Lewis10
Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, University College London, Lon- don, UK; 2 Traumatic Stress Clinic, St. Pancras Hospital, Camden and Islington NHS Foundation Trust, London, UK; 3 NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK; 4 National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK; 5 Department of Psychology, University of Bath, Bath, UK; 6 University of Oxford, Oxford, UK; 7 Oxford Centre for Cognitive Therapy, Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford, UK; 8 Department of Psychiatry, University of Oxford, Oxford, UK; 9 Research Department of Clinical, Health and Educational Psychology, University College London, London, UK; 10Division of Psychiatry, University College London, London, UK; 11Community Mental Health Department, University of Haifa, Haifa, Israel
Стр. 107-123
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Опубликовано: 1 февраля 2021
Аннотация / Abstract
a:2:{s:4:"TEXT";s:65526:"a:2:{s:4:"TYPE";s:4:"HTML";s:4:"TEXT";s:82433:"Наличие причинных связей между психологическими травматическими переживания в детстве и/или подростковом возрасте (далее «травмы развития» (ТР)) и психопатологией взрослого возраста были предположены в 19 в. Breuer и Freud 1 . В дальнейшем эти теории были разработаны Ferenczi 2 , который предположил, что сексуальное насилие в детстве может вызвать психотические симптомы у взрослых. Эти ранние концептуальные представления, несмотря на сторонние искажающие факторы, подтверждаются данными наблюдений, показывающих, что люди, которые испытывают ТР, имеют более высокий риск психоза в течение жизни 3-7 .
Метаанализ показывает, что вероятность возникновения психотического расстройства примерно в три раза выше у взрослых, переживших ТР, по сравнению с теми, кто не испытал таковых, при этом атрибутивный риск развития психоза у людей, испытавших ТР, составляет 33% 6,8 . Важно отметить, что связь между ТР и психозом в зрелом возрасте вряд ли может быть результатом обратной причинности или пассивной корреляции генов и среды 9 . Клинические данные показывают, что у взрослых, переживших ТР, отмечается более тяжелое течение психоза и они с большей вероятностью нуждаются в стационарном лечении, чем люди, страдающие психозами, но не имеющие ТР, что свидетельствует о срочной необходимости оптимизации лечения у данной части населения 10,11 .
Таким образом, есть четкие свидетельства того, что ТР связана с повышенным риском и тяжестью психоза, но пока отсутствует понимание задействованных в этой связи процессов. Несмотря на то, что недавно был достигнут прогресс в наших знаниях о биопсихосоциальных последствиях ТР 12 , остается неясным, как психотические симптомы возникают после нее. Это препятствует разработке эффективных мер вторичной профилактики для взрослых, перенесших ТР, и лечения для перенесших психоз 13 .
Существует...
Наличие причинных связей между психологическими травматическими переживания в детстве и/или подростковом возрасте (далее «травмы развития» (ТР)) и психопатологией взрослого возраста были предположены в 19 в. Breuer и Freud 1 . В дальнейшем эти теории были разработаны Ferenczi 2 , который предположил, что сексуальное насилие в детстве может вызвать психотические симптомы у взрослых. Эти ранние концептуальные представления, несмотря на сторонние искажающие факторы, подтверждаются данными наблюдений, показывающих, что люди, которые испытывают ТР, имеют более высокий риск психоза в течение жизни 3-7 .
Метаанализ показывает, что вероятность возникновения психотического расстройства примерно в три раза выше у взрослых, переживших ТР, по сравнению с теми, кто не испытал таковых, при этом атрибутивный риск...
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