Всемирная психиатрия. №3 2019

Посттравматическое стрессовое расстройство: обзор современных доказательных данных и проблем

Richard A. Bryant

School of Psychology, University of New South Wales, Sydney, NSW, Australia

Стр. 267-277

1975 просмотров

Опубликовано: 24 октября 2019

Аннотация / Abstract

a:2:{s:4:"TEXT";s:65535:"a:2:{s:4:"TYPE";s:4:"HTML";s:4:"TEXT";s:86721:"Перевод: Суслова Ж. В. (Москва) Редактура: к.м.н. Федотов И.А. (Рязань) Bryant RA. Post-traumatic stress disorder: a state-of-the-art review of evidence and challenges. World Psychiatry 2019;18(3):259–269. Посттравматическое стрессовое расстройство (ПТСР) является, вероятно, самым распространенным психическим расстройством, возникающим в результате воздействия травматического события. После того, как оно было официально введено в DSM-III в 1980 г., существенно возросла осведомленность о его причинах, механизмах развития и лечении. Тем не менее, несмотря на значительный прогресс в понимании, текущее определение этого расстройства по-прежнему остается предметом споров. DSM-5 и МКБ-11 определяют расстройство по-разному, что отражает разногласия по поводу того, должна ли концепция ПТСР охватывать широкий спектр психологических явлений, возникающих вследствие травмы, или же она должна быть сфокусирована непосредственно на феномене травматических воспоминаний. Это несоответствие в объяснении природы ПТСР препятствует возможности установления биомаркеров и специфических механизмов травматического стресса. В данной работе представлен современный обзор существующих определений ПТСР, имеющиеся сведения о его распространенности и факторах риска, основные объяснительные модели расстройства, а также доказательные методы лечения. Основной вывод состоит в том, что, хотя когнитивно-поведенческая терапия, сфокусированная на травме, является наиболее признанным методом лечения ПТСР, в последние десятилетия она переживает застой, и лишь две трети пациентов с ПТСР демонстрируют адекватный отклик на данное лечение. Кроме того, большинство людей с ПТСР не имеют доступа к доказательным методам лечения, и ситуация обстоит еще хуже в странах с низким и средним уровнем дохода. Определение процессов, которые могли бы помочь устранить эти серьезные препятствия на пути к улучшению состояния людей с ПТСР, оста...

Перевод: Суслова Ж. В. (Москва) Редактура: к.м.н. Федотов И.А. (Рязань) Bryant RA. Post-traumatic stress disorder: a state-of-the-art review of evidence and challenges. World Psychiatry 2019;18(3):259–269. Посттравматическое стрессовое расстройство (ПТСР) является, вероятно, самым распространенным психическим расстройством, возникающим в результате воздействия травматического события. После того, как оно было официально введено в DSM-III в 1980 г., существенно возросла осведомленность о его причинах, механизмах развития и лечении. Тем не менее, несмотря на значительный прогресс в понимании, текущее определение этого расстройства по-прежнему остается предметом споров. DSM-5 и МКБ-11 определяют расстройство по-разному, что отражает разногласия по поводу того, должна ли концепция ПТСР охватывать широкий спектр психологических явлений, возникающих вследствие травмы, или же...

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