与成人相比，儿童创伤后应激障碍(Ptsd)评估不足，而且与不
WESTPORT, CT (Reuters Health) - Post-traumatic stress disorder (PTSD) often goes undiagnosed in children, according to Dr. Jeffrey H. Newcorn, who spoke at the 48th annual meeting of the American Association of Child and Adolescent Psychiatry on Sunday.
"We need to be aware that children's traumatic stressors differ from adults' stressors," Dr. Newcorn told Reuters Health. "We also need to be aware that there is more pediatric PTSD than is being diagnosed and treated in clinical and non-clinical settings." Dr. Newcorn, director of child and adolescent psychiatry at the Mount Sinai Medical Center in New York City, moderated a symposium addressing child PTSD at the meeting.
, http://www.100md.com
He and colleagues found that 60% of children and adults surveyed reported an experience that qualified as a traumatic stressor, in that the experience caused the respondent to feel helpless and afraid. The 45 children and their parents or guardians were being seen in an inner-city psychiatric outpatient clinic.
"The grouping of traumatic stressors reported by adults were typically death, injury, family violence, and other issues that we commonly identify as traumatic," Dr. Newcorn told Reuters Health. "Children identified those issues as traumatic, but less consistently so. Their traumatic stressors were related to developmentally appropriate fears, such as falling off a bike or being bullied by another child."
, 百拇医药
Of respondents who reported a Criterion A trauma--an experience with an impact consistent with PTSD--20% to 30% had full PTSD, with symptoms including re-experiencing of the traumatic event, over-arousal, and avoidance of settings related to the traumatic event. Approximately 20% had partial PTSD.
"Ratings of traumatic stress were somewhat associated with ratings of mood and anxiety," Dr. Newcorn told Reuters Health. "Children in full or partial PTSD more often have problems with anxiety and depression, as well as symptoms of disruptive behavior. Clinicians tend to diagnose the mood and anxiety disorders and miss the PTSD."
, http://www.100md.com
"We have a general lack of awareness of PTSD symptoms," Dr. Newcorn added. "If the diagnosis can be missed in a psychiatric setting, it certainly must be true in a pediatric setting."
In other research presented at the symposium, Dr. Eyal Shemesh, also of Mount Sinai Medical Center, found high levels of PTSD in a small study of children who were being treated in emergency department settings and among pediatric transplant recipients. Of the three children who were severely noncompliant with post-transplant immunosuppressive therapy, all had full PTSD. Partial PTSD was not associated with non-adherence.
, 百拇医药
When children are exposed to domestic violence, 42% of them may develop PTSD, according to Dr. Claude Chemtob, of the National Center for PTSD in Honolulu. In a survey of families who used domestic violence agencies, the mothers could report their own symptoms, but "you couldn't tell which children had PTSD by talking to their mothers," said Dr. Newcorn, commenting on the research.
These findings show that an intervention on domestic violence must have a separate focus on the affected children as well as the family unit, in order to adequately treat all individuals, according to Dr. Chemtob.
-Westport Newsroom 203 319 2700, http://www.100md.com
"We need to be aware that children's traumatic stressors differ from adults' stressors," Dr. Newcorn told Reuters Health. "We also need to be aware that there is more pediatric PTSD than is being diagnosed and treated in clinical and non-clinical settings." Dr. Newcorn, director of child and adolescent psychiatry at the Mount Sinai Medical Center in New York City, moderated a symposium addressing child PTSD at the meeting.
, http://www.100md.com
He and colleagues found that 60% of children and adults surveyed reported an experience that qualified as a traumatic stressor, in that the experience caused the respondent to feel helpless and afraid. The 45 children and their parents or guardians were being seen in an inner-city psychiatric outpatient clinic.
"The grouping of traumatic stressors reported by adults were typically death, injury, family violence, and other issues that we commonly identify as traumatic," Dr. Newcorn told Reuters Health. "Children identified those issues as traumatic, but less consistently so. Their traumatic stressors were related to developmentally appropriate fears, such as falling off a bike or being bullied by another child."
, 百拇医药
Of respondents who reported a Criterion A trauma--an experience with an impact consistent with PTSD--20% to 30% had full PTSD, with symptoms including re-experiencing of the traumatic event, over-arousal, and avoidance of settings related to the traumatic event. Approximately 20% had partial PTSD.
"Ratings of traumatic stress were somewhat associated with ratings of mood and anxiety," Dr. Newcorn told Reuters Health. "Children in full or partial PTSD more often have problems with anxiety and depression, as well as symptoms of disruptive behavior. Clinicians tend to diagnose the mood and anxiety disorders and miss the PTSD."
, http://www.100md.com
"We have a general lack of awareness of PTSD symptoms," Dr. Newcorn added. "If the diagnosis can be missed in a psychiatric setting, it certainly must be true in a pediatric setting."
In other research presented at the symposium, Dr. Eyal Shemesh, also of Mount Sinai Medical Center, found high levels of PTSD in a small study of children who were being treated in emergency department settings and among pediatric transplant recipients. Of the three children who were severely noncompliant with post-transplant immunosuppressive therapy, all had full PTSD. Partial PTSD was not associated with non-adherence.
, 百拇医药
When children are exposed to domestic violence, 42% of them may develop PTSD, according to Dr. Claude Chemtob, of the National Center for PTSD in Honolulu. In a survey of families who used domestic violence agencies, the mothers could report their own symptoms, but "you couldn't tell which children had PTSD by talking to their mothers," said Dr. Newcorn, commenting on the research.
These findings show that an intervention on domestic violence must have a separate focus on the affected children as well as the family unit, in order to adequately treat all individuals, according to Dr. Chemtob.
-Westport Newsroom 203 319 2700, http://www.100md.com