Tratamento do transtorno do estresse pós-traumático complexo em crianças e adolescentes de acordo com a CID-11: revisão de literatura
DOI:
https://doi.org/10.25118/2763-9037.2023.v13.994Palavras-chave:
transtorno de estresse pós-traumatico complexo, Terapia Cognitiva Comportamental Focada no Trauma, Tratamento do Transtorno de Estresse Pós-Traumático Complexo, crianças, adolescentesResumo
Introdução: Mais de 60% dos jovens relatam ter experimentado pelo menos uma experiência traumática durante a infância. O Transtorno de Estresse Pós-Traumático Complexo (TEPTC) é um novo diagnóstico da CID-11, com poucos estudos publicados sobre seu tratamento, principalmente em crianças e adolescentes. Objetivo: Revisar a literatura disponível sobre o tratamento do Transtorno de Estresse Pós-Traumático Complexo na Infância e Adolescência (TEPTC-IA) e definir as melhores estratégias para seu tratamento. Método: Através de revisão narrativa, foram incluídos artigos abordando o tratamento do TEPTC-IA. O levantamento dos artigos publicados na literatura foi realizado nas bases de dados: 1) BVS – Biblioteca Virtual em Saúde, e 2) PubMed, com as palavras, suas variantes e siglas de Transtorno de Estresse Pós-Traumático Complexo na Infância e Adolescência e “Complex Post-Traumatic Stress Disorder in children and adolescents”. Resultado: Foram incluídos 5 artigos publicados sobre tratamento do TEPTC-IA, com ênfase principalmente em Terapia Cognitiva Comportamental Focada no Trauma (TCC-FT). Conclusão: O presente estudo observou que a TCC-FT é a terapia mais estudada e efetiva para TEPTC-IA, porém, os sintomas do TEPTC como desregulação afetiva ainda causam sofrimento relevante após o tratamento. Os estudos analisados sugerem necessidade de aperfeiçoamento do tratamento, como maior individualização da terapia, com ênfase nos aspectos mais deficientes de cada paciente, como maior tempo da TCC-FT na fase de tratamento da desregulação afetiva e funcionamento relacional. Um estudo de Terapia de Processamento Cognitivo Adaptada ao Desenvolvimento (TPCAD) demonstrou efetividade para TEPTC-IA
Downloads
Métricas
Referências
Copeland WE, Keeler G, Angold A, Costello EJ. Traumatic events and posttraumatic stress in childhood. Arch Gen Psychiatry. 2007;64(5):577-84. https://doi.org/10.1001/archpsyc.64.5.577 PMID:17485609 DOI: https://doi.org/10.1001/archpsyc.64.5.577
McLaughlin KA, Koenen KC, Hill ED, Petukhova M, Sampson NA, Zaslavsky AM, Kessler RC. Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. J Am Acad Child Adolesc Psychiatry. 2013;52(8):815-830.e14. https://doi.org/10.1016/j.jaac.2013.05.011 PMID:23880492 - PMCID:PMC3724231 DOI: https://doi.org/10.1016/j.jaac.2013.05.011
Beal SJ, Wingrove T, Mara CA, Lutz N, Noll JG, Greiner MV. Childhood adversity and associated psychosocial function in adolescents with complex trauma. Child Youth Care Forum. 2019;48:305-22. https://doi.org/10.1007/s10566-018-9479-5 PMID:31467469 - PMCID:PMC6715307 DOI: https://doi.org/10.1007/s10566-018-9479-5
Bertó C, Ferrin M, Barberá M, Livianos L, Rojo L, García-Blanco A. Abnormal emotional processing in maltreated children diagnosed of complex posttraumatic stress disorder. Child Abuse Negl. 2017;73:42-50. https://doi.org/10.1016/j.chiabu.2017.09.020 PMID:28945995 DOI: https://doi.org/10.1016/j.chiabu.2017.09.020
Currie J, Widom CS. Long-term consequences of child abuse and neglect on adult economic well-being. Child Maltreat. 2010;15(2):111-20. https://doi.org/10.1177/1077559509355316 PMID:20425881 - PMCID:PMC3571659 DOI: https://doi.org/10.1177/1077559509355316
Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS Med. 2012;9(11):e1001349. https://doi.org/10.1371/journal.pmed.1001349 PMID:23209385 - PMCID:PMC3507962 DOI: https://doi.org/10.1371/journal.pmed.1001349
Maercker A, Brewin CR, Bryant RA, Cloitre M, van Ommeren M, Jones LM, Humayan A, Kagee A, Llosa AE, Rousseau C, Somasundaram DJ, Souza R, Suzuki Y, Weissbecker I, Wessely SC, First MB, Reed GM. Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11. World Psychiatry. 2013;12(3):198-206. https://doi.org/10.1002/wps.20057 PMID:24096776 - PMCID:PMC3799241 DOI: https://doi.org/10.1002/wps.20057
World Health Organization. ICD-11 - International Classification of Diseases: the global standard for diagnostic health information. Geneva: World Health Organization; 2022. 6B41 Complex post traumatic stress disorder. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/585833559
Brewin CR. Complex post-traumatic stress disorder: a new diagnosis in ICD-11. BJPsych Adv. 2020;26:145-52. https://doi.org/10.1192/bja.2019.48 DOI: https://doi.org/10.1192/bja.2019.48
Dunn BJ, Keane CA, Paterson JL. The Tern programme study protocol for an implementation trial of a flexible, long-term psychosocial intervention for complex posttraumatic stress in young people. Eur J Psychotraumatol. 2021;12:1988479. https://doi.org/10.1080/20008198.2021.1988479 PMID:34868480 - PMCID:PMC8635648 DOI: https://doi.org/10.1080/20008198.2021.1988479
Cloitre M, Courtois CA, Charuvastra A, Carapezza R, Stolbach BC, Green BL. Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices. J Trauma Stress. 2011;24(6):615-27. https://doi.org/10.1002/jts.20697 PMID:22147449 DOI: https://doi.org/10.1002/jts.20697
Vallières F, Ceannt R, Daccache F, Abou Daher R, Sleiman J, Gilmore B, Byrne S, Shevlin M, Murphy J, Hyland P. ICD-11 PTSD and complex PTSD amongst Syrian refugees in Lebanon: the factor structure and the clinical utility of the international trauma questionnaire. Acta Psychiatr Scand. 2018;138(6):547-57. https://doi.org/10.1111/acps.12973 PMID:30357808 DOI: https://doi.org/10.1111/acps.12973
Brewin CR, Cloitre M, Hyland P, Shevlin M, Maercker A, Bryant RA, Humayun A, Jones LM, Kagee A, Rousseau C, Somasundaram D, Suzuki Y, Wessely S, van Ommeren M, Reed GM. A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD. Clin Psychol Rev. 2017;58:1-15. https://doi.org/10.1016/j.cpr.2017.09.001 PMID:29029837 DOI: https://doi.org/10.1016/j.cpr.2017.09.001
Kazlauskas E, Zelviene P, Daniunaite I, Hyland P, Kvedaraite M, Shevlin M, Cloitre M. The structure of ICD-11 PTSD and Complex PTSD in adolescents exposed to potentially traumatic experiences. J Affect Disord. 2020;265:169-74. https://doi.org/10.1016/j.jad.2020.01.061 PMID:32090738 DOI: https://doi.org/10.1016/j.jad.2020.01.061
American Psychological Association. Clinical practice guidelines for the treatment of PTSD: guideline development panel for the treatment of PTSD in adults. Washington: American Psychological Association; 2017. https://www.apa.org/ptsd-guideline/ptsd.pdf
Phoenix Australia. Australian guidelines for the prevention and treatment of acute stress disorder, post-traumatic stress disorder and complex PTSD. Melbourne: Phoenix Australia; 2021. https://www.phoenixaustralia.org/australian-guidelines-for-ptsd/
Jensen TK, Braathu N, Birkeland MS, Ormhaug SM, Skar AS. Complex PTSD and treatment outcomes in TF-CBT for youth: a naturalistic study. Eur J Psychotraumatol. 2022;13(2):2114630. https://doi.org/10.1080/20008066.2022.2114630 PMID:36186162 - PMCID:PMC9518270 DOI: https://doi.org/10.1080/20008066.2022.2114630
Jensen TK, Cohen J, Jaycox L, Rosner R. Treatment of PTSD and complex PTSD. In: Forbes D, Bisson JI, Monson CM, Berliner L, editors. Effective treatments for PTSD: practice guidelines from the International Society for Traumatic Stress Studies. 3rd ed. New York: Guilford Press; 2020. p. 385-413.
Maercker A, Cloitre M, Bachem R, Schlumpf YR, Khoury B, Hitchcock C, Bohus M. Complex post-traumatic stress disorder. Lancet. 2022;400(10345):60-72. https://doi.org/10.1016/s0140-6736(22)00821-2 PMID:35780794 DOI: https://doi.org/10.1016/S0140-6736(22)00821-2
Cohen JA, Mannarino AP, Deblinger E. Treating trauma and traumatic grief in children and adolescents. 2nd ed. New York: Guilford Press; 2017.
Arellano MA, Lyman DR, Jobe-Shields L, George P, Dougherty RH, Daniels AS, Ghose SS, Huang L, Delphin-Rittmon ME. Trauma-focused cognitive-behavioral therapy for children and adolescents: assessing the evidence. Psychiatr Serv. 2014;65(5):591-602. https://doi.org/10.1176/appi.ps.201300255 PMID:24638076 - PMCID:PMC4396183 DOI: https://doi.org/10.1176/appi.ps.201300255
Dorsey S, McLaughlin KA, Kerns SEU, Harrison JP, Lambert HK, Briggs EC, Revillion Cox J, Amaya-Jackson L. Evidence base update for psychosocial treatments for children and adolescents exposed to traumatic events. J Clin Child Adolesc Psychol. 2017;46(3):303-30. https://doi.org/10.1080/15374416.2016.1220309 PMID:27759442 - PMCID:PMC5395332 DOI: https://doi.org/10.1080/15374416.2016.1220309
Cohen JA, Berliner L, Mannarino A. Trauma focused CBT for children with co-occurring trauma and behavior problems. Child Abuse Negl. 2010;34(4):215-24. https://doi.org/10.1016/j.chiabu.2009.12.003 PMID:20304489 DOI: https://doi.org/10.1016/j.chiabu.2009.12.003
Cohen JA, Mannarino AP, Iyengar S. Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence: a randomized controlled trial. Arch Pediatr Adolesc Med. 2011;165(1):16-21. https://doi.org/10.1001/archpediatrics.2010.247 PMID:21199975 DOI: https://doi.org/10.1001/archpediatrics.2010.247
Goldbeck L, Muche R, Sachser C, Tutus D, Rosner R. Effectiveness of trauma-focused cognitive behavioral therapy for children and adolescents: a randomized controlled trial in eight german mental health clinics. Psychother Psychosom. 2016;85(3):159-70. https://doi.org/10.1159/000442824 PMID:27043952 DOI: https://doi.org/10.1159/000442824
Jensen TK, Holt T, Ormhaug SM, Egeland K, Granly L, Hoaas LC, Hukkelberg SS, Indregard T, Stormyren SD, Wentzel-Larsen T. A randomized effectiveness study comparing trauma-focused cognitive behavioral therapy with therapy as usual for youth. J Clin Child Adolesc Psychol. 2014;43(3):356-69. https://doi.org/10.1080/15374416.2013.822307 PMID:23931093 - PMCID:PMC4037845 DOI: https://doi.org/10.1080/15374416.2013.822307
Hébert M, Amédée LM. Latent class analysis of post-traumatic stress symptoms and complex PTSD in child victims of sexual abuse and their response to trauma-focused cognitive behavioural therapy. Eur J Psychotraumatol. 2020;11(1):1807171. https://doi.org/10.1080/20008198.2020.1807171 PMID:33062212 - PMCID:PMC7534355 DOI: https://doi.org/10.1080/20008198.2020.1807171
Cohen JA, Deblinger E, Mannarino AP. Trauma-focused cognitive behavioral therapy for children and families. Psychother Res. 2018;28(1):47-57. https://doi.org/10.1080/10503307.2016.1208375 PMID:27449400 DOI: https://doi.org/10.1080/10503307.2016.1208375
Sachser C, Keller F, Goldbeck L. Complex PTSD as proposed for ICD-11: validation of a new disorder in children and adolescents and their response to Trauma-focused cognitive behavioral therapy. J Child Psychol Psychiatry. 2017;58(2):160-8. https://doi.org/10.1111/jcpp.12640 PMID:27677771 DOI: https://doi.org/10.1111/jcpp.12640
Walker HE, Freud JS, Ellis RA, Fraine SM, Wilson LC. The prevalence of sexual revictimization: a meta-analytic review. Trauma Violence Abuse. 2019;20(1):67-80. https://doi.org/10.1177/1524838017692364 PMID:29333937 DOI: https://doi.org/10.1177/1524838017692364
Eilers R, Rimane E, Vogel A, Renneberg B, Steil R, Rosner R. Response of young patients with probable ICD-11 complex PTSD to treatment with developmentally adapted cognitive processing therapy. Eur J Psychotraumatol. 2021;12(1):1929024. https://doi.org/10.1080/20008198.2021.1929024 PMID:34262664 - PMCID:PMC8253183 DOI: https://doi.org/10.1080/20008198.2021.1929024
Bendall S, Phelps A, Browne V, Metcalf O, Cooper J, Rose B, Nursey J, Fava N. Trauma and young people: moving toward trauma-informed services and systems. Melbourne: Orygen; 2018. https://www.orygen.org.au/Orygen-Institute/Policy-Reports/Trauma-and-young-people-Moving-toward-trauma-info/Orygen_trauma_and_young_people_policy_report
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2023 Ricardo Akiyoshi Nakamura, Marcelo Bruno Generoso, Amelia Karoline Costa Bacalhau
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License.
Debates em Psiquiatria permite que o (s) autor (es) mantenha(m) seus direitos autorais sem restrições. Atribuição-NãoComercial 4.0 Internacional (CC BY-NC 4.0) - Debates em Psiquiatria é regida pela licença CC-BY-NC
