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Psychiatric comorbidity of developmental trauma disorder and posttraumatic Stress disorder: findings from the DTD field trial replication (DTDFT-R)
European Journal of Psychotraumatology ( IF 5.783 ) Pub Date : 2021-06-28 , DOI: 10.1080/20008198.2021.1929028
Julian D Ford 1 , Joseph Spinazzola 2 , Bessel van der Kolk 3
Affiliation  

ABSTRACT

Background: Developmental Trauma Disorder (DTD) has extensive comorbidity with internalizing and externalizing disorders distinct from posttraumatic stress disorder (PTSD).

Objective: To replicate findings of DTD comorbidity and to determine whether this comorbidity is distinct from, and extends beyond, comorbidities of PTSD.

Method: DTD was assessed by structured interview, and probable DSM-IV psychiatric disorders were identified with KSADS-PL screening modules, in a multi-site sample of 271 children (ages 8–18 years old; 47% female) in outpatient or residential mental health treatment for multiple (M = 3.5 [SD = 2.4]) psychiatric diagnoses other than PTSD or DTD.

Results: DTD (N = 74, 27%) and PTSD (N = 107, 39%) were highly comorbid and shared several DSM-IV internalizing and externalizing disorder comorbidities. Children with DTD with or without PTSD had more comorbid diagnoses (M = 5.7 and 5.2 [SD = 2.4 and 1.7], respectively) than children with PTSD but not DTD (M = 3.8[SD = 2.1]) or neither PTSD nor DTD (M = 2.1[SD = 1.9]), F[3,267] = 55.49, p < .001. Further, on a multivariate basis controlling for demographics and including all potential comorbid disorders, DTD was associated with separation anxiety disorder, depression, and oppositional defiant disorder after controlling for PTSD, while PTSD was associated only with separation anxiety disorder after controlling for DTD. Both DTD and PTSD were associated with suicidality.

Conclusions: DTD is associated with psychiatric comorbidity beyond that of PTSD, and DTD warrants assessment for treatment planning with children in intensive psychiatric services.



中文翻译:

发育性创伤障碍和创伤后应激障碍的精神病合并症:DTD 现场试验复制 (DTDFT-R) 的发现

摘要

背景:发育性创伤障碍 (DTD) 与创伤后应激障碍 (PTSD) 不同的内化和外化障碍具有广泛的共病。

目的:复制 DTD 合并症的发现,并确定这种合并症是否不同于 PTSD 合并症,并且是否超越了 PTSD 合并症。

方法:通过结构化访谈评估 DTD,并使用 KSADS-PL 筛查模块确定可能的DSM-IV精神障碍,在门诊或住院的 271 名儿童(8-18 岁;47% 为女性)的多地点样本中除 PTSD 或 DTD 之外的多种精神疾病诊断 ( M = 3.5 [SD = 2.4]) 的心理健康治疗。

结果:DTD(N =  74, 27%)和 PTSD(N =  107, 39%)是高度共病的,并且共有几种DSM-IV内化和外化障碍合并症。有或没有 PTSD 的 DTD 儿童比有 PTSD 但没有 DTD 的儿童(M = 3.8[SD = 2.1])或既没有 PTSD 也没有 DTD(分别为 M = 5.7 和 5.2 [SD = 2.4 和1.7 ] M = 2.1[SD = 1.9]), F [3,267] = 55.49, p<.001。此外,在控制人口统计学和包括所有潜在合并症的多变量基础上,在控制了 PTSD 后,DTD 与分离焦虑症、抑郁症和对立违抗性障碍相关,而在控制了 DTD 后,PTSD 仅与分离焦虑症相关。DTD 和 PTSD 都与自杀有关。

结论:除 PTSD 外,DTD 与精神病合并症相关,并且 DTD 保证对接受强化精神病学服务的儿童的治疗计划进行评估。

更新日期:2021-06-28
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