DÄ internationalArchive27-28/2014Drugs Can Only Affect Symptoms
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The comment relating to the risk of “overdiagnosis” with all its sequelae should be stressed, especially in view of certain figures—for example, it is claimed that 60% of the US population have experienced at least one traumatic event (defined as life-threatening).

It is inevitable that a review article will remain somewhat superficial, but in this case, important associations were not mentioned. The diagnostic criteria and the described therapeutic approaches are valid in that form only in the setting of “simple trauma” (type 1) and, even then, only for persons whose psychological stability is otherwise good. However, we often deal with persons from very problematic family backgrounds. It is especially in this setting that violent and sexual attacks are not altogether rare, which will result in serious psychological disorders, especially in young persons. This group is likely to include many of the persons with comorbid personality disorders such as and in particular borderline personality disorder, addiction disorders, affective disorders, somatoform disorders, but also psychoses. In this setting, the post-traumatic symptoms are difficult to distinguish from any comorbid psychopathologies. Accordingly, different therapeutic strategies need to be employed, which lie in the domain of psychodynamic approaches to therapy and usually necessitate long-term, comprehensive courses of treatment (1). Treatment that is narrowed to trauma-specific subjects would be contraindicated in this setting and might even be massively harmful, although the attribution of symptoms to a single cause and the handy therapeutic approach may hold great appeal for patients, treating healthcare professionals, and the public—including statutory health insurance funds and politicians.

Medications can only affect symptoms; they cannot cure PTSD.

DOI: 10.3238/arztebl.2014.0489a

Dr. med. Peter Brdiczka

Specialist in psychiatry and psychotherapy

Porta Westfalica

mail@praxis-brdiczka.de

Conflict of interest statement

The author declares that no conflict of interest exists.

1.
Sachse U: Traumazentrierte Psychotherapie. Stuttgart: Schattauer 2004, 115–37.
2.
Frommberger U, Angenendt J, Berger M: Post-traumatic stress disorder—a diagnostic and therapeutic challenge. Dtsch Arztebl Int 2014; 111: 59–65. VOLLTEXT
1.Sachse U: Traumazentrierte Psychotherapie. Stuttgart: Schattauer 2004, 115–37.
2.Frommberger U, Angenendt J, Berger M: Post-traumatic stress disorder—a diagnostic and therapeutic challenge. Dtsch Arztebl Int 2014; 111: 59–65. VOLLTEXT

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