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Neurobiologie posttraumatischer und somatoformer Störungen im Alter

Neurobiology of posttraumatic and somatoform disorders in the elderly

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Zusammenfassung

Hintergrund

Klinisch relevante Traumafolgestörungen gehen beinahe regelhaft mit körperlichen Symptomen einher, welche einerseits als somatoform klassifiziert werden, andererseits als somatische Komorbiditäten imponieren können. Erst heute werden zusehends die psychologischen, neurobiologischen, endokrinologischen und immunologischen Zusammenhänge verstanden. Dabei ist die Integration in ein gehaltvolles biopsychosoziales Modell eine noch ausstehende Aufgabe.

Ziele der Arbeit

Der folgende Artikel umreißt kondensiert das Wissen zum Zusammenhang zwischen Körper und Psyche bei Traumafolgespektrumstörungen und stellt das neurowissenschaftliche Fundament, welches eine biologische Verbindung zwischen den Störungsphänomenologien herstellen könnte, dar.

Ergebnisse

Die neurobiologische Befundlage zu posttraumatischen und somatoformen Störungen ist vielfältig wie uneinheitlich. Dies gilt umso mehr, wenn es um die Schnittmenge beider Störungsentitäten und darüber hinaus deren Besonderheiten im Alter geht. Psychophysiologische, neuroanatomische, endokrin-immunologische, genetische und epigenetische Faktoren spielen dabei eine wichtige Rolle. Mit Blick auf die posttraumatische Belastungsstörung konnte z. B. eine höhere vegetative Reaktivität festgestellt werden, welche auf eine erworbene allgemeine Sensitivierung des Nervensystems hinweist.

Abstract

Background

Clinically relevant posttraumatic stress disorders are almost always associated with physical symptoms, which are, on the one hand, classified as somatoform and, on the other hand, may also present as somatic comorbidities. The psychological, neurobiological, endocrinological and immunological correlations are only now beginning to be understood. Thereby, integration into a meaningful biopsychosocial model is still pending.

Purpose

The following article gives a concise summary of the knowledge concerning the relationship between body and psyche in posttraumatic stress spectrum disorders and provides the neuroscientific foundation which could establish a biological link between the phenomenologies of the disorder.

Results

Neurobiological data on posttraumatic disorders and somatoform disorders are diverse and not uniform. This is even more true when it comes to those disorders that are within the intersection of these two entities and, above all, their special features in the elderly. Psychophysiological, neuroanatomical, endocrine–immunological, genetic, and epigenetic factors play an important role here. With regard to posttraumatic stress disorder, for example, higher autonomic reactivity was observed, which indicates an acquired general sensitization of the nervous system.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Noll-Hussong gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland

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Noll-Hussong, M. Neurobiologie posttraumatischer und somatoformer Störungen im Alter. Z Gerontol Geriat 47, 209–213 (2014). https://doi.org/10.1007/s00391-014-0629-6

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