精神医学64巻4号

2022年04月発行

展望

小児期トラウマによる気分不安定化

著者： 吉村淳¹ 鈴木映二¹

所属機関： ¹東北医科薬科大学医学部　精神科学教室

ページ範囲：P.463 - P.480

抄録　近年，小児期トラウマによる生物学的な変化が徐々に解明されており，それらによって生じる精神的な症状，身体的な疾患，社会生活機能の低下などが指摘されている。本稿では，日々の臨床的視点から，小児期トラウマがもたらす気分の不安定化について着目した。双極性障害の短周期化，重症化，治療抵抗性を引き起こすことが明らかになり，トラウマが重複するほどに発症が早期化して，ラピッドサイクリングの比率が増えるとの用量反応関係も報告されている。また，小児期トラウマによってうつ病の再発が促進されることも提示した。最後に，小児期トラウマが気分の不安定化を招く生物学的要因についても概観し，臨床的にみられる現象を裏打ちした。

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