[Diagnosis of trauma sequelae]. / Diagnostik von Traumafolgestörungen. Wie gehen Sie im Verdachtsfall vor?

Traumatic events often trigger acute psychosomatic and psychiatric sequelae, which sometimes show a tendency to become chronic. The post-traumatic stress disorder (PTSD) is a complex syndrome with numerous mental and vegetative symptoms. The diagnosis of trauma sequelae requires a good knowledge of the differential diagnostically relevant comorbid conditions (e.g. anxiety disorders, depressive disorders, and somatoform disturbances). An appropriate management plan is possible only when suitable consideration is given to the traumatic genesis of symptoms. In the treatment of trauma, a stepped approach involving the principles stabilization, trauma processing and psychosocial re-integration has proven value.

[Is the borderline personality disorder a complex post-traumatic stress disorder? - The state of research]. / Ist die Borderline-Persönlichkeitsstörung eine komplexe posttraumatische Störung? Zum Stand der Forschung.

Regarding the high prevalence of traumatic experiences in patients with borderline personality disorders (BPD), we review the available literature focussing on the hypothesis that BPD is a subtype of trauma associated disorders. The criteria of BPD, of complex post-traumatic stress disorders (PTSD), and of disorders of extreme stress not otherwise specified (DESNOS) substantially overlap. Research of the long-term course of BPD and PTSD, trauma research, and research of vulnerability in both disorders yielded converging results. Neuropsychological deficits in BPD and PTSD as well as psychoendocrinological and neuroimaging studies in BPD und PTSD also revealed common features. A pathogenetic specificity of individual etiologic factors does not appear to exist, however the assumption of a diathesis-stress model with traumatisation as a necessary but etiologically insufficient condition seems justified. Further research will have to prove BPD as a complex and early-onset post-traumatic stress disorder after multiple and/or chronic (type II) traumatic experiences during childhood and/or youth. Definitive conclusions require further research efforts.