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Gesundheitliche Langzeitfolgen psychosozialer Belastungen in der Kindheit – ein Update

Health-related long-term effects of adverse childhood experiences – an update

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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Dass körperliche Misshandlung und emotionale Vernachlässigung in der Kindheit lebenslang das Risiko für psychische und funktionelle Störungen erhöhen, ist seit längerer Zeit wissenschaftlich gut belegt. Zusätzlich wurde in den letzten Jahren eine erhöhte Vulnerabilität für das Auftreten häufiger körperlicher Erkrankungen (Herz-Kreislauf-Erkrankungen, Typ-2-Diabetes, Hepatitiden, Chronisch obstruktive Lungenerkrankung (COPD), immunologische Erkrankungen und Schmerzerkrankungen, Pharynx- und Lungenkarzinom) und darüber hinaus eine eingeschränkte Lebenserwartung gesichert. Es wird ein Überblick über die diesbezügliche Studienlage sowie die neurobiologischen und entwicklungspsychologischen Mechanismen gegeben, welche diese Langzeitfolgen vermitteln. Ergebnisse zu familiären Risikokonstellationen zeigen Ansatzpunkte für eine gezielte Prävention, deren Wirksamkeit in Modellprojekten gut belegt ist. Nur durch deren Etablierung dürften die enormen gesundheitsbezogenen wie volkswirtschaftlichen Folgekosten (Arbeitsunfähigkeitsgage, Frühberentungen) künftig begrenzt werden können.

Abstract

In the last decade strong empirical evidence from several long-term studies supports the conclusion that physical and sexual abuse as well as emotional deprivation in childhood make people significantly more vulnerable to mental and functional disorders across their lifetime. Additionally, an increased vulnerability to several somatic disorders (cardiovascular disorders, type-2-diabetes, hepatitis, chronic obstructive pulmonary disease (COPD), immunological and pain disorders, pharynx and lung cancer) was demonstrated – most of them with a reduced life expectancy. A review of the current research will be presented that outlines the underlying developmental neurobiological and psychological mechanisms mediating these long-term effects. There is now sufficient evidence about familial risk constellations that demonstrates the well-documented impact of specific prevention strategies by several model projects. Only by establishing these strategies, future enormous health-related burdens and high economic costs (unfitness to work, early retirement) can presumably be limited.

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Authors and Affiliations

  1. Klinik Barmelweid, Aarau, Schweiz

    Ulrich T. Egle

  2. Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland

    Matthias Franz

  3. Klinik für Psychotherapie und Psychosomatik, Universitätsklinikums Dresden, Dresden, Deutschland

    Peter Joraschky

  4. Klinik für Medizinische Psychologie, Universitätsklinikum Innsbruck, Innsbruck, Österreich

    Astrid Lampe

  5. Abt. Entwicklungspsychologie, Psychologisches Institut, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland

    Inge Seiffge-Krenke

  6. Institut für Psychosoziale Prävention, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    Manfred Cierpka

  7. Wiesentalstr. 48, 79111, Freiburg, Deutschland

    Ulrich T. Egle

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  1. Ulrich T. Egle
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U.T. Egle, M. Franz, P. Joraschky, A. Lampe, I. Seiffge-Krenke und M. Cierpka geben an, dass kein Interessenkonflikt besteht.

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Egle, U.T., Franz, M., Joraschky, P. et al. Gesundheitliche Langzeitfolgen psychosozialer Belastungen in der Kindheit – ein Update. Bundesgesundheitsbl 59, 1247–1254 (2016). https://doi.org/10.1007/s00103-016-2421-9

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