[Exploring and treating complex trauma in everyday clinical reality in child and adolescent psychiatry].

IF 1 4区医学 Q4 NEUROSCIENCES

Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique Pub Date : 2025-08-23 DOI:10.1016/j.encep.2025.05.003

Marion Robin

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引用次数: 0

Abstract

Objective: This case report explores the efficacy of intravenous (IV) Ketamine in treating active suicidal ideation in a 24-year-old female with comorbid major depressive disorder (MDD), borderline personality disorder (BPD), post-traumatic stress disorder (PTSD), and functional neurological disorder (FND).

Case description: The patient, with a history of multiple suicide attempts and treatment-resistant MDD, demonstrated significant improvement following nine IV Ketamine sessions. The Montgomery-Åsberg Depression Rating Scale score decreased from 45 to 11, accompanied by sustained reductions in impulsivity, irritability, and depressive symptoms.

Discussion: This report highlights Ketamine's rapid action on glutamate pathways and its potential benefits in complex psychiatric profiles, where traditional treatments like electroconvulsive therapy often fail. A proposed staging model for suicidal behavior management underscores the importance of early intervention with non-classical treatments in high-risk cases.

Conclusion: IV Ketamine offers a promising therapeutic option for patients with severe suicidality and comorbidities, warranting further research on its long-term efficacy and safety.

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[探索和治疗儿童和青少年精神病学日常临床现实中的复杂创伤]。

目的：探讨静脉注射氯胺酮治疗1例伴有重度抑郁症（MDD）、边缘型人格障碍（BPD）、创伤后应激障碍（PTSD）和功能性神经障碍（FND）的24岁女性主动自杀意念的疗效。病例描述：患者有多次自杀企图和治疗难治性重度抑郁症的历史，在9次静脉注射氯胺酮后表现出显著改善。蒙哥马利-Åsberg抑郁评定量表得分从45分降至11分，同时冲动、易怒和抑郁症状持续减少。讨论：本报告强调氯胺酮对谷氨酸通路的快速作用及其对复杂精神疾病的潜在益处，在这些疾病中，传统的治疗方法如电休克疗法往往失败。一个提出的自杀行为管理分期模型强调了在高危病例中采用非经典治疗的早期干预的重要性。结论：IV氯胺酮对重度自杀及合并症患者是一种很有前景的治疗选择，值得进一步研究其长期疗效和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique 医学-精神病学

CiteScore

4.60

自引率

7.40%

发文量

162

审稿时长

6-12 weeks

期刊介绍： Une revue française de renommée internationale. - Un comite de rédaction représentant tous les aspects de la prise en charge psychiatrique du patient. - Une sélection rigoureuse d''articles faisant l''objet de plusieurs expertises. - Des travaux d''auteurs et de chercheurs de renommée internationale. - Des indexations dans les grandes bases de données (Current Contents, Excerpta Medica, etc.). - Un facteur d''impact qui témoigne de la grande notoriété de la revue. La tribune des publications originales de haut niveau. - Une très grande diversité des sujets traités, rigoureusement sélectionnés à travers des sommaires dynamiques : - des éditoriaux de médecins référents, - une revue de presse sur les actualités internationales, - des articles originaux pour approfondir vos connaissances, - des mises au point et des cas cliniques pour engager votre réflexion sur les indications et choix possibles au travers de mises en situation clinique, - des dossiers thématiques pour faire le tour d''une question. - L''actualité de l''AFPB : L''Encéphale publie régulièrement des comptes rendus de l''Association française de psychiatrie clinique.