Depresión y trauma temprano: hacia una caracterización clínica de perfiles de consulta en un servicio de salud secundario

摘要

Patients with depression maltreated during childhood differ from those depressive patients without this background. In patients with early trauma the disease emerges earlier, it is more severe anddoes not respond to the classical antidepressant therapy. Despite this evidence, research regardingthe clinical conceptualization and approach to these patients is still limited. The above becomesrelevant in Chile, considering the high prevalence of depression and history of adverse childhoodevents among Chilean depressive consulting health services. Based on the conceptualization ofcomplex Post traumatic stress disorder (PTSD), the overall objective of this article is to proposea conceptualization to the clinical characteristics presented in depressive patients with earlyabuse, who consult in a mental health service. We propose that in all these patients it needsto inquire actively about history of early adverse events, patterns of interpersonal difficulties,psychiatric comorbidity with emphasis on PTSD features and presence of dissociative symptoms.According to which of the areas is the most important to understand the reason of consultationand considering the observation of 41 patients treated in the context of the Psychic Tauma Unitin the Curicó Hospital, we postulate the existence of the following profiles: depressive, posttraumatic and dissociative. The main clinical characteristics of each profile are presented witha therapeutic approach.