Posttraumatic stress disorder (PTSD) in preschool children - Review on diagnostics, prevalence and health-care service delivery in Germany

Preschool-aged children between the ages of three and six have a high risk of experiencing violence or accidents, or they can be afflicted by life-threatening diseases or serious medical procedures. However, studies on the prevalence of traumatic experiences and disorders following trauma, e.g. Posttraumatic Stress Disorder (PTSD), in preschool children can so far only scarcely be found worldwide.This article therefore a) provides an overview over criteria and instruments for the diagnosis of PTSD in preschool children, b) summarises the results of a systematic literature review on the prevalence of PTSD in trauma-exposed preschool children, and c) describes the few available findings on psychiatric-psychotherapeutic care of young children with disorders following trauma, while taking possible barriers for the utilisation of professional aid in Germany into consideration. The seven studies included in the literature review, in which a total of 1,029 3- to 6-year-olds with experiences of war and other traumatic events were examined in Israel or the Palestinian Territories, the USA and Germany, showed PTSD-prevalence between 0% and 50 %. The few studies on the utilisation of psychotherapies indicate a lack of therapeutic treatment for trauma-exposed preschoolers. However, there is a lack of representative studies on preschool PTSD and the therapeutic care of preschoolers with PTSD. An underestimation of the number of affected children as well as a shortage of care could be assumed in traumatised preschool children, i.e. due to the little sensitive PTSD-criteria in the ICD-10 for this age group, the strong dependence on attachment figures and social environment as well as due to general barriers within psychiatric-psychotherapeutic care.