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Epidemiologie psychisch komorbider Störungen bei chronisch körperlichen Erkrankungen

Comorbid psychological disorders in patients with chronic somatic diseases

  • Leitthema
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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Anhand einer Literaturübersicht wird ein Überblick gegeben zur Erfassung psychischer Komorbidität in epidemiologischen Studien, zu den Prävalenzraten psychischer Komorbidität und zum Einfluss psychischer Erkrankungen auf das Entstehen und den Verlauf chronischer Erkrankungen am Beispiel koronarer Herzerkrankungen. Psychische Komorbidität geht mit verminderter Lebensqualität, schlechterem Krankheitsverlauf und erhöhter Mortalität einher, wie zahlreiche Studien an Patienten mit koronaren Herzerkrankungen und anderen chronischen Erkrankungen zeigen. Trotz valider Screeningverfahren, die groß angelegte Bevölkerungsstudien ermöglichen, stellen sich diagnostische Probleme beispielsweise bei der Trennung psychischer und somatischer Symptome und der zuverlässigen Diagnostik somatischer Erkrankungen. Eine nicht erkannte psychische Komorbidität ist in der medizinischen Versorgung häufig. Sie stellt für den weiteren somatischen sowie auch psychischen Krankheitsverlauf ein hohes Risiko dar, das sowohl mit individuellem Leid, aber auch mit erheblichen gesundheitsökonomischen Konsequenzen einhergeht. Forschungsbedarf besteht zu geeigneten Interventionen bei komorbid erkrankten Patienten und zur Verbesserung der Versorgungssituation.

Abstract

Based on the literature, the assessment of psychological comorbidity in epidemiological studies is reviewed along with prevalence rates of psychological comorbidity and the effect of mental diseases on the development and course of chronic disease as exemplified by coronary heart disease. Psychological comorbidity is associated with reduced quality of life, disease progression, and increased mortality, as numerous studies in coronary heart disease and other chronic diseases have shown. In spite of available valid screening measures which enable large population surveys, diagnostic problems remain, especially with respect to separating mental and somatic symptoms and diagnosing somatic diseases reliably. Psychological comorbidity is frequently overlooked in medical care and poses a high risk for the future somatic and mental course of disease, associated with individual suffering and serious health economic consequences. There is a need for research on suitable interventions for patients with chronic disorders and psychological comorbidity in order to improve their care.

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  1. Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz, Mainz, Deutschland

    M.E. Beutel

  2. Medizinische Psychologie, Universitätskrankenhaus Hamburg-Eppendorf, Martinistr. , 20246, Hamburg, Deutschland

    H. Schulz

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Beutel, M., Schulz, H. Epidemiologie psychisch komorbider Störungen bei chronisch körperlichen Erkrankungen. Bundesgesundheitsbl. 54, 15–21 (2011). https://doi.org/10.1007/s00103-010-1191-z

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