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DOI: 10.1055/a-0829-6990
Die Rolle Der Psychotherapie Beim Reizdarmsyndrom
The Role of Psychotherapy in the Treatment of Irritable Bowel SyndromePublication History
eingereicht 27 April 2018
akzeptiert 17 December 2018
Publication Date:
07 February 2019 (online)
![](https://www.thieme-connect.de/media/ppmp/20190910/lookinside/thumbnails/0994_10-1055-a-0829-6990-1.jpg)
Zusammenfassung
Das Reizdarmsyndrom ist eine häufige funktionelle gastrointestinale Störung, die aufgrund wiederkehrender gastrointestinaler Beschwerden wie Bauchschmerzen oder Stuhlveränderungen die Lebensqualität erheblich beeinträchtigen kann. Basierend auf dem biopsychosozialen Krankheitsmodell wird die Ausprägung des Reizdarmsyndroms durch die Kombination von veränderten physiologischen Prozessen, sozialen Aspekten und psychischen Faktoren beeinflusst. Während der Fokus bisher auf der Linderung der Darmbeschwerden mittels Diät sowie medikamentöser Therapie lag, stellen Psychotherapieverfahren angesichts der starken Assoziation mit psychischen Komorbiditäten (u. a. Depression, Angststörung) zunehmend alternative oder ergänzende Behandlungsmethoden mit mittlerweile sehr guter Evidenz dar. Grundsätzlich können zusätzliche psychische Begleitsymptome die Wahrscheinlichkeit komplizierter Krankheitsverläufe erhöhen, wobei sich psychische Symptome und Darmbeschwerden maßgeblich gegenseitig beeinflussen. Mithilfe von kognitiver Verhaltenstherapie, psychodynamischer Psychotherapie, Hypnotherapie, achtsamkeitsbasierter Therapie und anderen psychotherapeutischen Verfahren sollen die Krankheitsbewältigung und -kontrolle gesteigert und fehlregulierte kognitive Prozesse umstrukturiert werden. In dieser Übersichtsarbeit fokussieren wir uns auf den psychosozialen Aspekt des Reizdarmsyndroms und diskutieren den Nutzen der psychotherapeutischen Verfahren.
Abstract
Irritable bowel syndrome is a common functional gastrointestinal disorder that greatly impacts on quality of life due to gastrointestinal complaints such as pain or altered stool habits. Based on the biopsychosocial model the severity of the disease is affected by the combination of physiological processes, social aspects and psychological factors. While treatment approaches mainly focused on the reduction of gut complaints by dietary means or medication, psychotherapy is becoming an alternative or additional approach with very good evidence, especially in light of associated psychiatric comorbidities (e. g. depression, anxiety disorder). Often psychiatric symptoms/comorbidities increase the probability of a complicated course of the disease with a reciprocal interaction of gut complaints and psychiatric symptoms. Behavioral therapy, psychodynamic psychotherapy, hypnotherapy, mindfulness interventions and other psychotherapeutic methods are used to increase coping as well as disease control and to restructure dysregulated cognitive processes. The current review focuses on psychosocial aspects of the irritable bowel syndrome and discusses the benefit of psychotherapeutic interventions.
Schlüsselwörter
Reizdarmsyndrom - Psychotherapie - Pathophysiologie - Behandlung - psychosoziale FaktorenKey words
irritable bowel syndrome - psychotherapy - psychosocial factors - pathophysiology - treatmentErgänzendes Material
- Online-Tab. 1 finden Sie unter https://doi.org/10.1055/a-0829-6990
- Ergänzendes Material
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