Psychiatrische und medizinische Komorbidität en bei Betroffenen mit bipolar affektiver Störung

Zusammenfassung

Gegenstand und Ziel

Bipolare Störungen gehen oft mit psychischen und somatischen Komorbiditäten einher. Diese führen häufig zu einer Verlängerung der Liegedauern und einer Verschlechterung der Responseraten. Ziel der Analyse ist es, eine Übersicht über die Häufigkeit psychiatrischer und somatischer Komorbiditäten bipolar affektiver Erkrankter anhand von Sekundärdaten des Projektes “Versorgungsindikatoren in der Psychiatrie und Psychosomatik” (VIPP) zu gewinnen.

Material und Methoden

In die Analyse wurden 8 528 stationäre Fälle mit der ICD-Diagnose (F31.X) aus den Jahren 2011 und 2012 eingeschlos-sen.

Ergebnisse

61% aller bipolar Betroffenen litten an mindestens einer Komorbidität. Die häufigsten Komorbiditäten waren in absteigender Reihenfolge: Hypertonie (18%), psychische und Verhaltensstörungen durch psychotrope Substanzen (16%), Schilddrüsenerkrankungen (9%), Diabetes mellitus (8%), ischämische Herzkrankheiten (7%), Persönlichkeits-und Verhaltensstörungen (6%), neurotische, Belastungs- und somatoforme Störungen (4%), organische, einschließlich symptomatischer psychischer Störungen (3%).

Schlussfolgerungen

Da Patienten mit psychischen Störungen krankheitsbedingt der Zugang zum medizinischen Versorgungssystem erschwert ist, werden dem Psychiater zunehmend bei der interdisziplinären Versorgung der Komorbiditäten auch Aufgaben aus dem allgemeinmedizinischen Bereich übertragen.

Summary

Objective

Bipolar disorders are often associated with psychiatric and somatic comorbidities, which can result in longer hospital stays and worse response rates. Aim of the descriptive analysis was to give an overview over the prevalence rates of psychiatric and somatic comorbidities of patients with bipolar affective disorder, based on secondary data of the VIPP project “Supply indicators for psychiatric and psychosomatic settings”.

Material and methods

The analysis included 8 528 adult cases with any ICD-10 bipolar diagnosis (F31.X) (years 2011 and 2012).

Results

61% of all patients had at least one psychic or somatic comorbidity. The most prevalent psychic comorbidities were in declining order: Hypertensive diseases (18%), mental and behavioral disorders due to psychoactive substance use (16%), disorders of the thyroid gland (9%), diabetes mellitus (8%), ischemic heart diseases (7%), disorders of adult personality and behavior (6%), obesity and other hyperalimentation (4%), neurotic, stress-related and somatoform disorders (4%), organic, including symptomatic, mental disorders (3%).

Conclusion

Since patients with bipolar disorders have less access to the healthcare system as compared to patients without mental disorders, psychiatrists should also focus on the diagnosis and treatment of associated medical comorbidities. This often may include tasks usually provided by general practitioners.

Schlüsselwörter

Komorbiditäten - bipolare Störungen - metabolisches Syndrom

Keywords

Comorbidity - bipolar disorders - metabolic syndrome

^* VIPP: Versorgungsrelevante Indikatoren in der Psychiatrie und Psychosomatik (Steuerungsgruppe: Frank Godemann (Sprecher), Claus Woff-Menzler (stellvertretender Sprecher), Florian Seemüller, Roland Nitschke, Michael Löhr, Hans-Joachim Salize, Iris Hauth (DGPPN), Gerhard Längle (Bundes-direktorenkonferenz), Arno Deister (ackpa)

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