Depressive Störungen bei internistischen und neurologischen Erkrankungen

Zusammenfassung

Die hohe Koinzidenz von somatischen Erkrankungen und Depressionen macht deutlich, wie wichtig ein generelles Screening bezüglich depressiver Störungen in den somatischen Fachdisziplinen ist. Aktuelle Erkenntnisse zur Depressionshäufigkeit, Pathophysiologie, prognostischen Bedeutung und der Therapie von depressiven Syndromen bei ausgewählten somatischen Erkrankungen werden vorgestellt: Diabetes mellitus, kardiovaskuläre Erkrankungen, Leber- und Darmerkrankungen, Morbus Parkinson sowie Multiple Sklerose. Für das gehäufte Auftreten somatischer Erkrankungen scheint bei Patienten mit depressiven Störungen übergreifend eine ungünstige Lebensführung (z. B. Bewegungsmangel, Adipositas, Rauchen, erhöhter Alkoholkonsum) eine entscheidende Rolle zu spielen. Dies gilt auch für die Umsetzung der therapeutischen Strategien. Ebenso werden biologische Veränderungen (Stresshormon- und Immunaktivierung) als mögliche Ursachen für eine erhöhte Morbidität und Mortalität diskutiert. Generell werden epidemiologische Daten, interdisziplinäre klinisch-therapeutische Studien sowie grundlagenwissenschaftlichen Untersuchungen zur Pathophysiologie komorbider Depressionen bei körperlichen Erkrankungen benötigt.

Summary

The high coincidence of somatic disorders and depression demonstrates the importance of a general screening for depressive disorders also in somatic disciplines. With respect to prevalence, pathophysiology, prognostic significance, and treatment of depressive syndromes current knowledge on depression in selected somatic diseases are presented: diabetes mellitus, cardiovascular diseases, liver and bowel disease, Parkinson’s disease as well as multiple sclerosis. Overall an unfavorable lifestyle (e.g lack of exercise, obesity, smoking, high alcohol consumption) appears to play a crucial role for the increase in incidence of somatic diseases in patients with depressive disorders. This applies to the implementation of therapeutic strategies, too. Likewise, biological changes (stress hormone and immune activation) are discussed as possible causes of increased morbidity and mortality. In general, substantial epidemiological data, interdisciplinary clinical and therapeutic studies and basic scientific research on the pathophysiology of comorbid depression in physical illness are needed.

Schlüsselwörter

Depression - somatische Erkrankung - Antidepressiva

Keywords

Depression - somatic disease - antidepressants

^* Geteilte Erstautorenschaften

• Literatur

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