Komorbidität von Abhängigkeits-erkrankungen, affektiven Störungen und Angststörungen

M. Lorscheider; C. Fehr

doi:10.1055/s-0038-1628676

Nervenheilkunde, Table of Contents

Nervenheilkunde 2009; 28(08): 523-532
DOI: 10.1055/s-0038-1628676

Suchterkrankungen

Schattauer GmbH

Komorbidität von Abhängigkeits-erkrankungen, affektiven Störungen und Angststörungen

Eine BehandlungsherausforderungComorbidity of substance use disorders, affective disorders und anxiety disordersA therapeutic challenge

M. Lorscheider

¹Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz

,

C. Fehr

¹Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz

› Author Affiliations

Abstract

Zusammenfassung

Aufgrund der häufigen Komorbidität von Suchterkrankungen und affektiven Störungen bzw. Angsterkrankungen und der erschwerten Behandlung bei Vorliegen beider Störungsbilder, ist es das Ziel der vorliegenden Arbeit, einen aktuellen Überblick über die Komorbidität der Erkrankungen mit besonderem Fokus auf Epidemiologie, Ursachen und Therapie zu vermitteln. Dazu wurde eine systematische Literaturrecherche durchgeführt, wobei wir uns aufgrund der Datenmenge auf ausgewählte, klinisch relevante Publikationen beschränkten. Zwischen 45 und 72% der Patienten mit einer Suchterkrankung leiden an mindestens einer weiteren psychiatrischen Erkrankung, darüber hinaus ist die Komorbidität mit einer schlechteren Prognose und einem erhöhten Suizidrisiko assoziiert. Für die Ursache der sich teilweise wechselseitig beeinflussenden Krankheitssymptome sind neben gemeinsamen und spezifischen genetischen auch umweltbedingte Faktoren und substanzspezifische Effekte von Bedeutung. Eine antidepressive Pharmakotherapie ist zwar bei komorbider Substanzstörung wirksam, besitzt jedoch nur eine geringe Wirksamkeit in Bezug auf die Suchterkrankung, sodass zusätzlich auch suchtspezifische pharmakologische und psychotherapeutische Behandlungsverfahren zum Einsatz kommen.

Summary

Because of the high comorbidity of substance use disorders, affective and/or anxiety disorders and the complicated therapy, we tried to give a contemporary review on the comorbidity of these disorders with a specific focus on epidemiology, causes and treatment options. Due to the plentitude of abstracts retrieved with the predefined keywords, cited references were limited to clinically relevant publications. Between 45 and 72% of the substance use disorder patients suffer at least from one additional psychiatric disorder. Furthermore, the comorbidity between both disorders is associated with adverse outcome and a high risk of suicide. Recent research indicates that comorbidity is caused by common and disease specific genetic factors, environmental factors disorder and substance specific effects. Although antidepressant pharmacotherapy is effective treatment among patients suffering from comorbid substance use disorder, its effects on abstinence and on alcohol and substance consumption are rather low. Thus, further substance specific pharmacologic and psychotherapeutic methods should be applied.

Schlüsselwörter

Substanzstörung - affektive Störungen - Pharmakotherapie - Psychotherapie

Keywords

Substance use disorders - affective disorders - pharmacotherapy - psychotherapy

Full Text

References

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