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Suchttherapie 2000; 1(1): 8-15
DOI: 10.1055/s-2000-13133
Schwerpunktthema
© Georg Thieme Verlag Stuttgart · New York

Alkoholabhängigkeit und psychiatrische Komorbidität - ein Überblick

Alcohol Dependence and Psychiatric Comorbidity - an OverviewJens Wittfoot, Martin Driessen
  • Psychiatrische Klinik, Bielefeld
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Publication History

Publication Date:
31 December 2000 (online)

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Zusammenfassung

Zusätzliche psychische Störungen, insbesondere Angst- und affektive Störungen, finden sich bei Alkoholabhängigen in Behandlungseinrichtungen sehr viel häufiger als bei unbehandelten Abhängigen. Im Sinne des Komorbiditätskonzepts und auf der Grundlage operationalisierter Diagnostik zeigt bereits der zeitliche Zusammenhang ein komplexes Muster simultaner und sukzessiver Komorbidität. Eindeutige Belege für eine gemeinsame hereditäre bzw. genetische Grundlage von Abhängigkeit und komorbiden Störungen existieren nicht. So fokussiert sich das Interesse derzeit auf drei Fragen: 1. Stellen Alkoholabhängigkeit und komorbide psychische Störung wechselseitig Risikofaktoren für das Auftreten der jeweils anderen Erkrankung dar? 2. Beeinflussen komorbide Störungen und/oder das Ausmaß der aktuellen Psychopathologie den Verlauf der Abhängigkeit? 3. Sind komorbide psychische Störungen therapierelevant? Während Behandlungsprogramme für Alkoholabhängige mit komorbiden psychischen Störungen in der Praxis bereits existieren, fehlen bisher Untersuchungen zum Beleg der Wirksamkeit definierter pharmako-, psycho- und sozialtherapeutischer Interventionen.

Alcohol Dependence and Psychiatric Comorbidity - an Overview

Additional psychiatric disorders, i.e. mainly anxiety and affective disorders, were more frequently found in treated than in non treated alcohol-dependent persons. Basing on the concept of comorbidity operationalized diagnostic investigations revealed a complex pattern of successive and simultaneous comorbidity. A common hereditary and/or genetic origin of substance use disorders and comorbid psychiatric disorders cannot be stated. The current interest of researches and clinicians focusses on three issues: 1. Are alcohol dependence and additional psychiatric disorders pathogenetic risk factors for each other? 2. Do comorbid psychiatric disorders and/or the degree of current psychopathology interact with the course of alcohol dependence? 3. Are comorbid disorders relevant for alcoholism treatment? While treatment programmes for comorbid alcoholics were introduced into the clinical practice, up to now, evidence is missing for the efficacy (and efficiency) of defined psychopharmacological, psychotherapeutical, and social interventions in the field.

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Dr. Jens Wittfoot

Psychiatrische Klinik
Krankenanstalten Gilead, Bethel

Remterweg 69-71

33617 Bielefeld

Email: wittfoot@psychiatrie.gilead.de