Angst im Alter - Epidemiologie, Diagnostik und therapeutische Optionen

Zusammenfassung

Angsterkrankungen im höheren Lebensalter stellen mit einer Prävalenz von annähernd 10 % eine wichtige psychiatrische Störung dieser Altersgruppe dar, die bisher in Schweregrad und Bedeutung völlig unterschätzt wurde. Die Problematik der Nichterkennung und Nichtbehandlung im klinischen Alltag ist erheblich. Möglicherweise spielt eine Rolle, dass pathologische Altersformen vermutlich nicht leicht von normalpsychologischen Phänomenen abzugrenzen sind und bei der Definition soziokulturelle Wertmaßstäbe eine wichtige Rolle spielen. Die Komorbidität von Angsterkrankungen untereinander mit weiteren psychiatrischen Störungen wie Depressionen ist beträchtlich. Die psychosozialen Folgen sind für die Betroffenen erheblich. Studien zeigen, dass neuere Antidepressiva wie Venlafaxin oder Verfahren der Verhaltenstherapie wirksam eingesetzt werden können.

Abstract

Anxiety disorders in older age represent with a prevalence rate of 10 % an important psychiatric problem, which has not been adequately recognised and diagnosed. This can be explained from the idea, that pathologic anxiety was evaluated as a normal reaction by elderly people. The actual classification of anxiety disorders with ICD-10 or DSM-IV was not sufficient and should be complemented by a syndromanal approach. The comorbidity of anxiety disorders with other psychiatric disorders, e. g. depression, and also with somatic diseases was high. The psychosocial consequences are important. Psychopharmacological and psychotherapeutic interventions have been proven in some studies and should be practised more in the future.

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