Bei Menschen mit Substanzkonsumstörungen treten besonders häufig affektive
Störungen, schizophrene Psychosen, Angsterkrankungen und posttraumatische
Belastungsstörungen auf. Die richtige Diagnosestellung und eine
störungsspezifische Psychotherapie sind für den weiteren Erkrankungsverlauf
entscheidend. Obwohl eine integrierte Behandlung der komorbiden Störungen in
aktuellen Leitlinien empfohlen wird, wird sie durch viele Barrieren
erschwert.
Abstract
Substance use disorders (SUD) frequently co-occur with other mental disorders,
particularly affective disorders, anxiety disorders, schizophrenia, and
post-traumatic stress disorder (PTSD). This can exacerbate the course of both
conditions, in many cases leading to longer suffering, higher relapse rates, and
poorer prognoses. This article describes challenges for health care and
evidence-based psychotherapeutic approaches for treating SUD and psychiatric
comorbidities. Key approaches such as Motivational Interviewing (MI) and
Cognitive Behavioral Therapy (CBT) have proven particularly effective. Current
guidelines recommend integrated treatment of both disorders to enable a coherent
and flexible therapeutic process. However, structural barriers, especially in
outpatient settings, continue to limit access to integrated care. The article
concludes by discussing specialized treatment approaches for various
comorbidities and emphasizes the need for further research and specialized care
offerings.
Schlüsselwörter
Komorbidität - Substanzkonsumstörungen - Versorgungsbarrieren - Leitlinienempfehlungen
Key words
comorbidity - substance use disorders - barriers to health care - guideline recommendations
