Psychosoziale Aspekte bei Long COVID – Ein psychotherapeutisches Behandlungsmanual aus dem PsyLoCo-Projekt

Zusammenfassung

Long COVID beschreibt gesundheitliche Langzeitfolgen nach einer SARS-CoV-2-Infektion. Die Pathogenese von Long COVID ist trotz verschiedener theoretischer Ansätze noch nicht vollständig geklärt und die Diagnosekriterien unscharf. Dadurch ist die Entwicklung zielgerichteter, ursachenspezifischer Therapien herausfordernd. Viele Betroffene leiden neben den Symptomen an verschiedenen psychosozialen Belastungen und einer deutlich reduzierten Lebensqualität. Um dies zu adressieren, sollten neben einer symptomorientierten Behandlung psychosomatische bzw. psychotherapeutische Interventionen eingesetzt werden. Im PsyLoCo-Projekt wurde ein psychosomatisch-psychotherapeutisches Behandlungsmanual entwickelt, das auf die spezifischen Bedarfe von Long COVID-Patient*innen zugeschnitten ist. In vier Modulen wird darin auf (1) Coping und Distressmanagement, (2) Körperbeschwerden und Schmerzen, (3) Chronische Erschöpfung und affektive Symptome und das (4) Sozial- und Arbeitsleben eingegangen. In einer multizentrischen, randomisiert-kontrollierten Pilotstudie wurde das Manual auf Machbarkeit und Wirksamkeit untersucht. Die Inhalte dieses Behandlungsmanuals werden im Folgenden vorgestellt.

Abstract

Long COVID describes long-term health sequelae after a SARS-CoV-2 infection. Despite various theoretical approaches, the pathogenesis of long COVID is not yet fully understood and the diagnostic criteria are vague. This makes the development of targeted, cause-specific therapies challenging. In addition to the symptoms, many patients suffer from various psychosocial burdens and a significantly reduced quality of life. In order to address this, psychosomatic or psychotherapeutic interventions should be used in addition to symptom-oriented treatment. Within the PsyLoCo project, a psychotherapeutic treatment manual was developed that is tailored to the specific needs of long COVID patients. In four modules, it addresses (1) coping and distress management, (2) physical complaints and pain, (3) chronic fatigue and affective symptoms and (4) social and working life. The manual was tested for feasibility and effectiveness in a multicentre, randomized controlled pilot study. The contents of this treatment manual are presented below.

Schlüsselwörter

Long COVID - Post-COVID-Syndrom - Psychotherapie - Kurzzeittherapie - Behandlungsmanual

Keywords

Long COVID - post-COVID syndrome - psychotherapy - short-term therapy - treatment manual

Publikationsverlauf

Eingereicht: 29. August 2024

Angenommen: 03. Februar 2025

Artikel online veröffentlicht:
03. April 2025

• Literatur

• 1 Davis HE, Assaf GS, McCorkell L. et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 2021; 38: 101019
• 2 Lopez-Leon S, Wegman-Ostrosky T, Perelman C. et al. More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis. Available at SSRN 3769978 2021
• 3 Nasserie T, Hittle M, Goodman SN. Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19: A Systematic Review. JAMA network open 2021; 4: e2111417
• 4 WHO-Europe. Post COVID-19 condition (Long COVID). Verfügbar unter https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition2022 (Aufgerufen am 17. Juli 2024)
• 5 Koczulla AR, Ankermann T, Behrends U. et al. S1-Leitlinie Long-/Post-COVID. Pneumologie 2022; 76: 855-907
• 6 National Institute for Health and Care Excellence. Clinical Guidelines. COVID-19 rapid guideline: managing the long-term effects of COVID-19. 2020. London: National Institute for Health and Care Excellence (NICE);
• 7 Nittas V, Gao M, West EA. et al. Long COVID Through a Public Health Lens: An Umbrella Review. Public Health Reviews 2022; 43
• 8 Tran VT, Porcher R, Pane I. et al. Course of post COVID-19 disease symptoms over time in the ComPaRe long COVID prospective e-cohort. Nature communications 2022; 13: 1812
• 9 Kim Y, Bae S, Chang H-H. et al. Long COVID prevalence and impact on quality of life 2 years after acute COVID-19. Scientific reports 2023; 13: 11207
• 10 Cutler DM. The Costs of Long COVID. JAMA health forum 2022; 3: e221809
• 11 Gupta A, Madhavan MV, Sehgal K. et al. Extrapulmonary manifestations of COVID-19. Nature Medicine 2020; 26: 1017-1032
• 12 Davis HE, McCorkell L, Vogel JM. et al. Long COVID: major findings, mechanisms and recommendations. Nature reviews Microbiology 2023; 21: 133-146
• 13 Sneller MC, Liang CJ, Marques AR. et al. A Longitudinal Study of COVID-19 Sequelae and Immunity: Baseline Findings. Annals of internal medicine 2022; 175: 969-979
• 14 Ballering AV, van Zon SKR, Olde Hartman TC. et al. Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study. Lancet (London, England) 2022; 400: 452-461
• 15 Srikanth S, Boulos JR, Dover T. et al. Identification and diagnosis of long COVID-19: A scoping review. Progress in Biophysics and Molecular Biology 2023; 182: 1-7
• 16 Wang S, Quan L, Chavarro JE. et al. Associations of Depression, Anxiety, Worry, Perceived Stress, and Loneliness Prior to Infection With Risk of Post–COVID-19 Conditions. JAMA Psychiatry 2022; 79: 1081-1091
• 17 Lemogne C, Gouraud C, Pitron V. et al. Why the hypothesis of psychological mechanisms in long COVID is worth considering. J Psychosom Res 2023; 165: 111135
• 18 Schurr M, Junne F, Martus P. et al. SARS-CoV-2 infection is associated with physical but not mental fatigue – Findings from a longitudinal controlled population-based study. Journal of Psychosomatic Research 2024; 178: 111598
• 19 Wallis H, Elgner M, Schurr M. et al. Stress and Depressive and Anxiety Symptoms in the General Population and in SARS-CoV-2-Infected Patients—Findings from a Population-Based Three-Wave Study. Journal of Clinical Medicine 2023; 12: 6240
• 20 Allwang C, Frank T, Bruckmann P. et al. Addressing psychosocial needs in patients with Long-COVID (PsyLoCo-Study): study protocol of a pilot-study of a specialized modular intervention. Front Psychiatry 2024; 15: 1305691