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Nervenheilkunde 2012; 31(05): 305-310
DOI: 10.1055/s-0038-1628165
Depression
Schattauer GmbH

Depression und Alkoholabhängigkeit

Eine therapeutische HerausforderungDepression and alcohol addiction
T. Hillemacher
1   Center for Addiction Research (CARe), Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover
,
J. Wilhelm
1   Center for Addiction Research (CARe), Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover
,
A. Heberlein
1   Center for Addiction Research (CARe), Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover
› Author Affiliations
Further Information

Publication History

Eingegangen am: 20 July 2011

angenommen am: 25 July 2011

Publication Date:
23 January 2018 (online)

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Zusammenfassung

Die Therapie depressiver Störungen von alkoholabhängigen Patienten stellt im klinischen Alltag eine Herausforderung dar. Beispielsweise erschweren gesetzliche Rahmenbedingungen den Zugang zu einer notwendigen psychotherapeutischen Behandlung. So stellt z. B. die Forderung einer dauerhaften Abstinenz eine Voraussetzung für die Kostenübernahme einer psychotherapeutischen Behandlung dar. Konträr zu solchen Forderungen, die nicht mit dem gegenwärtigen Forschungsstand zu neurobiologischen Grundlagen von Suchterkrankungen vereinbar sind, zeigen klinische Studien, dass die gleichzeitige Behandlung von Depression und Abhängigkeitserkrankung den größten Therapieerfolg bringen. Im Hinblick auf die Pharmakotherapie bietet sich eine kombinierte Behandlung mit rückfallprophylaktischen und antidepressiven Medikamenten an. Psychotherapeutisch kann eine Kombination aus motivationssteigernden Ansätzen und kognitiv-verhaltenstherapeutischen Verfahren die effektive Behandlung beider Störungen ermöglichen.

Summary

The treatment of depressive disorders in alcohol-dependent patients is often a difficult clinical challenge. For example, regulatory framework inhibits the access to psychotherapeutic treatment. So, the demand of a permanent abstinence is a prerequisite for the reimbursement of psychotherapeutic treatment. Contrary to those claims that are not compatible with the current state of research on the neurobiological basis of addiction, clinical studies show that combined treatment strategies including the simultaneous treatment of depression and addictive disorders lead to higher therapeutic success rates. Regarding pharmacotherapy, a combined treatment with drugs for relapse prevention and antidepressives may be considered useful. Psychotherapeutically, a combination of motivation-enhancing approaches and cognitivebehavioral methods can be considered an effective treatment of both disorders.

Schlüsselwörter

Alkoholabhängigkeit - Depression - Rückfallprophylaxe - Psychotherapie

Keywords

Alcohol dependence - depression - relapse prevention - psychotherapy
 

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