Das Berliner Algorithmusprojekt

K. Wiethoff; R. Ricken; M. E. Keck; T. Baghai; M. Bauer; H.-J. Möller; M. Adli

doi:10.1055/s-0038-1628599

Nervenheilkunde, Table of Contents

Nervenheilkunde 2009; 28(04): 179-185
DOI: 10.1055/s-0038-1628599

Thema zum Schwerpunkt

Schattauer GmbH

Das Berliner Algorithmusprojekt

Vergleich systematischer Therapiealgorithmen mit der Standardbehandlung bei Patienten mit unipolarer DepressionThe German Algorithm ProjectTherapy algorithms in comparison to treatment as usual in patients with unipolar depression

Authors

K. Wiethoff

¹Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Campus Charité Mitte
R. Ricken

¹Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Campus Charité Mitte
M. E. Keck

²Neuroscience Center Universität Zürich, Klinik Schlössli, Privatklinik für Psychiatrie Oetwil
T. Baghai

³Klinik für Psychiatrie und Psychotherapie Ludwig-Maximilians-Universität München
M. Bauer

⁴Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
H.-J. Möller

³Klinik für Psychiatrie und Psychotherapie Ludwig-Maximilians-Universität München
M. Adli

¹Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Campus Charité Mitte

Abstract

Zusammenfassung

Trotz der erheblichen Zunahme an Behandlungsoptionen und neuen, besser verträglichen Substanzen, bleiben therapieresistente depressive Störungen bis heute ein großes Problem. Ein Ansatzpunkt zur Verbesserung der Behandlungsergebnisse liegt in der Optimierung des Therapieprozesses durch die Anwendung von Therapiealgorithmen. Diese umfassen strukturierte und systematische Behandlungsempfehlungen für den Fall, dass eine adäquate antidepressive Monotherapie nicht zu dem zuvor definierten Behandlungserfolg führt. Im Rahmen des mehrphasigen Berliner Algorithmusprojekts wurde die algorithmusgestützte Depressionsbehandlung im Vergleich zur üblichen Therapie nach freier Arztentscheidung einer Evaluation unterzogen. Die Ergebnisse dieser und weiterer Algorithmusstudien, die in dieser Übersicht dargestellt werden, zeigen den Nutzen systematischer Therapiealgorithmen in der Depressionsbehandlung in Bezug auf das Therapieergebnis und die Qualität der Behandlung. Ziel der weiteren Algorithmusforschung liegt in der Identifizierung von geeigneten klinischen oder biologischen Parametern, die eine effektive Individualisierung algorithmusgestützter Therapie ermöglichen.

Summary

Despite the enormous increase in treatment options and the development of new and better tolerated substances, treatment resistance remains a major clinical problem in the therapy of major depression. Treatment algorithms are therefore considered as key instruments in optimizing the treatment of depressive disorders. They offer structured and systematic treatment recommendations for the case of incomplete response to an adequately performed antidepressant monotherapy. The multiphasic German Algorithm Project (“Berliner Algorithmusprojekt”) aimed at comparing algorithm guided treatments with treatment as usual. The results and other algorithm studies, which are reviewed in this article, show the benefit of treatment algorithms for treatment outcome and treatment quality. Valid clinical or pharmacogenetic predictors of response are needed to further tailor specific algorithms to individual patients.

Schlüsselwörter

Depression - Therapiealgorithmen - Therapieresistenz - Berliner Algorithmusprojekt

Keywords

Depression - treatment algorithms - treatment resistance - German Algorithm Project

Full Text

References

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