Psychiatrie und Psychotherapie up2date 2007; 1(03): 197-210
DOI: 10.1055/s-2006-952042
Angststörungen, Zwangsstörungen und stressassoziierte Störungen

Zwangsstörungen

Ulrich Voderholzer
,
Anne Katrin Külz
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Kernaussagen

  • Die Zwangsstörung ist eine schwere, meist chronische psychische Erkrankung, die häufig vor anderen Personen, insbesondere auch vor Ärzten und Psychotherapeuten, verheimlicht wird.

  • Zwangsstörungen weisen eine hohe Komorbidität mit anderen psychischen Erkrankungen auf, insbesondere mit depressiven Störungen, Angststörungen, Persönlichkeitsstörungen und Essstörungen.

  • An effektiven Behandlungsstrategien steht heute die kognitive Verhaltenstherapie mit Reizkonfrontation (Exposition) und Reaktionsmanagement sowie selektive Serotonin-Wiederaufnahmehemmer zur Verfügung. Die Kombination beider Verfahren kann zu Responderraten von 80 bis 90 % der Patienten führen. Bei Therapieresistenz ist die Wirksamkeit atypischer Neuroleptika erwiesen.

  • Behandlungserfolg bzw. Response bedeutet bei Zwangsstörungen meist eine deutliche Symptomreduktion, äußerst selten jedoch eine Remission.

  • Die Versorgungssituation für Patienten, die an Zwangsstörungen erkrankt sind, ist noch sehr unzureichend. Bei vielen Patienten werden unwirksame Fehlbehandlungen durchgeführt, bevor spezifische, evidenzbasierte Therapien zur Anwendung kommen.



Publication History

Publication Date:
16 April 2007 (online)

© Georg Thieme Verlag KG Stuttgart · New York

 

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