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Der Nervenarzt

, Volume 85, Issue 4, pp 437–444 | Cite as

Depressive und Angststörungen bei neurologischen Erkrankungen

Aus der Perspektive der Multimorbidität
  • H.P. KapfhammerEmail author
Leitthema

Zusammenfassung

Neurologische Erkrankungen weisen eine hohe Koexistenz von depressiven und Angststörungen auf. Diese Koexistenz bedeutet ein höheres subjektives Leiden, ein reduziertes Coping, mögliche negative Interferenzen mit somatischen Therapien und Rehabilitationen, eine stärkere Beeinträchtigung der Lebensqualität sowie höhere Grade an psychosozialer Behinderung. Sie schließt auch oft ein höheres somatisches Morbiditäts- und Mortalitätsrisiko im weiteren Verlauf ein. Die komplexen Zusammenhänge sind vorteilhaft innerhalb eines biopsychosozialen Krankheitsmodells zu integrieren. Psychologische und psychosoziale Stressoren sind eigenständig zu betrachten, aber auch in ihrer typischen neurobiologischen Vermittlung zu reflektieren. Gemeinsam geteilte pathogenetische Mechanismen von emotionaler Dysregulation einerseits und neurologischem Krankheitsprozess andererseits müssen betont werden. Anhand der ausgewählten neurologischen Erkrankungen Schlaganfall und Parkinson-Krankheit wird diese Perspektive der Multimorbidität hinsichtlich Prävalenz und klinischer Relevanz von koexistenten depressiven und Angststörungen, gemeinsamer pathogenetischer Mechanismen und therapeutischer Implikationen skizziert.

Schlüsselwörter

Komorbidität Depressive Störungen Angststörungen Schlaganfall Morbus Parkinson 

Coexistent depressive and anxiety disorders in neurological diseases

From a perspective of multimorbidity

Summary

The high rate of coexistent emotional disorders in neurological diseases is challenging. As a rule this coexistence comprises a more dramatic subjective suffering, reduced psychological coping, possible negative interferences with somatic treatments and rehabilitation, an impaired quality of life and higher grades of psychosocial disability. It may also lead to an overall increased risk of somatic morbidity and even mortality in the further course of illness. The complex interrelations may be favorably integrated within a biopsychosocial model. Psychological and psychosocial stressors can be appreciated on their own discrete levels but have to be reflected in their neurobiological correlates. Both neurological and emotional disorders frequently share decisive pathogenetic mechanisms, i.e. the underlying process of neurological disease may contribute to major affective problems also in a somatopsychic direction. From a perspective of multimorbidity the prevalence and clinical relevance of coexistent depressive and anxiety disorders, common pathogenetic mechanisms and implications for treatment will be described for stroke and Parkinson’s disease, as selected neurological disorders.

Keywords

Comorbidity Depressive disorders Anxiety disorders Stroke Parkinson’s disease 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt. H.P. Kapfhammer gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Klinik für PsychiatrieMedizinische Universität GrazGrazÖsterreich

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