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Evidenzbasierte Psychotherapie der Panikstörung mit und ohne Agoraphobie

Überblick zur S1-Leitlinie der Deutschen Gesellschaft für Psychologie

Evidence-based psychotherapy of panic disorder with or without agoraphobia

Overview of the S1 guidelines of the German Society of Psychology

Zusammenfassung

Bei den beiden Angststörungen Panikstörung und Agoraphobie handelt es sich um klinisch hoch prävalente Störungsbilder, die trotz nachgewiesenermaßen effektiver Behandlungsmöglichkeiten nach wie vor häufig nicht angemessen therapiert werden, obwohl zu deren psychotherapeutischer Behandlung inzwischen zahlreiche gute empirische Studien vorliegen. Die Qualität der vorliegenden Studien erlaubte die Erstellung der in diesem Beitrag vorgestellten Leitlinie [Heinrichs et al. (2009) Evidenzbasierte Leitlinie zur Psychotherapie der Panikstörung mit und ohne Agoraphobie. Hogrefe, Göttingen]. Diese Leitlinie verfolgt verschiedene Ziele auf unterschiedlichen Ebenen: Auf der Ebene der betroffenen Patienten sollen Verbesserungen des Erkrankungsverlaufs, des Funktionsniveaus und der Lebenszufriedenheit erreicht werden. Der behandelnde Therapeut soll Unterstützung in der Auswahl diagnostischer Instrumente und spezifisch wirksamer Maßnahmen erfahren, und auf der strukturellen Ebene des Versorgungsnetzes soll eine Optimierung von Versorgungsabläufen erzielt werden. Empfehlungen zur Therapie der Panikstörung mit und ohne Agoraphobie sowie der Agoraphobie ohne Panikstörung können überwiegend für die kognitive Verhaltenstherapie ausgesprochen werden.

Abstract

From the evidence reported in the recent guidelines [Heinrichs et al. (2009) Evidenzbasierte Leitlinie zur Psychotherapie der Panikstörung mit und ohne Agoraphobie. Hogrefe, Göttingen] the following conclusions can be drawn with respect to the treatment of panic disorder with or without agoraphobia, as well as for agoraphobia without panic disorder:

  1. 1.

    Every psychotherapy should be preceded by suitable diagnostics and a case formulation.

  2. 2.

    The effectiveness of every psychotherapy should be evaluated with well established measures.

  3. 3.

    For the treatment of panic disorder without agoraphobia, cognitive behavioral treatment (CBT) and applied relaxation have been shown to be effective (evidence grade 1).

  4. 4.

    For panic disorder with agoraphobia, CBT, combination treatment (CBT plus medication), as well as panic-focused psychodynamic psychotherapy in the outpatient setting have shown short-term effectiveness (evidence grade 1). Longer lasting effects have been documented for CBT (evidence grade 1).

  5. 5.

    For agoraphobia without panic disorder, CBT with a focus on situational exposure can be recommended (evidence grade 1).

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Correspondence to Georg W. Alpers.

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Diese Zusammenfassung kann nur einen Überblick über Entstehung und Bestandteile der Leitlinie geben und hat nicht zum Ziel, die gründliche Lektüre der ausführlicheren Leitlinie zu ersetzen. Dort finden sich die Daten und Literaturangaben, die hier nur in übersichtlicher Form zusammengefasst werden (Heinrichs et al. 2009).

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Alpers, G., Gerlach, A. & Heinrichs, N. Evidenzbasierte Psychotherapie der Panikstörung mit und ohne Agoraphobie. Psychotherapeut 56, 535–548 (2011). https://doi.org/10.1007/s00278-011-0864-x

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Schlüsselwörter

  • Verhaltenstherapie
  • Kognitive Therapie
  • Entspannungstherapie
  • Randomisierte kontrollierte Studien
  • Behandlungsergebnis

Keywords

  • Behavior therapy
  • Cognitive therapy
  • Relaxation therapy
  • Randomized controlled trial
  • Treatment outcome