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Psychosoziale Behandlung des metabolischen Syndroms

Psychosocial treatment of the metabolic syndrome

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Psychosomatik und Konsiliarpsychiatrie

Summary

Due to the increased prevalence over the past 20 years, the metabolic syndrome is now considered a global epidemic. More frequently than expected by chance, the metabolic syndrome is associated with psychiatric disorders, especially depressive disorders. Common factors, such as inactivity, social withdrawal, and non-compliance contribute to the reciprocal amplification of psychiatric disorders and the metabolic syndrome. Therefore, the psychosocial management of patients with metabolic syndrome must assure that physical and psychological problems are treated simultaneously. Elements of the individually tailored treatment plan are psychoeducation, encouragement of health behaviour, explicit definitions of treatment focus and treatment aims, inclusion of the patient’s family, as well as the development of problem solving competences. Psychosocial interventions in patients with metabolic syndrome have the potential to not only enhance psychological wellbeing and functional impairment, but also to improve glycemic control, hypertension, hyperlipidaemia, and obesity.

Zusammenfassung

Aufgrund des starken Anstiegs des metabolischen Syndroms in den letzten 20 Jahren wird mittlerweile von einer globalen Epidemie gesprochen. Überzufällig häufig ist das metabolische Syndrom mit psychischen Störungen, insbesondere depressiven Störungen, vergesellschaftet. Das metabolische Syndrom und psychische Störungen können sich im Sinne eines Circulus vitiosus durch Faktoren wie Inaktivität, sozialen Rückzug und Non-Compliance wechselseitig verstärken. Bei der psychosozialen Behandlung von Patienten mit metabolischem Syndrom muss deshalb eine simultane Behandlung der körperlichen und psychischen Probleme sichergestellt werden. Bestandteile des individuell abzustimmenden Behandlungsplanes sind Psychoedukation, Förderung von Gesundheitsverhalten, der Bezug auf subjektive Erklärungsmodelle, gemeinsame Fokus- und Therapiezieldefinition, Einbezug der Familie sowie der Aufbau von Problemlösekompetenzen. Psychosoziale Interventionen bei Patienten mit metabolischem Syndrom haben das Potenzial, nicht nur die psychische Gesundheit und die Funktionsfähigkeit günstig zu beeinflussen, sondern auch den Blutzuckerhaushalt, den Bluthochdruck, die Hyperlipidämie und die Adipositas.

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Literatur

  1. Adams RJ, Appleton S, Wilson DH, Taylor AW, Dal Grande E, Chittleborough C, Gill T, Ruffin R (2005) Population comparison of two clinical approaches to the metabolic syndrome: implications of the new International Diabetes Federation consensus definition. Diabetes Care 28:2777–2779

    Article  PubMed  Google Scholar 

  2. Alberti KG, Zimmet P, Shaw J (2005) The metabolic syndrome—a new worldwide definition. Lancet 366:1059–1062

    Article  PubMed  Google Scholar 

  3. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ (2001) The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 24:1069–1078

    Article  PubMed  CAS  Google Scholar 

  4. Bonnet F, Irving K, Terra JL, Nony P, Berthezene F, Moulin P (2005) Depressive symptoms are associated with unhealthy lifestyles in hypertensive patients with the metabolic syndrome. J Hypertens 23:611–617

    Article  PubMed  CAS  Google Scholar 

  5. Correll CU, Frederickson AM, Kane JM, Manu P (2006) Metabolic syndrome and the risk of coronary heart disease in 367 patients treated with secondgeneration antipsychotic drugs. J Clin Psychiatry 67:575–583

    Article  PubMed  CAS  Google Scholar 

  6. Didjurgeit U, Kruse J, Schmitz N, Stückenschneider P, Sawicki PT (2002) A time-limited, problem-orientated psychotherapeutic intervention in Type 1 diabetic patients with complications: a randomized controlled trial. Diabet Med 19:814–821

    Article  PubMed  CAS  Google Scholar 

  7. Eckel RH, Grundy SM, Zimmet PZ (2005) The metabolic syndrome. Lancet 365:1415–1428

    Article  PubMed  CAS  Google Scholar 

  8. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 285:2486–2497

  9. Ford ES (2005) Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the US, Diabetes Care 28:2745–2749

    Article  PubMed  Google Scholar 

  10. Ford ES (2005) Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. Diabetes Care 28:1769–1778

    Article  PubMed  Google Scholar 

  11. Glassman AH, O’Connor CM, Califf RM, Swedberg K, Schwartz P, Bigger JT, Krishnan KR, Van Zyl LT, Swenson JR, Finkel MS, Landau C, Shapiro PA, Pepine CJ, Mardekian J, Harrison WM (2002) Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA 288:701–709

    Article  PubMed  CAS  Google Scholar 

  12. Kahl KG (2005) Metabolisches Syndrom und psychische Erkrankungen: Relevanz Risikofaktoren, und praktische Konsequenzen MMW Fortschr Med 147:32–34, 36

    PubMed  CAS  Google Scholar 

  13. Kahn R, Buse J, Ferrannini E, Stern M (2005) The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 28:2289–2304

    Article  PubMed  Google Scholar 

  14. Kaplan NM (1989) The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med 149:1514–1520

    Article  PubMed  CAS  Google Scholar 

  15. Kreyenbuhl J, Dickerson FB, Medoff DR, Brown CH, Goldberg RW, Fang L, Wohlheiter K, Mittal LP, Dixon LB (2006) Extent and management of cardiovascular risk factors in patients with type 2 diabetes and serious mental illness. J Nerv Ment Dis 194:404–410

    Article  PubMed  Google Scholar 

  16. Löwe B, Hochlehnert A, Nikendei C (2006) Metabolisches Syndrom und Depression. Ther Umsch 63:521–527

    Article  PubMed  Google Scholar 

  17. Löwe B, Spitzer RL, Gräfe K, Kroenke K, Quenter A, Zipfel S, Bucholz C, Witte S, Herzog W (2004) Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. J Affect Disord 78:131–140

    Article  PubMed  Google Scholar 

  18. Löwe B, Schulz U, Gräfe K, Wilke S (2006) Medical patients’ attitudes toward emotional problems and their treatment. What do they really want? J Gen Intern Med 21:39–45

    Article  PubMed  Google Scholar 

  19. Lustman PJ, Griffith LS, Freedland KE, Kissel SS, Clouse RE (1998) Cognitive behavior therapy for depression in type 2 diabetes mellitus. A randomized, controlled trial. Ann Intern Med 129:613–621

    PubMed  CAS  Google Scholar 

  20. Murray CJ, Lopez AD (1997) Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 349:1498–1504

    Article  PubMed  CAS  Google Scholar 

  21. Petrlova B, Rosolova H, Hess Z, Podlipny J, Simon J (2004) Depressive disorders and the metabolic syndrome of insulin resistance. Semin Vasc Med 4:161–165

    Article  PubMed  Google Scholar 

  22. Ramasubbu R (2002) Insulin resistance: a metabolic link between depressive disorder and atherosclerotic vascular diseases. Med Hypotheses 59:537–551

    Article  PubMed  CAS  Google Scholar 

  23. Sacks FM (2004) Metabolic syndrome: epidemiology and consequences. J Clin Psychiatry 65(Suppl 18):3–12

    PubMed  Google Scholar 

  24. Sinha R, Fisch G, Teague B, Tamborlane WV, Banyas B, Allen K, Savoye M, Rieger V, Taksali S, Barbetta G, Sherwin RS, Caprio S (2002) Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med 346:802–810

    Article  PubMed  CAS  Google Scholar 

  25. Wajchenberg BL (2000) Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 21:697–738

    Article  PubMed  CAS  Google Scholar 

  26. Weber-Hamann B, Hentschel F, Kniest A, Deuschle M, Colla M, Lederbogen F, Heuser I (2002) Hypercortisolemic depression is associated with increased intra-abdominal fat. Psychosom Med 64:274–277

    PubMed  Google Scholar 

  27. WHO Consultation (1999) Definition, diagnosis and classification of diabetes mellitus and its complications. World Health Organization, pp 31–33

  28. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364:937–952

    Article  PubMed  Google Scholar 

  29. Ziegelstein RC, Fauerbach JA, Stevens SS, Romanelli J, Richter DP, Bush DE (2000) Patients with depression are less likely to follow recommendations to reduce cardiac risk during recovery from a myocardial infarction. Arch Intern Med 160:1818–1823

    Article  PubMed  CAS  Google Scholar 

  30. Zimmet P, Alberti KG, Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414:782–787

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Klinik für Psychosomatische und Allgemeine Klinische Medizin, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany

    Bernd Löwe & Wolfgang Herzog

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  1. Bernd Löwe
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  2. Wolfgang Herzog
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Correspondence to Bernd Löwe.

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Löwe, B., Herzog, W. Psychosoziale Behandlung des metabolischen Syndroms. Psychosom Konsiliarpsychiatr 1, 19–27 (2006). https://doi.org/10.1007/s11800-006-0018-0

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  • DOI: https://doi.org/10.1007/s11800-006-0018-0

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