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Klinisches Management

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Altersdepression

Zusammenfassung

Klinisches Management bedeutet im medizinischen Fachjargon eine strukturierte, sowohl individualisierte als auch leitliniengerechte medizinische Versorgung. „Manager“ ist in diesem Fall der behandelnde Facharzt. Seine Tätigkeit umfasst eine Vielzahl von Bestandteilen aus psychiatrischer Diagnostik, Klärung psychosozialer Kontextfaktoren und somatischer Komorbidität, Berücksichtigung von Patientenpräferenzen und Arbeit an der Therapieadhärenz sowie schließlich strukturell-organisatorische Maßnahmen. In klinischen Studien zur Wirksamkeit von Medikamenten oder spezifischen psychotherapeutischen Verfahren wird das klinische Management verstanden als die Summe der nichtspezifischen therapeutischen Faktoren, gegen die u. a. eine spezifische Therapie getestet wird. Es konnte sowohl für die Psychotherapie als auch für die medikamentöse antidepressive Therapie gezeigt werden, dass das klinische Management, das neben der Gabe eines Antidepressivums oder der Anwendung eines psychotherapeutischen Manuals durchgeführt wurde, selbst eine hohe Effektivität besitzt.

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Literatur

  • Abu-Omar K, Rütten A (2006) Sport oder körperliche Aktivität im Alltag? Zur Evidenzbasierung von Bewegung in der Gesundheitsförderung. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz 49(11):1162–1168

    Article  PubMed  Google Scholar 

  • Alexopoulos GS, Raue PJ, McCulloch C, Kanellopoulos D, Seirup JK, Sirey JA, Banerjee S, Kiosses DN, Arean PA (2016) Clinical case management versus case management with problem solving therapy in low-income, disabled elders with major depression: a randomized clinical trial. Am J Geriatr Psychiatry 24(1):50–59

    Article  PubMed  Google Scholar 

  • Amann U, Schmedt N, Garbe E (2012) Prescribing of potentially inappropriate medications for the elderly: an analysis based on the PRISCUS list. Dtsch Arztebl Int 109(5):69–75

    PubMed  PubMed Central  Google Scholar 

  • Angermeyer MC, Matschinger H, Schomerus G (2013) Attitudes towards psychiatric treatment and people with mental illness: changes over two decades. Br J Psychiatry 203(2):146–151

    Article  PubMed  Google Scholar 

  • Arean PA (2012) Personalizing behavioral interventions: the case of late-life depression. Neuropsychiatry (London) 2(2):135–145

    Article  Google Scholar 

  • Bao Y, Alexopoulos GS, Casalino LP, Ten Have TR, Donohue JM, Post EP, Schackman, BR, Bruce ML (2011) Collaborative depression care management and disparities in depression treatment and outcomes. Arch Gen Psychiatry 68(6):627–636

    Article  PubMed  PubMed Central  Google Scholar 

  • Blanchard MR, Waterreus A, Mann A (1999) Can a brief intervention have a longer-term benefit? The case of the research nurse and depressed older people in the community. Int J Geriatr Psychiatry 14(9):733–738

    Article  CAS  PubMed  Google Scholar 

  • Boehlen FH, Herzog W, Maatouk I, Saum KU, Brenner H, Wild B (2016) Behandlungswünsche von älteren Menschen mit psychischen Erkrankungen. Z Gerontol Geriatr 49(2):120–125

    Article  CAS  PubMed  Google Scholar 

  • Cohen A, Houck PR, Szanto K, Dew MA, Gilman SE, Reynolds CF 3rd (2006) Social inequalities in response to antidepressant treatment in older adults. Arch Gen Psychiatry 63(1):50–56

    Article  PubMed  Google Scholar 

  • Cornman JC, Goldman N, Glei DA, Weinstein M, Chang MC (2003) Social ties and perceived support: two dimensions of social relationships and health among the elderly in Taiwan. J Aging Health 15(4):616–644

    Article  PubMed  Google Scholar 

  • Dodel R (2014) Multimorbidität: Konzept, Epidemiologie, Versorgung. Nervenarzt 85(4):401–408

    Article  CAS  PubMed  Google Scholar 

  • Gallo JJ, Hwang S, Joo JH, Bogner HR, Morales KH, Bruce ML, Reynolds CF 3rd (2016) Multimorbidity, depression, and mortality in primary care: randomized clinical trial of an evidence-based depression care management program on mortality risk. J Gen Intern Med 31(4):380–386

    Article  PubMed  Google Scholar 

  • Gerrits MM, van Marwijk HW, van Oppen P, van der Horst H, Penninx BW (2013) The role of somatic health problems in the recognition of depressive and anxiety disorders by general practitioners. J Affect Disord 151(3):1025–1032

    Article  PubMed  Google Scholar 

  • Gilbody S, Whitty P, Grimshaw J, Thomas R (2003) Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA 289(23):3145–3151

    Article  PubMed  Google Scholar 

  • Glaeske G, Schicktanz C (2013) BARMER GEK Arzneimittelreport 2013. Asgard Verlagsservice GmbH, Siegburg

    Google Scholar 

  • Goldberg D (2010) The detection and treatment of depression in the physically ill. World Psychiatry 9(1):16–20

    Article  PubMed  PubMed Central  Google Scholar 

  • Gühne U, Stein J, Riedel-Heller S (2016) Depression im Alter – Herausforderung langlebiger Gesellschaften. Psychiatr Prax 43(2):107–110

    PubMed  Google Scholar 

  • Gum AM, Arean PA, Hunkeler E, Tang L, Katon W, Hitchcock P, Steffens DC, Dickens J, Unützer J (2006) Depression treatment preferences in older primary care patients. Gerontologist 46(1):14–22

    Article  PubMed  Google Scholar 

  • Gum AM, Iser L, King-Kallimanis BL, Petkus A, DeMuth A, Schonfeld L (2011) Six-month longitudinal patterns of mental health treatment utilization by older adults with depressive symptoms. Psychiatr Serv 62(11):1353–1360

    Article  PubMed  PubMed Central  Google Scholar 

  • Gustafsson M, Sandman PO, Karlsson S, Isaksson U, Schneede J, Sjolander M, Lovheim H (2015) Reduction in the use of potentially inappropriate drugs among old people living in geriatric care units between 2007 and 2013. Eur J Clin Pharmacol 71(4):507–515

    Article  PubMed  Google Scholar 

  • Hautzinger M, Welz S (2008) Kurz- und längerfristige Wirksamkeit psychologischer Interventionen bei Depressionen im Alter. Z Klin Psychol Psychother 37:52–60

    Article  Google Scholar 

  • Hegel MT, Arean PA (2003) Problem-solving treatment for primary care (PST-PC): a treatment manual for depression. Dartmouth Medical School, University of California, San Francisco CA

    Google Scholar 

  • Hegeman JM, de Waal MW, Comijs HC, Kok RM, van der Mast RC (2015) Depression in later life: a more somatic presentation? J Affect Disord 170:196–202

    Article  CAS  PubMed  Google Scholar 

  • Holt S, Schmiedl S, Thurmann PA (2010) Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int 107(31–32):543–551

    PubMed  PubMed Central  Google Scholar 

  • Hunkeler EM, Meresman JF, Hargreaves WA, Fireman B, Berman WH, Kirsch AJ, Groebe J, Hurt SW, Braden P, Getzell M, Feigenbaum PA, Peng T, Salzer M (2000) Efficacy of nurse telehealth care and peer support in augmenting treatment of depression in primary care. Arch Fam Med 9(8):700–708

    Article  CAS  PubMed  Google Scholar 

  • Johansson T, Abuzahra ME, Keller S, Mann E, Faller B, Sommerauer C, Hock J, Loffler C, Kochling A, Schuler J, Flamm M, Sonnichsen A (2016) Impact of strategies to reduce polypharmacy on clinically relevant endpoints – a systematic review and meta-analysis. Br J Clin Pharmacol. 82(2):532–48

    Article  PubMed  Google Scholar 

  • Joo JH, Hwang S, Abu H, Gallo JJ (2016) An innovative model of depression care delivery: peer mentors in collaboration with a mental health professional to relieve depression in older adults. Am J Geriatr Psychiatry 24(5):407–416

    Article  PubMed  PubMed Central  Google Scholar 

  • Kasckow J, Klaus J, Morse J, Oslin D, Luther J, Fox L, Reynolds C, Haas GL (2014) Using problem solving therapy to treat veterans with subsyndromal depression: a pilot study. Int J Geriatr Psychiatry 29(12):1255–1261

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Katona C, Livingston G (2000) Impact of screening old people with physical illness for depression? Lancet 356(9224):91–92

    Article  CAS  PubMed  Google Scholar 

  • Kilbourne AM, Williams M, Bauer MS, Arean P (2012) Implementation research: reducing the research-to-practice gap in depression treatment. Depress Res Treat:476027

    Google Scholar 

  • Kunisch R (2012) Medizinsoftware für die Kitteltasche: Medikamenten-Apps. Dt Arztebl 109(9):A440

    Google Scholar 

  • Levine S, Unützer J, Yip JY, Hoffing M, Leung M, Fan MY, Lin EH, Grypma L, Katon W, Harpole LH, Langston CA (2005) Physicians' satisfaction with a collaborative disease management program for late-life depression in primary care. Gen Hosp Psychiatry 27(6):383–391

    Article  PubMed  Google Scholar 

  • Leykin Y, Derubei RJ, Gallop R, Amsterdam JD, Shelton RC, Hollon SD (2007) The relation of patients' treatment preferences to outcome in a randomized clinical trial. Behav Ther 38(3):209–217

    Article  PubMed  Google Scholar 

  • Lohman M, Dumenci L, Mezuk B (2016) Depression and frailty in late life: evidence for a common vulnerability. J Gerontol B Psychol Sci Soc Sci 71(4):630–640

    Article  PubMed  Google Scholar 

  • Luck-Sikorski C, Stein J, Heilmann K, Maier W, Kaduszkiewicz H, Scherer M, Weyerer S, Werle J, Wiese B, Moor L, Bock JO, König HH, Riedel-Heller SG (2016) Treatment preferences for depression in the elderly. Int Psychogeriatr 28:1–10 [Epub ahead of print]

    Google Scholar 

  • Lyness JM, Yu Q, Tang W, Tu X, Conwell Y (2009) Risks for depression onset in primary care elderly patients: potential targets for preventive interventions. Am J Psychiatry 166(12):1375–1383

    Article  PubMed  PubMed Central  Google Scholar 

  • Mead S, Hilton D, Curtis L (2001) Peer support: a theoretical perspective. Psychiatr Rehabil J 25(2):134–141

    Article  CAS  PubMed  Google Scholar 

  • Mechakra-Tahiri SD, Zunzunegui MV, Preville M, Dube M (2010) Gender, social relationships and depressive disorders in adults aged 65 and over in Quebec. Chronic Dis Can 30(2):56–65

    PubMed  Google Scholar 

  • Mitchell AJ, Rao S, Vaze A (2010) Do primary care physicians have particular difficulty identifying late-life depression? A meta-analysis stratified by age. Psychother Psychosom 79(5):285–294

    Article  PubMed  Google Scholar 

  • Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B (2007) Depression, chronic diseases, and decrements in health: results from the world health surveys. Lancet 370(9590):851–858

    Article  PubMed  Google Scholar 

  • Müller S, Heinz A (2013) Stigmatisierung oder Entstigmatisierung durch Biologisierung psychischer Krankheiten? Nervenheilkunde 32(12):955–961

    Google Scholar 

  • Peerenboom, L, Collard RM, Naarding P, Comijs HC (2015) The association between depression and emotional and social loneliness in older persons and the influence of social support, cognitive functioning and personality: a cross-sectional study. J Affect Disord 182:26–31

    Article  CAS  PubMed  Google Scholar 

  • Pfaff JJ, Almeida OP (2005) A cross-sectional analysis of factors that influence the detection of depression in older primary care patients. Aust N Z J Psychiatry 39(4):262–265

    Article  PubMed  Google Scholar 

  • Pitt V, Lowe D, Hill S, Prictor M, Hetrick SE, Ryan R, Berends L (2013) Consumer-providers of care for adult clients of statutory mental health services. Cochrane Database Syst Rev 3:CD004807

    Google Scholar 

  • Repper J, Carter T (2011) A review of the literature on peer support in mental health services. J Ment Health 20(4):392–411

    Article  PubMed  Google Scholar 

  • Riepe MW (2015) Clinical preference for factors in treatment of geriatric depression. Neuropsychiatr Dis Treat 11:25–31

    CAS  PubMed  Google Scholar 

  • Rodic D, Meyer AH, Meinlschmidt G (2015) The association between depressive symptoms and physical diseases in Switzerland: a cross-sectional general population study. Front Public Health 3:47

    Article  PubMed  PubMed Central  Google Scholar 

  • Rutherford BR, Tandler J, Brown PJ, Sneed JR, Roose SP (2014) Clinic visits in late-life depression trials: effects on signal detection and therapeutic outcome. Am J Geriatr Psychiatry 22:1452–1461

    Article  PubMed  Google Scholar 

  • Schwarzbach M, Luppa M, Forstmeier S, Konig HH, Riedel-Heller, SG (2014) Social relations and depression in late life-a systematic review. Int J Geriatr Psychiatry 29(1):1–21

    Article  PubMed  Google Scholar 

  • Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Friedman SJ, Meyers BS (2001) Stigma as a barrier to recovery: Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatr Serv 52(12):1615–1620

    Article  CAS  PubMed  Google Scholar 

  • Unützer J, Powers D, Katon W, Langston C (2005) From establishing an evidence-based practice to implementation in real-world settings: IMPACT as a case study. Psychiatr Clin North Am 28(4):1079–1092

    Article  PubMed  Google Scholar 

  • Utschakowski J, Sielaff G, Schulz G (2015) Aus Erfahrung wird Wissen und Kompetenz. Ausbildung von Experten durch Erfahrung. Nervenheilkunde 34(4):271–274

    Google Scholar 

  • van den Bussche H, Koller D, Kolonko T, Hansen H, Wegscheider K, Glaeske G, von Leitner EC, Schafer I, Schon G (2011) Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany. BMC Public Health 11:101

    Article  Google Scholar 

  • van’t Veer-Tazelaar PJ, van Marwijk HW, van Oppen P, van der Horst HE, Smit F, Cuijpers P, Beekman AT (2011) Prevention of late-life anxiety and depression has sustained effects over 24 months: a pragmatic randomized trial. Am J Geriatr Psychiatry 19(3):230–239

    Article  Google Scholar 

  • Williams JW Jr, Katon W, Lin EH, Noel PH, Worchel J, Cornell J, Harpole L, Fultz BA, Hunkeler E, Mika VS, Unützer J, Investigators I (2004) The effectiveness of depression care management on diabetes-related outcomes in older patients. Ann Intern Med 140(12):1015–1024

    Article  PubMed  Google Scholar 

  • Wolter DK (2016) Depressionen im höheren Lebensalter, Teil 1: Entstehung, klinische Symptome, Diagnose und Wechselwirkung zwischen Depression und Demenz. Z Gerontol Geriatr 49(4):335–348

    Article  PubMed  Google Scholar 

  • Zeeh J (2012) Polypharmazie im Alter: Des Guten zu viel? MMW Fortschr Med 154(21):46–49

    Article  PubMed  Google Scholar 

  • Zimmermann TM, Clouth J, Elosge M, Heurich M, Schneider E, Wilhelm S, Wolfrath A (2013) Patient preferences for outcomes of depression treatment in Germany: a choice-based conjoint analysis study. J Affect Disord 148(2–3):210–219

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Deutsche Gesellschaft für Gerontopsychiatrie und -psychotherapie, Retzdorffpromenade 3, 12161, Berlin, Deutschland

    Hans Gutzmann

  2. Charité - Universitätsmedizin Berlin, Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Luisenstr. 57, 10117, Berlin, Deutschland

    Anne Berghöfer

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  1. Hans Gutzmann
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Correspondence to Hans Gutzmann .

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Editors and Affiliations

  1. Abteilung für Gerontopsychiatrie Rheinhessen-Fachklinik Landeskrankenhaus (AöR), Alzey, Germany

    Andreas Fellgiebel

  2. Fachbereich Psychologie, Eberhard-Karls-Universität Tübingen, Tübingen, Germany

    Martin Hautzinger

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Gutzmann, H., Berghöfer, A. (2017). Klinisches Management. In: Fellgiebel, A., Hautzinger, M. (eds) Altersdepression. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53697-1_9

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  • DOI: https://doi.org/10.1007/978-3-662-53697-1_9

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