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Endokrine Störungen

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Depression, Angst, traumatischer Stress und internistische Erkrankungen

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Zusammenfassung

Endokrine Krankheiten verweisen auf Störungen komplexer hormoneller Regelkreise mit multiplen systemischen Auswirkungen. Sie können prinzipiell in einer Unter- oder Überfunktion imponieren. Störungen der Schilddrüse, der Nebenschilddrüsen sowie der Nebennieren werden skizziert. Eine affektive Komorbidität ist mit bedeutsamen negativen Effekten auf den Krankheitsverlauf assoziiert. Bei Unterformen von Schilddrüsenüberfunktionen (Morbus Basedow) wird eine mögliche pathogenetische Rolle von schwerwiegenden psychosozialen Stressoren in der Auslösung von hyperthyreoten Krisen und auch von Rezidiven im weiteren Krankheitsverlauf diskutiert. In einer „psycho-somatischen“ und „somato-psychischen“ Perspektive sind komplexe psychologische und biologische Interaktionen zu beachten. Zentralnervöse Auswirkungen können auch mit psychotischen Symptomen oder diffusen Persönlichkeitsveränderungen einhergehen. Trotz hoher empirischer Assoziation liegen bisher keine explizit störungsorientierten Studien zur Psychotherapie und Psychopharmakotherapie einer affektiven Komorbidität bei Schilddrüsenerkrankungen vor. Untersuchungen zur Augmentation einer antidepressiven Medikation mit Schilddrüsenhormonen bei Therapie-refraktären Depressionen sind klinisch relevant. Bei selteneren endokrinen Störungen (Hypo-/ Hyperparathyreoidismus, M. Cushing, Addison Syndrom, Phäochromozytom) stützen sich psychopharmakologische Interventionen lediglich auf Einzelfallbeobachtungen.

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    Hans-Peter Kapfhammer

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Kapfhammer, HP. (2022). Endokrine Störungen. In: Depression, Angst, traumatischer Stress und internistische Erkrankungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-65873-4_9

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