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Organische Ursachen

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Akute und therapieresistente Depressionen

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Zusammenfassung

Hirnschädigungs- und Hirndegenerationssyndrome sowie systemische somatische Erkrankungen können Ursachen für Chronizität und Therapieresistenz der Depression sein. Sie können den Verlauf der Depression und die Therapie auf den Ebenen der Pathophysiologie, Pharmakokinetik, Pharmakodynamik und Compliance beeinflussen. Spätestens nach Feststellung der Therapieresistenz einer Depression sind diagnostische Schritte zur Erkennung einer organischen Ursache notwendig, wie Laboruntersuchungen, neuropsychologische Testverfahren, neurophysiologische und bildgebende Untersuchungen. Eine Überlappung der Symptomatik von Depression und Hirnschädigungssyndromen bzw. systemisch-organischer Erkrankung erschwert die Diagnostik. Für die Differenzialdiagnose problematisch ist in einigen Fällen, dass kognitive Leistungseinschränkungen auch im Rahmen rein affektiver Erkrankungen ohne organische Ursachen auftreten. Sie sind dann entweder als sog. depressive Pseudodemenz, als regressive Phänomene oder amotivationale Syndrome bei potenziell lang dauernden Depressionen anzusehen.

Bei therapieresistenter Depression aufgrund von Hirnschädigungs- oder Hirndegenerationssyndromen bzw. systemischen somatischen Erkrankungen mit Auswirkungen auf das ZNS ist, je nach der Grunderkrankung, in einigen Fällen eine internistische oder neurologische Therapie und in anderen eine symptomatische antidepressive Therapie sinnvoll, um die depressive Symptomatik zu beenden.

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Authors
  1. F.M. Reischies
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Editors and Affiliations

  1. Klinik für Psychatrie und Psychotherapie, Charité — Universitätsklinik Berlin, Campus Charité Mitte (CCM), Schumannstr. 20/21, 10117, Berlin

    Michael Bauer  & Mazda Adli  & 

  2. Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité — Universitätsklinik Berlin, Campus Charité Mitte (CCM), Luisenstr. 57, 10117, Berlin

    Anne Berghöfer

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Reischies, F. (2005). Organische Ursachen. In: Bauer, M., Berghöfer, A., Adli, M. (eds) Akute und therapieresistente Depressionen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28049-9_6

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  • DOI: https://doi.org/10.1007/3-540-28049-9_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-40617-4

  • Online ISBN: 978-3-540-28049-1

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