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Differenzielle Indikation für Psychotherapie am Beispiel der Depression

Differential indications for psychotherapy exemplified by depression

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Zusammenfassung

Die allgemeine Wirksamkeit psychotherapeutischer Ansätze bei der Behandlung psychiatrischer Störungen ist durch Metaanalysen gesichert. Dabei haben sich störungsorientierte Verfahren zunehmend durchgesetzt. Bei leichten und mittelschweren Depressionen erwiesen sich psychologische Ansätze gleichermaßen effektiv wie Pharmakotherapie, jedoch nachhaltiger wirksam nach Therapieende. Die Kombinationsbehandlung hat einen hohen Stellenwert bei schweren und chronischen Depressionen. Über den Schweregrad und Verlaufstyp hinaus sollte die Indikation weiter differenziert werden, z. B. nach dem Vorliegen früher Traumatisierungen, Komorbidität, Patientenschwierigkeit sowie der wissenschaftlichen Absicherung des gewählten Verfahrens.

Summary

The general efficacy of psychotherapeutic approaches in the treatment of mental disorders has been demonstrated by meta-analyses. Disorder-specific methods are increasingly dominating the field. In the field of depression psychological interventions have proven to be as equally effective as pharmacotherapy in mild and moderate depressives but with longer lasting effects after termination of treatment. The combination of both methods is particularly relevant for the therapy of severe and chronic depression. The indications should be differentiated beyond the severity and course of the disorder, e.g. according to previous traumatization, comorbidity, patient difficulty and the empirical evidence of the different approaches.

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Schramm, E., Berger, M. Differenzielle Indikation für Psychotherapie am Beispiel der Depression. Nervenarzt 82, 1414–1424 (2011). https://doi.org/10.1007/s00115-011-3350-3

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