Psychotherapie bei Substanzabhängigkeit und psychischer Komorbidität

Bei Menschen mit Substanzkonsumstörungen treten besonders häufig affektive Störungen, schizophrene Psychosen, Angsterkrankungen und posttraumatische Belastungsstörungen auf. Die richtige Diagnosestellung und eine störungsspezifische Psychotherapie sind für den weiteren Erkrankungsverlauf entscheidend. Obwohl eine integrierte Behandlung der komorbiden Störungen in aktuellen Leitlinien empfohlen wird, wird sie durch viele Barrieren erschwert.

Schlüsselwörter

Substanzkonsumstörung - SKS - affektive Störung - Angsterkrankungen - Psychosen

Publikationsverlauf

Artikel online veröffentlicht:
03. Mai 2024

• Literatur

• 1 Dauber H, Braun B, Pfeiffer-Gerschel T. et al. Co-occurring mental disorders in substance abuse treatment: The current health care situation in Germany. Int J Ment Health Addict 2018; 16: 66-80 DOI: 10.1007/s11469-017-9784-5. (PMID: 29491767)
• 2 Moggi F, Preuss U. Suchterkrankungen und komorbide psychische Störungen. et al. In: Soyka M, Batra A, Heinz A. Suchtmedizin. München: Elsevier; 2019: 333-347
• 3 Dirks H, Scherbaum N, Kis B. et al. ADHD in adults and comorbid substance use disorder: Prevalence, clinical diagnostics and integrated therapy. Fortschr Neurol Psychiatr 2017; 85: 336-344 DOI: 10.1055/s-0043-100763. (PMID: 28645126)
• 4 Singer S, Maier L, Paserat A. et al. Wartezeiten auf einen Psychotherapieplatz vor und nach der Psychotherapiestrukturreform. Psychotherapeut 2022; 67: 176-184
• 5 Wangensteen T, Hystad J. Trust and collaboration between patients and staff in SUD treatment: A qualitative study of patients' reflections on inpatient SUD treatment four years after discharge. Nordisk Alkohol Nark 2022; 39: 418-436 DOI: 10.1177/14550725221082366. (PMID: 36003119)
• 6 Enke M, Wallenwein E, Weber T. Entwöhnungsbehandlung (Sucht-Rehabilitation) der Alkoholabhängigkeit. PSYCH up2d 2022; 16: 109-127
• 7 Morrens M, Dewilde B, Sabbe B. et al. Treatment outcomes of an integrated residential programme for patients with schizophrenia and substance use disorder. Eur Addict Res 2011; 17: 154-163 DOI: 10.1159/000324480.
• 8 Swofford CD, Kasckow JW, Scheller-Gilkey G. et al. Substance use: A powerful predictor of relapse in schizophrenia. Schizophr Res 1996; 20: 145-151 DOI: 10.1016/0920-9964(95)00068-2. (PMID: 8794502)
• 9 Cantwell R. Substance use and schizophrenia: Effects on symptoms, social functioning and service use. Br J Psych 2003; 182: 324-329 DOI: 10.1192/bjp.182.4.324. (PMID: 12668408)
• 10 Baker AL, Hiles SA, Thornton LK. et al. A systematic review of psychological interventions for excessive alcohol consumption among people with psychotic disorders. Acta Psychiatra Scand 2012; 126: 243-255 DOI: 10.1111/j.1600-0447.2012.01885.x.
• 11 Barrowclough C, Haddock G, Wykes T. et al. Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: Randomised controlled trial. BMJ 2010; 341: c6325 DOI: 10.1136/bmj.c6325.
• 12 Baker AL, Thornton LK, Hiles S. et al. Psychological interventions for alcohol misuse among people with co-occurring depression or anxiety disorders: A systematic review. J Affect Dis 2012; 139: 217-229 DOI: 10.1016/j.jad.2011.08.004. (PMID: 21890213)
• 13 Gregory Jr VL, Ellis RJB. Cognitive-behavioral therapy and buprenorphine for opioid use disorder: A systematic review and meta-analysis of randomized controlled trials. Am J Drug Alcoh Ab 2020; 46: 520-530 DOI: 10.1080/00952990.2020.1780602. (PMID: 32960649)
• 14 Klerman GWM, Rounsaville B, Chevron E. Interpersonal Psychotherapy of Depression. New York: Basic Books; 1984
• 15 Markowitz JC, Kocsis JH, Christos P. et al. Pilot study of interpersonal psychotherapy versus supportive psychotherapy for dysthymic patients with secondary alcohol abuse or dependence. J Nerv Ment Dis 2008; 196: 468-474 DOI: 10.1097/NMD.0b013e31817738f1. (PMID: 18552624)
• 16 Penberthy JK, Khanna S, Lynch M. et al. Effective treatment for co-occurring alcohol use disorder and persistent depression: A case report. MOJ Add Med Ther 2017; 3: 66-69
• 17 Weiss RD, Griffin ML, Kolodziej ME. et al. A randomized trial of integrated group therapy versus group drug counseling for patients with bipolar disorder and substance dependence. Am J Psych 2007; 164: 100-107 DOI: 10.1176/ajp.2007.164.1.100.
• 18 Schadé A, Marquenie LA, van Balkom AJ. et al. The effectiveness of anxiety treatment on alcohol-dependent patients with a comorbid phobic disorder: A randomized controlled trial. Alcoh Clin Exp Res 2005; 29: 794-800 DOI: 10.1097/01.alc.0000163511.24583.33.
• 19 Roberts NP, Lotzin A, Schäfer I. A systematic review and meta-analysis of psychological interventions for comorbid post-traumatic stress disorder and substance use disorder. Eur J Psychotraum 2022; 13: 2041831 DOI: 10.1080/20008198.2022.2041831. (PMID: 35558682)
• 20 Mills KL, Teesson M, Back SE. et al. Integrated exposure-based therapy for co-occurring posttraumatic stress disorder and substance dependence: A randomized controlled trial. JAMA 2012; 308: 690-699 DOI: 10.1001/jama.2012.9071. (PMID: 22893166)
• 21 Najavits LM, Gallop RJ, Weiss RD. Seeking safety therapy for adolescent girls with PTSD and substance use disorder: A randomized controlled trial. J Behav Health Serv Res 2006; 33: 453-463 DOI: 10.1007/s11414-006-9034-2. (PMID: 16858633)
• 22 Schäfer I, Lotzin A, Hiller P. et al. A multisite randomized controlled trial of seeking safety vs. relapse prevention training for women with co-occurring posttraumatic stress disorder and substance use disorders. Eur J Psychotraum 2019; 10: 1577092 DOI: 10.1080/20008198.2019.1577092.
• 23 Pilz R, Hartleb R, Konrad G. et al. The role of eye movement desensitization and reprocessing (EMDR) in substance use disorders: A systematic review. Forts Neurol Psych 2017; 85: 584-591 DOI: 10.1055/s-0043-118338. (PMID: 29017196)
• 24 van Emmerik-van Oortmerssen K, Vedel E, Kramer FJ. et al. Integrated cognitive behavioral therapy for ADHD in adult substance use disorder patients: Results of a randomized clinical trial. Drug Alcoh Depend 2019; 197: 28-36 DOI: 10.1016/j.drugalcdep.2018.12.023.
• 25 Bihlar Muld B, Jokinen J, Bölte S. et al. Skills training groups for men with ADHD in compulsory care due to substance use disorder: A feasibility study. Attent Def Hyperact Dis 2016; 8: 159-172 DOI: 10.1007/s12402-016-0195-4.
• 26 Dimeff LA, Linehan MM. Dialectical behavior therapy for substance abusers. Addict Sci Clin Pract 2008; 4: 39-47 DOI: 10.1151/ascp084239. (PMID: 18497717)
• 27 Gregory RJ, DeLucia-Deranja E, Mogle JA. Dynamic deconstructive psychotherapy versus optimized community care for borderline personality disorder co-occurring with alcohol use disorders: A 30-month follow-up. J Nerv Ment Dis 2010; 198: 292-298 DOI: 10.1097/NMD.0b013e3181d6172d. (PMID: 20386259)
• 28 Ball SA. Manualized treatment for substance abusers with personality disorders: Dual focus schema therapy. Addict Beh 1998; 23: 883-891 DOI: 10.1016/S0306-4603(98)00067-7.
• 29 Nielsen P, Røjskjær S, Hesse M. Personality-guided treatment for alcohol dependence: A quasi-randomized experiment. Am J Addict 2007; 16: 357-364 DOI: 10.1080/10550490701525640. (PMID: 17882606)