Psychotherapie bei bipolaren Störungen – Therapiekonzepte, ihre Inhalte und Wirksamkeit

Zusammenfassung

Kognitiv-behaviorale Interventionen haben in der Kombination mit Pharmakotherapie bei der Behandlung bipolarer Erkrankungen an Bedeutung gewonnen. Basierend auf dem Vulnerabilitäts-Stress-Instabilitäts-Modell werden psychoedukative, kognitiv-behaviorale, interpersonelle und familienbezogene Interventionen durchgeführt. Dieser Beitrag gibt einen Überblick über Therapieansätze und ihre Schwerpunkte. Die Wissensvermittlung über die Erkrankung und ihre Behandlung, die Modifikation dysfunktionaler Kognitionen, das Symptommanagement und die Rückfallprävention durch Förderung eines ausgeglichenen Lebensstils sind von zentraler Bedeutung. Mehrere kontrolliert randomisierte Studien mit mehrjährigen Katamnesen aus dem englischen und dem deutschen Sprachraum belegen die Wirksamkeit eines derartigen Vorgehens. Im deutschen Sprachraum liegen seit 2004 manualisierte Therapiekonzepte vor, die sich klinisch bewährt haben.

Abstract

Cognitive-behavioural interventions combined with pharmacotherapy have gained importance in the treatment of bipolar disorders. Based on the vulnerability-stress instability model psychoeducational, cognitive-behavioural, interpersonal and family interventions are provided. This paper gives an overview of treatment programmes and their foci. They include providing knowledge about the illness and its treatment, modifying dysfunctional cognitions and symptom management as well as relapse prevention by promoting a stable life style. There are several English- and German-based randomised controlled follow-up studies in English-speaking countries which provide support for the efficacy of combined treatment. Since 2004 German-based manualised treatment programmes have become available and have been shown to be clinically feasible and promising.

Schlüsselwörter

Kognitiv-behaviorale Therapie - Psychoedukation - psychologische Therapieansätze - Wirksamkeit - bipolare Störung

Key words

cognitive-behavioural therapy - psychoeducation - psychological treatment programmes - effectiveness - bipolar disorder

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