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Krankenhauspsychiatrie 2002; 13(Sh1): 26-30
DOI: 10.1055/s-2002-34600
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Effekte einer niedrigfrequenten, langzeitigen Paartherapie einzeln und in slow-open und geschlossenen Gruppen bei zyklothymen Patienten unter naturalistischen Bedingungen

Results of Low Frequency, Long-Term Marital Therapy Singly and in Slow-Open and Closed Groups with Patients Suffering from Bipolar Disorders Under Naturalistic SettingsL.  Adler1 , D.  Bernstein1
  • 1Ökomenisches Hainich Klinikum, Mühlhausen
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Publication History

Publication Date:
09 October 2002 (online)

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Zusammenfassung

Psychotherapie bei bipolaren affektiven Störungen beginnt nach Jahrzehnten als „forgotten treatment modality”, in den letzten Jahren zunehmend Interesse hervorzurufen; der Kenntnisstand ist aber nach wie vor völlig unzureichend. Vorgestellt werden die Ergebnisse zweier naturalistischer Behandlungsstudien bei zyklothymen Patienten mit ungünstigem Verlauf. Die Patienten wurden in einer Slow-open- oder in einer geschlossenen Gruppen- und Einzeltherapie von Paaren adjunktiv zur Medikation behandelt. In der Slow-open-Gruppe reduzierte sich die durchschnittliche Liegezeit pro Jahr nach im Mittel 5,6 Jahren Psychotherapie von 15,8 % auf 5,04 % (p < 0,005); gleichzeitig milderte sich ggf. die Schwere des Fehlverhaltens vorher und die Schwere der Erkrankung bei Wiederaufnahme signifikant ab. In der kleinen geschlossenen Gruppe kam es nach im Mittel 3,1 Jahren mit 8,49 % stationärer Behandlungstage/Jahr zu keiner Wiederaufnahme. Die Behandlungen werden beschrieben und mögliche Gründe für die Effekte diskutiert.

Abstract

After decades as a forgotten treatment modality bipolar disorders psychotherapy becomes of growing interest, although methodologically sound treatment studies are sparse. We present the results of two naturalistic treatment groups of patients with bipolar disorder. All patients had had a difficult course of their illness. Adjunctive to medication both groups were treated with a combined marital therapy in groups and alone. Group A was slow-open and had a therapeutic splitting. Group B was closed with one therapist for psychotherapy and medication. During follow-up of s = 5.6 years in group A the average in-patient-days/year were reduced from 15.8 % to 5.04 % (P < 0.005). Parallel psychosocial lapses and severity of illness prior to admission were reduced. In group B there was within s = 3.1 years no relapse, but 8.46 % days/year before psychotherapy. Possible reasons for this effect are discussed.

Schlüsselwörter

Bipolare Störungen - Gruppentherapie - Paartherapie - Verlauf

Key words

Bipolar Disorders - Group Therapy - Marital Therapy - Course of Illness

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PD Dr. L. Adler

Ökomenisches Hainich Klinikum

Pfafferode 102

99974 Mühlhausen

Email: ladler@t-online.de