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Psychiatrie und Psychotherapie up2date 2007; 1(03): 197-210
DOI: 10.1055/s-2006-952042
Angststörungen, Zwangsstörungen und stressassoziierte Störungen

Zwangsstörungen

Ulrich Voderholzer
,
Anne Katrin Külz
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Kernaussagen

  • Die Zwangsstörung ist eine schwere, meist chronische psychische Erkrankung, die häufig vor anderen Personen, insbesondere auch vor Ärzten und Psychotherapeuten, verheimlicht wird.

  • Zwangsstörungen weisen eine hohe Komorbidität mit anderen psychischen Erkrankungen auf, insbesondere mit depressiven Störungen, Angststörungen, Persönlichkeitsstörungen und Essstörungen.

  • An effektiven Behandlungsstrategien steht heute die kognitive Verhaltenstherapie mit Reizkonfrontation (Exposition) und Reaktionsmanagement sowie selektive Serotonin-Wiederaufnahmehemmer zur Verfügung. Die Kombination beider Verfahren kann zu Responderraten von 80 bis 90 % der Patienten führen. Bei Therapieresistenz ist die Wirksamkeit atypischer Neuroleptika erwiesen.

  • Behandlungserfolg bzw. Response bedeutet bei Zwangsstörungen meist eine deutliche Symptomreduktion, äußerst selten jedoch eine Remission.

  • Die Versorgungssituation für Patienten, die an Zwangsstörungen erkrankt sind, ist noch sehr unzureichend. Bei vielen Patienten werden unwirksame Fehlbehandlungen durchgeführt, bevor spezifische, evidenzbasierte Therapien zur Anwendung kommen.



Publikationsverlauf

Publikationsdatum:
16. April 2007 (online)

© Georg Thieme Verlag KG Stuttgart · New York

 

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