psychoneuro 2006; 32(5): 237-246
DOI: 10.1055/s-2006-947138
Schwerpunkt

© Georg Thieme Verlag Stuttgart · New York

Depression und Angst bei Koronarpatienten

Depression and Anxiety in patients with coronary heart diseaseUllrich Buss1
  • 1Abteilung für Psychosomatische Medizin und Psychotherapie, Georg-August-Universität Göttingen
Further Information

Publication History

Publication Date:
01 June 2006 (online)

Angst und Depression sind häufige Symptome bei Patienten mit koronarer Herzerkrankung (KHK). Depression geht zudem mit einer erhöhten kardiovaskulären Morbidität wie auch Mortalität einher. Depression belastet das Gesundheitsverhalten und begünstigt andere bekannte KHK-Risikofaktoren. Zum anderen wird sie - davon parziell unabhängig - über psychophysiologische Mechanismen bzw. eine erhöhte Aktivierung stressphysiologischer Mechanismen vermittelt. Das Risikopotenzial erhöhter Angst bei KHK ist weniger konsistent belegt, aber auch hier liegen ungünstige verhaltenswirksame wie auch akute psychophysiologische Effekte nahe. Die Diagnostik KHK-relevanter Angst und Depression bedarf einer Systematisierung durch Screeningverfahren oder mittels weniger, spezifischer anamnestischer Fragen. Die therapeutische Behandlung krankheitswertiger Störungen sollte bedarfsorientiert und angepasst an die kardiale Grunderkrankung erfolgen. Die primäre Behandlungsindikation besteht in der Reduktion des psychischen Beschwerdedrucks und einer Verbesserung der Lebensqualität ängstlicher und depressiver Koronarpatienten.

Anxiety and depression are highly prevalent in coronary heart disease (CHD). Moreover, depression comes along with increased cardiovascular morbidity and mortality. Depression puts a negative impact on health behaviour and promotes other important risk circumstances. Besides depression is mediated by psychophysiological mechanisms and stress responding systems respectively. The hazard status of anxiety in CHD is less consistently proved, yet increased anxiety also suggesting unfavourable behavioural and short-term psychophysiological effects. Clinical diagnostics of anxiety and depression in CHD needs more systematic screening by special methods or single reliable questions. Psychotherapy should be performed demand-oriented and adjusted to cardiological requirements and themes, supplemented by pharmacotherapy where necessary. The treatment indication in CHD-patients with anxiety and depressive disorders should be primarily guided by symptom load and improvement of quality of life.

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Korrespondenzadresse:

Dr. med. Dipl.-Psych. Ullrich Buss

Universitätsklinikum Göttingen, Zentrum Psychosoziale Medizin

Abteilung für Psychosomatische Medizin und Psychotherapie

Von-Siebold-Str. 5

37075 Göttingen

Email: ubuss@gwdg.de