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Psychiatr Prax 2016; 43(06): 312-317
DOI: 10.1055/s-0034-1387623
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Diagnostik metabolischer Risikofaktoren bei stationär-psychiatrischen Patienten[*]

Analyse des VIPP-DatensatzesDiagnosis of Metabolic Risk Factors in Psychiatric InpatientsAnalysis of the VIPP-Dataset
Sibylle Häfner
1   Universitätsklinik für Psychiatrie und Psychotherapie Heidelberg
,
Claus Wolff-Menzler
2   Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Göttingen
,
Michael Schulz
3   Fachhochschule der Diakonie Bielefeld
7   Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Halle (Saale)
,
Rüdiger Noelle
3   Fachhochschule der Diakonie Bielefeld
,
Hauke Felix Wiegand
5   Klinik für Seelische Gesundheit im Alter und Verhaltensmedizin, Alexianer St. Joseph Krankenhaus, Berlin-Weißensee
,
Florian Seemüller
6   KBO-Lech-Mangfall-Kliniken, Garmisch-Partenkirchen
,
Andre Nienaber
4   LWL-Klinikum Gütersloh
7   Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Halle (Saale)
,
Michael Löhr
3   Fachhochschule der Diakonie Bielefeld
7   Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Halle (Saale)
,
Frank Godemann
5   Klinik für Seelische Gesundheit im Alter und Verhaltensmedizin, Alexianer St. Joseph Krankenhaus, Berlin-Weißensee
› Author Affiliations
Further Information

Publication History

Publication Date:
17 April 2015 (online)

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Zusammenfassung

Ziel: Überprüfung der Diagnosecodierung metabolischer Risikofaktoren (MR) bei psychisch kranken Patienten.

Methode: Anhand des „Versorgungsindikatoren in der Psychiatrie und Psychosomatik Datensatzes“ Beschreibung der Häufigkeit der Diagnosecodierung von MR.

Ergebnisse: Im Vergleich zu bekannten Prävalenzzahlen waren Adipositas (2,8 %), Nikotinabhängigkeit (4,2 %), Hyperlipidämien (2,8 %) deutlich, Diabetes (6,8 %) und arterielle Hypertonie (17,7 %) leicht unterdiagnostiziert.

Schlussfolgerung: MR sind bei psychiatrischen Patienten unzureichend dokumentiert, vermutlich auch unzureichend behandelt.

Abstract

Objective: Individuals suffering from mental illness have one to two decades reduced life expectancy. The increased morbidity and mortality is mainly due to cardiometabolic disorders. Despite these numbers, international studies give evidence that diagnoses and treatment of metabolic risk factors in psychiatric patients is insufficient. We assume that in Germany metabolic risk factors are also underdiagnosed and insufficiently treated.

Methods: We tested for the frequency of diagnoses of the metabolic risk factors obesity, nicotine dependence and abuse, disorders of lipid metabolism, hypertension and diabetes in 139 307 cases of residential treatment and semi-residential care in 47 psychiatric hospitals in Germany in the year 2012. Data were derived from the VIPP(indicators of treatment quality in psychiatry and psychosomatic medicine)-project, a project that comprises the routine data of psychiatric hospitals, that are sent to the InEK (institute for the lump sum payment system for hospitals). Frequencies were compared with prevalence of metabolic risk factors in the German population and prevalences of metabolic risk factors found in psychiatric patients in international studies.

Results: In particular obesity (2.8 %), disorders of lipid metabolism (2.8 %) and nicotin dependence (4.2 %) were underdiagnosed. We assume that also diabetes (6.8 %) and hypertension (17.7 %) were underdiagnosed.

Conclusion: The results give evidence that metabolic risk factors are underdiagnosed and possibly insufficiently treated in German psychiatric hospitals. We cannot exclude that the results might also be due to poor documentation. It remains to be seen if the introduction of the PEPP (the new lump sum payment system in German psychiatry) will heighten the level of attention for metabolic risk factors and their treatment.

Schlüsselwörter

metabolische Risikofaktoren - unterdiagnostiziert - psychiatrische Erkrankungen

Keywords

metabolic risk factors - underdiagnosed - psychiatric disorders

* VIPP: Versorgungsrelevante Indikatoren in der Psychiatrie und Psychosomatik; Steuerungsgruppe: Frank Godemann (Sprecher), Claus Woff-Menzler (stellvertretender Sprecher), Florian Seemüller, Roland Nitschke, Michael Löhr, Hans-Joachim Salize (ZI-Mannheim), Iris Hauth (DGPPN), Gerhard Längle (Bundesdirektorenkonferenz), Arno Deister (ackpa)


 

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