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PSYCH up2date 2018; 12(05): 415-431
DOI: 10.1055/a-0498-3661
Essstörungen, somatische Belastungsstörungen, Schlafstörungen und sexuelle Funktionsstörungen

Bulimia nervosa

Jennifer Svaldi
,
Brunna Tuschen-Caffier
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Mit einer Lebenszeitprävalenz von 1 – 2% ist die Bulimia nervosa keine sehr häufig auftretende psychische Störung. Sie ist jedoch mit gravierenden psychischen und körperlichen Begleiterscheinungen verbunden und nimmt unbehandelt oftmals einen chronischen Verlauf. Die kognitive Verhaltenstherapie ist die wirksamste Behandlungsmethode. Zentrale Therapiebausteine sind dabei die Normalisierung des Essverhaltens und der Körperbildstörung sowie die Reduktion dysfunktionaler Stressreaktionen.

Kernaussagen

Der Erkrankungsbeginn der BN ist in der späten Adoleszenz. Die Erkrankung wird häufig lange verheimlicht und nimmt oftmals unbehandelt einen chronischen Verlauf. Komorbide psychische und Persönlichkeitsstörungen sind häufig. Kennzeichnend für BN-Patientinnen ist eine ambivalente Therapiemotivation, die einerseits vom hohen Wunsch nach einer Genesung, andererseits von einer geringen Toleranz gegenüber Änderungen im Essverhalten und Gewicht geprägt ist. Daher ist die Förderung der Therapiemotivation durch entsprechende Techniken der Gesprächsführung sehr wichtig. Behandlungsmethode der Wahl ist die kognitive Verhaltenstherapie. Da eine rasche Reduktion des gezügelten Essverhaltens sowie der Häufigkeit unangemessener kompensatorischer Maßnahmen Prädiktoren für einen günstigen Therapieverlauf sind, sollten Interventionen, die auf eine Normalisierung des Essverhaltens abzielen, frühzeitig in der Therapie implementiert werden.

Schlüsselwörter

Essstörungen - Diagnostik - kognitive Verhaltenstherapie - Körperwahrnehmung


Publication History

Publication Date:
11 September 2018 (online)

Georg Thieme Verlag KG
Stuttgart · New York

 

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