Die Behandlung der Anorexia nervosa

Zusammenfassung

Die Anorexia nervosa („Magersucht“) ist eine relativ seltene, jedoch durch hohe Komorbidität und Letalität sowie eine Tendenz zur Chronifizierung belastete psychische Störung. Ihre Behandlung sollte möglichst früh und konsequent erfolgen. Sie gestaltet sich aufgrund des weitgehend ich-syntonen Charakters der Störung typischerweise schwierig und wechselhaft, was hohe Anforderungen an die Moral und Kompetenz der Behandler stellt. Wesentlich für den Behandlungserfolg sind eine vollständige Ernährungsrehabilitation sowie eine langfristig angelegte, entwicklungsfördernde Psychotherapie. Begleitend sind oft Pharmakotherapie bzw. komplementäre Behandlungsangebote, wie etwa betreute Wohngruppen, erforderlich. Auch wenn die Evidenzbasierung des probaten therapeutischen Vorgehens bis heute als schwach angesehen werden muss, haben sich die wesentlichen therapeutischen Regeln und Maßnahmen in der Praxis bewährt.

Summary

Anorexia nervosa is a rare psychological disease, but it shows a high co-morbidity, lethality and tends to a chronicity. The treatment should start early and should be consequent. Treatment can be difficult, because of the individual character of the disease and can be a challenge for the therapist. A complete rehabilitation of alimentation and a long-term psychotherapy are necessary for success. Addon, there should be pharmacotherapy and additional methods, like flat-sharing communities. Even though evidencebased therapy is not highly recommended, basic therapeutic rules and measures are proven.

Schlüsselwörter

Anorexia nervosa - Diagnostik - Psychotherapie - Pharmakotherapie - Ernährungsrehabilitation - „social brain“-Hypothese - „Refeeding Syndrom“

Keywords

Anorexia nervosa - diagnostic - psychotherapy - pharmacotherapy - rehabilitation of alimentation - social brain hypothesis - refeeding syndrome

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