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Fortschr Neurol Psychiatr 2003; 71(7): 358-365
DOI: 10.1055/s-2003-40562
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Depression bei körperlichen Erkrankungen - Diagnose und Therapie vor konsiliar-psychiatrischem Hintergrund

Depression in the Medically Ill: Diagnosis and Treatment Considerations in C-L Psychiatry SettingsH.-B.  Rothenhäusler1 , H.-P.  Kapfhammer1
  • 1Universitätsklinik für Psychiatrie der Karl-Franzens-Universität Graz (Vorstand: Prof. Dr. Dr. H.-P. Kapfhammer)
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Publication History

Publication Date:
14 July 2003 (online)

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Zusammenfassung

Depressionen gehören bei Allgemeinkrankenhauspatienten zu den häufigsten psychischen Störungen. Sie haben nicht selten negative Auswirkungen auf die Prognose und die Behandlung körperlicher Erkrankungen. Andererseits werden sie in der medizinischen Versorgungssituation oftmals nicht erkannt oder suffizient behandelt. Neben einem historischen Abriss der diagnostischen Konzeptualisierung der sekundären Depression gibt der Artikel einen Überblick über körperliche Erkrankungen und Medikamente mit klarer Assoziation zu Depressionen. Phänomenologische Aspekte, die von Relevanz für die Diagnosestellung einer Depression bei somatisch Kranken sind, sowie therapeutische Behandlungsrationalen im psychiatrischen Konsiliardienst werden diskutiert. Überlegungen aus konsiliarpsychiatrischer Sicht zur Wahl eines geeigneten Antidepressivums bei körperlich Kranken werden exemplarisch anhand der häufig mit Depressionen assoziierten Parkinsonerkrankung und Epilepsie erörtert.

Abstract

Depression in general hospital patients is one of the main psychiatric problems in the medically ill. It often complicates the treatment and prognosis of patients with active medical conditions. However, depression in the medically ill is frequently under-recognized and under-treated. This article reviews the historical concept of secondary depression, and gives an overview of medical conditions and medications associated with depression. Phenomenological issues in the diagnosis of depression in medically ill populations and treatment considerations in C-L psychiatry settings will be discussed. The authors have used the examples of Parkinson's disease and epilepsy commonly associated with depression to illustrate how these considerations affect the C-L psychiatrist's choice of an antidepressant in the medically ill.

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Dr. med. Hans-Bernd Rothenhäusler

Universitätsklinik für Psychiatrie der Karl-Franzens-Universität Graz

Auenbruggerplatz 31

8036 Graz

Österreich

Email: Hans-Bernd.Rothenhaeusler@klinikum-graz.at

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