Zusammenfassung
In der Gesundheitsversorgung nimmt Asthma bronchiale eine bedeutsame Rolle ein. Aufgrund des geschlechtsunabhängigen Vorkommens in allen Altersstufen zählt Asthma bronchiale zu den großen Volkskrankheiten mit entsprechend hohem Behandlungsbedarf. Ein substanzieller Teil der erkrankten Personen leidet unter komorbiden psychischen Belastungen und Störungen. Ziel dieser Studie ist, einen Überblick über die Häufigkeit und Art komorbider psychischer Belastungen und Störungen zu geben. Hierzu wurden für den Zeitraum von 1980 - 2002 Studien analysiert, die die Prävalenz psychischer Belastungen und Störungen bei Patienten mit Asthma bronchiale untersuchten. Auf der Basis einer umfassenden Datenbankrecherche mittels „MEDLINE” wurden 26 Originalstudien ermittelt. Patienten mit Asthma weisen mit Prävalenzraten von bis zu 41 % und 52 % häufig affektive und Angststörungen auf. Zwischen der Schwere des Asthmas und dem Vorliegen einer psychischen Belastung oder Störung kann kein signifikanter Zusammenhang aufgezeigt werden. Hingegen sind Patienten mit schwer einzustellendem Asthma (Brittle Asthma) belasteter als Patienten mit gut behandelbarem Asthma. Patienten mit guter Compliance weisen eine deutlich niedrigere Prävalenz depressiver Belastungen auf als Patienten mit schlechter Compliance. Insgesamt zeichnen sich die analysierten Studien durch eine große Heterogenität hinsichtlich der verschiedenen Erhebungsinstrumente und Studiendesigns aus, wodurch die Ergebnisinterpretation erheblich eingeschränkt wird. Es bedarf in Zukunft repräsentativer, epidemiologischer Studien, um generalisierbare Prävalenzraten komorbider psychischer Belastungen und Störungen bei Asthma bronchiale zu erhalten.
Abstract
Bronchial asthma occurs independently from gender and in all age groups belonging to the frequent diseases with a high demand for treatment. A part of those affected suffer from comorbid mental burden and disorders. The review analyses studies investigating the prevalence of mental burden and disorders in patients with bronchial asthma. The database MEDLINE was searched for studies published from 1980 to 2002. Patients with bronchial asthma frequently show mood and anxiety disorders, with prevalence rates up to 41 % and 52 %. There is no significant correlation between the severity of asthma and the existence of a mental burden or disorder. However, persons with difficult-to-treat asthma (brittle asthma) show more mental burden than patients with controllable symptoms. Compliant patients show a lower prevalence rate of depressive burden than noncompliant patients. The reviewed studies are very heterogeneous with respect to their methodology and the investigated samples limiting the interpretation of their results significantly. In the future more well-designed epidemiological studies have to be performed to achieve valid and representative conclusions about the prevalence rates of mental burden and disorders in patients with bronchial asthma.
Key words
Bronchial asthma - respiratory tract diseases - epidemiology - comorbidity - mental disorders - anxiety - depression
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Harald BaumeisterDipl.-Psych.
Abteilung für Psychiatrie und Psychotherapie · Universitätsklinikum Freiburg
Hauptstraße 5
79104 Freiburg
eMail: harald_baumeister@psyallg.ukl.uni-freiburg.de