Psychotherapie bei Substanzabhängigkeit und psychischer Komorbidität

Bei Menschen mit Substanzkonsumstörungen treten besonders häufig affektive Störungen, schizophrene Psychosen, Angsterkrankungen und posttraumatische Belastungsstörungen auf. Die richtige Diagnosestellung und eine störungsspezifische Psychotherapie sind für den weiteren Erkrankungsverlauf entscheidend. Obwohl eine integrierte Behandlung der komorbiden Störungen in aktuellen Leitlinien empfohlen wird, wird sie durch viele Barrieren erschwert.

Abstract

Substance use disorders (SUD) frequently co-occur with other mental disorders, particularly affective disorders, anxiety disorders, schizophrenia, and post-traumatic stress disorder (PTSD). This can exacerbate the course of both conditions, in many cases leading to longer suffering, higher relapse rates, and poorer prognoses. This article describes challenges for health care and evidence-based psychotherapeutic approaches for treating SUD and psychiatric comorbidities. Key approaches such as Motivational Interviewing (MI) and Cognitive Behavioral Therapy (CBT) have proven particularly effective. Current guidelines recommend integrated treatment of both disorders to enable a coherent and flexible therapeutic process. However, structural barriers, especially in outpatient settings, continue to limit access to integrated care. The article concludes by discussing specialized treatment approaches for various comorbidities and emphasizes the need for further research and specialized care offerings.

Schlüsselwörter

Komorbidität - Substanzkonsumstörungen - Versorgungsbarrieren - Leitlinienempfehlungen

Key words

comorbidity - substance use disorders - barriers to health care - guideline recommendations

Publication History

Article published online:
06 February 2025

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