Subscribe to RSS
DOI: 10.1055/a-2741-8651
Integrative Interpersonell-Dynamische Therapie bei Depression nach Schlaganfall
Integrative Interpersonal-Dynamic Therapy for Post-Stroke DepressionAuthors
Zusammenfassung
Depressive Symptome nach einem Schlaganfall sind ein häufiges Phänomen. Etwa ein Drittel aller Patient:innen entwickeln eine klinisch relevante depressive Symptomatik, die zu erheblichem Leiden und einer Verschlechterung der Lebensqualität und Prognose führt. Neben der existierenden psychopharmakologischen Behandlung fehlen spezifische psychotherapeutische Behandlungsoptionen für diese unterbehandelte Patient:innengruppe. Die Integrative Interpersonell-Dynamische Therapie für Depression nach Schlaganfall (INID) setzt hier an und hat zum Ziel, die persönlichen, lebenslang gewachsenen Verarbeitungsstrategien vor dem Hintergrund des Akutereignis Schlaganfall zu adressieren. INID ist eine intensive Kurzzeittherapie über 18 Sitzungen und fokussiert auf zentrale Beziehungskonflikte, die durch den Schlaganfall und eventuelle Folgen (re-)aktualisiert bzw. verschärft wurden. Dazu dienen 8 definierte Module. Auf der Basis eines dynamischen Beziehungskonfliktmodells weitere zeitgenössische psychodynamische wie behaviorale Behandlungselemente integriert. Familienangehörige werden systematisch einbezogen. INID erweitert die Behandlungsoptionen für depressiv Erkrankte nach Schlaganfall und hat somit das Potential, zur besseren Versorgung dieser vulnerablen Patient:innengruppe beizutragen.
Abstract
Poststroke depressive symptoms are a common phenomenon. About one out of three patients develop clinically relevant depressive symptoms, leading to significant suffering and a deterioration in quality of life and prognosis. In addition to existing pharmacological treatments, there is a lack of specific psychotherapeutic treatment options for this patient group. The Integrative Interpersonal-Dynamic Therapy for Depression after Stroke (INID) addresses this gap by targeting personal, lifelong interpersonal strategies in the context of the acute stroke event. INID is an intensive short-term therapy consisting of 18 sessions, focusing on core conflictual relational themes that have contributed to the depressive crisis following the experience of stroke and potential consequences. The therapy includes 8 defined modules. Based on a dynamic conflictual relationship pattern, further contemporary psychodynamic as well as cognitive-behavioral treatment elements are integrated. Family members are systematically involved as part of the process. INID expands the treatment options for stroke patients suffering from depression and thus has the potential to contribute to better care for this vulnerable patient group.
Schlüsselwörter
Depression nach Schlaganfall - Psychodynamische Psychotherapie - zentraler Beziehungskonflikt - BehandlungsmanualKeywords
Post stroke Depression - Psychodynamic psychotherapy - core conflictual relationship theme - Treatment ManualPublication History
Received: 30 August 2024
Accepted: 07 November 2025
Article published online:
03 December 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
-
Literatur
- 1 Towfighi A, Ovbiagele B, El Husseini N. et al. Poststroke depression: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2017; 48: e30-e43
- 2 Hackett ML, Pickles K. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. International journal of stroke : official journal of the International Stroke Society 2014; 9: 1017-1025
- 3 Werheid K. A Two-Phase Pathogenetic Model of Depression after Stroke. Gerontology. 2015; 62: 33-39
- 4 Kutlubaev MA, Hackett ML. Part II: predictors of depression after stroke and impact of depression on stroke outcome: an updated systematic review of observational studies. Int J Stroke 2014; 9: 1026-1036
- 5 Wijeratne T, Sales C. Understanding Why Post-Stroke Depression May Be the Norm Rather Than the Exception: The Anatomical and Neuroinflammatory Correlates of Post-Stroke Depression. J Clin Med 2021; 10
- 6 Yuvaraj R, Murugappan M, Norlinah MI. et al. Review of emotion recognition in stroke patients. Dement Geriatr Cogn Disord 2013; 36: 179-196
- 7 Medeiros GC, Roy D, Kontos N. et al. Post-stroke depression: A 2020 updated review. Gen Hosp Psychiatry. 2020; 66: 70-80
- 8 Zhou H, Wei Y-J, Xie G-Y. Research progress on post-stroke depression. Exp Neurol 2024; 373: 114660
- 9 de Man-van Ginkel JM, Hafsteinsdóttir TB, Lindeman E. et al. Clinical Manifestation of Depression after Stroke: Is It Different from Depression in Other Patient Populations?. PLoS ONE 2015; 10: e0144450
- 10 Cumming TB, Churilov L, Skoog I. et al. Little evidence for different phenomenology in poststroke depression. Acta Psychiatr Scand 2010; 121: 424-430
- 11 Ladwig S, Werheid K, Südmeyer M. et al. Predictors of post-stroke depression: Validation of established risk factors and introduction of a dynamic perspective in two longitudinal studies. Front Psychiatry 2023; 14
- 12 Ladwig S, Zhou Z, Xu Y. et al. Comparison of Treatment Rates of Depression After Stroke Versus Myocardial Infarction. A Systematic Review and Meta-Analysis of Observational Data. Psychosom Med 2018;
- 13 Werheid K, Volz M, Ladwig S. et al. Too Much and Too Little: Antidepressant Treatment in Stroke Survivors during the First Year. JIN 2022; 21
- 14 Kruse J, Kampling H, Bouami S. et al. Ambulante psychotherapeutische Versorgung in Deutschland. Evaluation der Strukturreform. Deutsches Ärzteblatt International 2024; 121: 315-322
- 15 Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Unipolare Depression – Langfassung, Version 3.2. 2022 [cited: 2024-08-29]
- 16 Allida S, Cox KL, Hsieh C-F. et al Pharmacological, psychological and non-invasive brain stimulation interventions for preventing depression after stroke. Cochrane Database Syst Rev 2020; 5: CD003689
- 17 Xie J, Geng X, Fan F. et al. The efficacy of therapies for post-stroke depression in aging: An umbrella review. Frontiers in aging neuroscience 2022; 14: 993250
- 18 Steinert C, Dinger U, Schauenburg H. et al. Psychodynamische Kurzzeittherapie der Depression – ein evidenzbasiertes vereinheitlichtes Therapieprotokoll. Psychother Psychosom Med Psychol 2016; 66: 9-20
- 19 Barlow DH, Farchione TJ, Sauer-Zavala S. et al. Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. Oxford: University Press; 2017
- 20 Luborsky L. Principles of psychoanalytic psychotherapy. Manual for supportive-expressive treatment. New York: Basic Books; 1984
- 21 Scholte op Reimer WJ, de Haan RJ, Rijnders PT. et al. The burden of caregiving in partners of long-term stroke survivors. Stroke 1998; 29: 1605-1611
- 22 Franzén-Dahlin Å, Hoang MT, von Koch L. et al. A cross-sectional study of associations between stroke survivors’ disability and caregiver burden dimensions. Journal of Clinical Neuroscience 2025; 141: 111599 Advance online publication
- 23 Bateman A, Fonagy P. Mentalization based treatment for borderline personality disorder. World Psychiatry 2010; 9: 11-15
- 24 Dinger U, Schauenburg H, Volz M. Integrative interpersonell-dynamische Therapie bei Depression nach Schlaganfall: Behandlungsmanual. Unveröffentlichtes Manuskript, Heinrich-Heine Universität, Düsseldorf. 2024
- 25 Volz M, Mundiyanapurath S, Schauenburg H. et al. Integrative-Interpersonal Dynamic Therapy for Post-Stroke Depression (INID): Study protocol of a randomized-controlled pilot trial. BMJ Open 2023; 13: e077656
