Psychopharmako- und Psychotherapie bei Patienten mit minorer Depression

Zusammenfassung

Patienten mit depressiven Syndromen bei starker Beeinträchtigung des psychosozialen Funktionsniveaus, die aber die nach ICD-10 oder DSM-IV-TR erforderlichen Kriterien einer depressiven Störung nur teilweise erfüllen, sind in nervenärztlichen Praxen häufig anzutreffen. Im Folgenden werden wichtige therapeutische Ansätze bei derartigen minoren Depressionen präsentiert und deren klinische Signifikanz diskutiert. Da die Evidenzbasis für eine spezifische Pharmakooder Psychotherapie unzureichend ist, kommen aktives Monitoring oder unspezifische Beratungsund Betreuungsangebote in Betracht. Spezifische Behandlungsangebote (Antidepressiva, Psychotherapie) müssen in Erwägung gezogen werden bei Suizidalität, Suizidversuchen in der Anamnese, hohem Leidensdruck, früheren depressiven Episoden, Residualsymptomatik nach majorer Depression oder positiver Familienanamnese für affektive Störungen.

Summary

In psychiatric practices, depressive syndromes going along with considerable impairment of psychosocial functioning and only partly fulfilling the diagnostic criteria of a depressive disorder according to ICD-10 or DSM-IV-TR are frequent phenomena. In this paper, relevant therapeutic aspects of minor depression will be presented and their clinical significance will be discussed. In view of the insufficient evidence base for a specific drug therapy or psychotherapy in patients with minor depression watchful waiting, unspecific counselling and support can be considered. Specific treatment like antidepressant drugs or psychotherapy must be taken into consideration in the case of the following factors: suicidality, previous suicide attempts, high psychological strain, previous depressive episodes or residual symptoms after an episode of major depression as well as family history of affective disorders.

Schlüsselwörter

Antidepressiva - klinische Studie - minore Depression - Placebo-Verum-Differenz

Keywords

Antidepressants - clinical trial - minor depression - placebo-verum difference

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