Psychosoziale Faktoren bei depressiven Erkrankungen

Zusammenfassung:

Der vorliegende Artikel gibt einen Überblick über die Bedeutung psychosozialer Faktoren für das Auftreten und den Verlauf depressiver Erkrankungen. Dabei wird vor allem auf die Arbeiten von G.W. Brown u. Mitarb. Bezug genommen, die seit den 70er Jahren eine Vielzahl von Studien zur Pathogenese der Depression durchgeführt haben. Es werden Ansätze für Interventionsstrategien vorgestellt, die sich auf mögliche protektive bzw. prophylaktische Effekte psychosozialer Faktoren beziehen. Es soll dargelegt werden, dass eine systematische Behandlung der Depression neben spezifischer Psychotherapie und antidepressiver Pharmakotherapie auch psychosoziale Interventionen umfassen sollte. Zu diesem Bereich liegen bisher kaum kontrollierte Studien vor. Interessante Ansätze sind „befriending”-Projekte mit ehrenamtlichen Mitarbeitern sowie psychosoziale Interventionen bei Risikogruppen, z. B. alleinerziehenden Müttern. Mit „befriending” ist dabei eine spezifische Art der Beziehungsaufnahme gemeint, die sich strukturell von der Beziehung zwischen Therapeut und Klient unterscheidet. Interventionen dieser Art könnten angesichts der Häufigkeit depressiver Erkrankungen eine wichtige, Public-Health-relevante Intervention darstellen.

Psychosocial Factors and Depressive Disorders: Pathogenetic Model and Intervention Strategies:

This article gives an overview of the impact of psychosocial factors on the manifestation and course of depressive disorders. It focusses primarily on the large body of work done by G.W. Brown and his coworkers since the 1970s on the pathogenesis of depression. A systematic approach to the treatment of depression should contain not only specific psychotherapy as well as antidepressant drug treatment, but should also include interventions of a psychosocial nature. There are so far hardly any controlled studies in this area. So-called “befriending” projects and psychosocial support schemes for at-risk groups, e. g. single mothers, promise to be interesting approaches. Befriending in this context means a specific kind of relationship that differs structurally from the relationship between a therapist and his client. Interventions of this type on the basis of the prevalence of depressive disorders could have a substantial impact on public health.

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