Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
-
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Jan 2011
[Psychological comorbidity. A challenge in acute care].
Comorbid mental disorders are common in patients with chronic conditions. It can be assumed that around 30% of all inpatients have some kind of mental disorder. Most frequent are depressive disorders, anxiety disorders, somatoform disorders, and addictive disorders. ⋯ However, despite its importance comorbid mental disorders are often not recognized or appropriately treated. Wherever possible, patients with psychological issues should be presented to a psychosomatic or psychiatric consultation-liaison service for further diagnosis and treatment. To treat patients with comorbid mental disorders, physicians must be well experienced in psychotherapeutic treatment and a collaborative interdisciplinary working environment must have been established.
-
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Jan 2011
[Comorbidity of chronic somatic illness and psychological disorders. Problems in outpatient mental health care].
Especially when chronic, the presence of a somatic disorder is accompanied by various levels of psychological stress, which can range up to comorbidity with mental disorders. In addition, chronic somatic diseases and mental disorders are often interdependent. Treatment for persons with mental and somatic comorbidity is frequently offered in the context of medical rehabilitation. ⋯ In addition to the expert skills of psychotherapists, interprofessional training, basic knowledge, and communication with physicians are necessary. The present article outlines conditions for outpatient psychotherapeutic care of persons with chronic somatic diseases and addresses central problems in the differential diagnosis of mental and somatic disorders as well as treatment indications when comorbidity is present. Selected examples for the diagnosis and treatment of patients with cardiovascular disorder and diabetes, respectively, illustrate these aspects.
-
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Jan 2011
[Somatic-psychiatric comorbidity. Definition and basic concept].
Patients with a complex history of illness and multiple diseases are increasingly the rule rather than the exception. To describe these patients, the term comorbidity is frequently used. The present overview provides a definition and description of the construct comorbidity. ⋯ The description of comorbidity comprises definition of the term against the similar constructs multimorbidity, burden of illness, and patient complexity as well as a subcategorization of types of comorbidity. With regard to measuring comorbidity, possibilities of aggregating comorbidities into a single sum score are presented. Finally, specific aspects of somatic-psychiatric comorbidity are critically discussed.
-
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Jan 2011
[Screening and diagnostic procedures of comorbid mental disorders in somatic illnesses].
Because of the close association between physical diseases and mental disorders, early and precise detection of mental disorders is of high clinical importance in medical care. Specific aspects have to be considered for diagnosis of mental disorders in somatic diseases. Therefore, the important categories of mental disorders related to chronic somatic illnesses are discussed and specified instruments for dimensional (screening tools) and categorical (clinical interview) diagnostic procedures are presented. Furthermore, the article introduces current developments of new instruments from a methodological point of view and, with regard to content, meeting the specific problems of psychiatric diagnosis in somatic illnesses.
-
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Jan 2011
[Psychological comorbidity. Diagnosis and indications for further treatment in medical rehabilitation].
Psychosocial comorbidity in somatic disorders is considered an important problem from the epidemiological point of view as well as from the perspective of care. Therefore, the different origins or development are etiologically discussed. In this article, an overview of the prevalence of psychiatric comorbidity of musculoskeletal disorders, using chronic back pain in somatic medical rehabilitation as an example, is given. ⋯ It was found that three papers reported data on the prevalence of psychological comorbidity and addressed diagnostic screening. This is discussed from a perspective that addresses potential barriers on the part of therapists as well as the patients. More attention should be directed to implementing the appropriate screening and follow-up care.