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Depression als Systemeffekt bei rheumatoider Arthritis

Depression as a systemic feature of rheumatoid arthritis

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Zusammenfassung

Die gesellschaftliche Betrachtung von Depressionen – auch als Komorbidität bei anderen Erkrankungen wie beispielsweise rheumatoider Arthritis (RA) – hat sich in den vergangenen Jahren grundlegend verändert. Neuere Studien zeigen, dass für die Entwicklung einer Depression bei RA-Patienten insbesondere der Umgang mit der Erkrankung und ihren Auswirkungen im Alltag eine zentrale Rolle spielt. Fühlt sich der Patient hierbei seiner Erkrankung hilflos ausgeliefert und fehlen entsprechende Strategien für Lösungsansätze, so können Depressionen die Folge sein. Um dementsprechende Entwicklungen frühzeitig erkennen zu können, stehen verschiedene Verfahren wie Patientenfragebögen oder auch Patienteninterviews zur Verfügung, deren Ergebnisse im Hinblick auf die Symptomüberlappung von RA und Depressionen zu interpretieren sind. Nach der gesicherten Diagnose bietet neben der Therapie mit Antidepressiva die kognitiv-behavioral orientierte Psychotherapie die Möglichkeit, ursächliche Faktoren der Depression zu identifizieren und effektive Strategien im Umgang mit RA zu erlernen, um so das Gefühl zu erlangen, die Erkrankung zu einem gewissen Anteil auch selbstbestimmt kontrollieren zu können.

Abstract

The social recognition of depression in general and as a comorbidity in illnesses such as rheumatoid arthritis (RA) has essentially changed in recent years. Previous studies have shown that the occurrence of depression in RA patients is closely related to the individual ways of coping with disease and the corresponding impact of disease on daily life. Patients who are experiencing feelings of helplessness while facing the illness are prone to depressive disorders, especially if effective strategies for managing the impact of disease are lacking. Tools for early recognition of depression include instruments such as patient questionnaires or interview protocols which should be interpreted with caution due to the overlap of symptoms arising from RA and depression. A supplemental cognitive behavioral intervention in addition to medication with antidepressive drugs provides an opportunity to identify the underlying cause of depression and learn about effective coping strategies to at least partially maintain self-control of RA.

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Englbrecht, M., Wendler, J. & Alten, R. Depression als Systemeffekt bei rheumatoider Arthritis. Z. Rheumatol. 71, 859–863 (2012). https://doi.org/10.1007/s00393-011-0926-z

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