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Fortschr Neurol Psychiatr 2015; 83(09): 506-515
DOI: 10.1055/s-0035-1553717
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Halluzinogen-induzierte Persistierende Wahrnehmungsstörung (HPPD) und Flashback-Phänomene – Differenzialdiagnose und Erklärungsmodelle

Hallucinogen Persisting Perception Disorder (HPPD) and Flashback Phenomena – Differential Diagnosis and Explanation Models
L. Hermle
1   Psychiatrie und Psychotherapie, Christophsbad, Göppingen
,
M. Ruchsow
1   Psychiatrie und Psychotherapie, Christophsbad, Göppingen
,
K. L. Täschner
2   Forensische Psychiatrie, Institut für psychiatrische Begutachtung, Stuttgart
› Author Affiliations
Further Information

Publication History

03 July 2015

14 August 2015

Publication Date:
30 September 2015 (online)

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Zusammenfassung

Ziel dieser Arbeit ist es, einen Überblick über den Forschungsstand bezüglich „Halluzinogen-induzierter persistierender Wahrnehmungsstörung, HPPD“ und „Flashback“-Phänomenen zu geben. Die diagnostischen Merkmale und Begriffe von „Flashback“-Phänomenen und „HPPD“ nach Halluzinogeneinnahme blieben bis heute unklar und wurden seit 1994 austauschbar verwendet.

Methode: Die Literaturauswahl erfolgte mittels einer MEDLINE-Datenrecherche der Jahrgänge 1994 – 2014 mit den Suchbegriffen „Hallucinogen Persisting Perception Disorder“ (HPPD) sowie durch Sichtung weiterführender Literaturhinweise. Von weit über 100 Literaturhinweisen wurden schließlich 75 Artikel in die Auswertung einbezogen.

Ergebnisse: In Übereinstimmung mit ICD-10-Definition (F16.70) „Nachhallzustände“ (Flashback) wird der Begriff oft benutzt, um eine kurzdauernde visuelle Wahrnehmung, eine veränderte Stimmung und einen veränderten Bewusstseinszustand zu beschreiben, die den Wirkungen einer akuten Halluzinogenintoxikation entsprechen. Viele Halluzinogenkonsumenten bewerten Flashback-Phänomene positiv und teilweise als angenehm. HPPD wird im DSM-5 als visuelle Wahrnehmungsstörung beschrieben, die manchmal Monate bis Jahre persistiert und im individuellen Fall massive Stressbelastungen zur Folge hat. Die Prävalenz von HPPD ist unbekannt. Es ist erstaunlich, dass angesichts der Millionen Halluzinogenkonsumenten seit den 60er und 70er Jahren relativ wenige Kasuistiken publiziert wurden. Trotz der Vielfalt ätiologischer und therapeutischer Ansätze sind die bei HPPD zugrunde liegenden pathophysiologischen Mechanismen schwer zu fassen. Gegenwärtig scheint HPPD weiterhin ein DSM-5-genuines, aber immer noch rätselhaftes Störungsbild zu sein. Die verschiedenen Folgewirkungen und neue ätiologische und therapeutische Ansätze werden praxisrelevant dargestellt.

Abstract

Objective: The purpose of this article is to provide an overview of the current research on “Hallucinogen Persisting Perception Disorder” (HPPD) and “Flashback” phenomena. The definition and diagnostic features of “Flashback” and HPPD remained often unclear and since the 1960 s interchangeable.

Methods: Relevant literature was identified by means of a computerized MEDLINE search including the years 1994 – 2014. Finally 75 journal articles out were included in the review.

Results: Consistent with the ICD-10 (F16.70) definition “Flashback” is often used to describe brief visual perceptual, mood, and altered states of consciousness effects reminiscent of acute hallucinogen intoxication effects. Many users regard flashback phenomena as benign and even pleasant. HPPD is described in DSM-5 as a visual perceptual disorder, sometimes persisting for months or years causing severe individual distress. The prevalence of flashback and HPPD is unknown. It is considered to be remarkable in view of the relatively few case reports published out of millions of hallucinogen users since the 1960 s and 1970 s. Despite a multitude of etiological and therapeutic approaches the exact pathophysiological mechanisms underlying HPPD remain elusive. At present HPPD appears to be further a DSM-5-genuine but still puzzling disorder. The different consequences including new therapeutic approaches are discussed in clinical context.

Schlüsselwörter

Halluzinogen-induzierte Persistierende Wahrnehmungsstörung (HPPD) - Flashbacks - Drogenmissbrauch

Key words

hallucinogen persisting perception disorder (HPPD) - flashbacks - drug abuse
 

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