Download PDF
Zeitschrift für Palliativmedizin 2016; 17(06): 289-301
DOI: 10.1055/s-0042-118765
Fort- und Weiterbildung
© Georg Thieme Verlag KG Stuttgart · New York

Psychotherapie in der palliativen Versorgung[1]

Psychotherapy in Palliative Care
A. Mehnert
1   Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig
,
F. Nauck
2   Klinik für Palliativmedizin, Universitätsmedizin Göttingen
› Author Affiliations
Further Information

Publication History

Publication Date:
24 November 2016 (online)

Also available at
    Permissions and Reprints

Lernziele

Nach dieser Lektüre werden Sie

  • die häufigsten psychosozialen Belastungen bei Patienten mit einer fortgeschrittenen lebensbedrohlichen Erkrankung kennen

  • einen Einblick in Besonderheiten der Diagnostik psychosozialer Belastungen und psychischer Störungen bei schwer kranken Patienten erhalten

  • einen Überblick über zentrale Konzepte und Zielsetzungen psychotherapeutischer Interventionen bei Patienten mit einer fortgeschrittenen lebensbedrohlichen Erkrankung erhalten

  • besondere psychotherapeutische Anforderungen in der palliativen Versorgung kennen.

1 Erstveröffentlichung in: Psychother Psych Med 2015; 65: 387 – 397


 

  • Literatur

  • 1 World Health Organization (WHO). Cancer pain relief. Genf: World Health Organisation; 1990
    Google Scholar
  • 2 Kaasa S, Loge JH. Quality of life in palliative care: principles and practice. In: Cherny NI, Fallon M, Kaasa S, et al., eds. Oxford Textbook of Palliative Medicine. Oxford: University Press; 2015: 1198-1209
    CrossrefGoogle Scholar
  • 3 Irwin S, von Gunten C. The role of palliative care in cancer care transitions. In: Holland J, Breitbart W, Jacobsen P, et al., eds. Psycho-Oncology. New York: Oxford University Press; 2010: 277-283
    CrossrefGoogle Scholar
  • 4 Smith TJ, Temin S, Alesi ER et al. American Society of Clinical Oncology Provisional Clinical Opinion: The Integration of Palliative Care Into Standard Oncology Care. J Clin Oncol 2012; 30: 880-887
    CrossrefPubMedGoogle Scholar
  • 5 Li M, Hales S, Rodin G. Adjustment Disorders. In: Holland J, Breitbart W, Jacobsen P, et al., Hrsg. Psycho-Oncology. New York: Oxford University Press; 2010: 303-310
    CrossrefGoogle Scholar
  • 6 Girgis A, Waller A. Palliative care needs and assessment tools. In: Cherny NI, Fallon M, Kaasa S, et al., eds. Oxford textbook of palliative medicine. Oxford: University Press; 2015: 363-375
    CrossrefGoogle Scholar
  • 7 Chochinov HM, Hassard T, McClement S et al. The landscape of distress in the terminally ill. J Pain Symptom Manage 2009; 38: 641-649
    CrossrefPubMedGoogle Scholar
  • 8 Vehling S, Mehnert A. Symptom burden, loss of dignity, and demoralization in patients with cancer: a mediation model. Psychooncology 2014; 23: 283-290
    CrossrefPubMedGoogle Scholar
  • 9 Tan A, Zimmermann C, Rodin G. Interpersonal processes in palliative care: an attachment perspective on the patient-clinician relationship. Palliat Med 2005; 19: 143-150
    CrossrefPubMedGoogle Scholar
  • 10 Rodin G, Walsh A, Zimmermann C et al. The contribution of attachment security and social support to depressive symptoms in patients with metastatic cancer. Psychooncology 2007; 16: 1080-1091
    CrossrefPubMedGoogle Scholar
  • 11 Vehling S, Oechsle K, Koch U et al. Receiving palliative treatment moderates the effect of age and gender on demoralization in patients with cancer. PloS one 2013; 8: e59417
    CrossrefPubMedGoogle Scholar
  • 12 Ziegler L, Hill K, Neilly L et al. Identifying psychological distress at key stages of the cancer illness trajectory: a systematic review of validated self-report measures. J Pain Symptom Manage 2011; 41: 619-636
    CrossrefPubMedGoogle Scholar
  • 13 Oechsle K, Wais MC, Vehling S et al. Relationship between symptom burden, distress, and sense of dignity in terminally ill cancer patients. J Pain Symptom Manage 2014; 48: 313-321
    CrossrefPubMedGoogle Scholar
  • 14 Hudson PL, Kristjanson LJ, Ashby M et al. Desire for hastened death in patients with advanced disease and the evidence base of clinical guidelines: a systematic review. Palliat Med 2006; 20: 693-701
    CrossrefPubMedGoogle Scholar
  • 15 Singer S, Das-Munshi J, Brähler E. Prevalence of mental health conditions in cancer patients in acute care – a meta-analysis. Ann Oncol 2010; 21: 925-930
    CrossrefPubMedGoogle Scholar
  • 16 Mehnert A, Brähler E, Faller H et al. Four-week prevalence of mental disorders in patients with cancer across major tumor entities. J Clin Oncol 2014; 32: 3540-3546
    CrossrefPubMedGoogle Scholar
  • 17 Mitchell AJ, Chan M, Bhatti H et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol 2011; 12: 160-174
    CrossrefPubMedGoogle Scholar
  • 18 Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C.: American Psychiatric Association; 2013
    Google Scholar
  • 19 Miovic M, Block S. Psychiatric disorders in advanced cancer. Cancer 2007; 110: 1665-1676
    CrossrefPubMedGoogle Scholar
  • 20 Mehnert A, Vehling S, Scheffold K et al. Prävalenz von Anpassungsstörung, Akuter und Posttraumatischer Belastungsstörung sowie somatoformen Störungen bei Krebspatienten. Psychother Psychosom Med Psychol 2013; 63: 466-472
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Vehling S, Koch U, Ladehoff N et al. Prevalence of affective and anxiety disorders in cancer: systematic literature review and meta-analysis. Psychother Psychosom Med Psychol 2012; 62: 249-258
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Roth AJ, Massie MJ. Anxiety and its management in advanced cancer. Curr Opin Support Palliat Care 2007; 1: 50-56
    CrossrefPubMedGoogle Scholar
  • 23 Teunissen SCCM, de Graeff A, Voest EE et al. Are anxiety and depressed mood related to physical symptom burden? A study in hospitalized advanced cancer patients. Palliat Med 2007; 21: 341-346
    CrossrefPubMedGoogle Scholar
  • 24 Roy-Byrne PP, Davidson KW, Kessler RC et al. Anxiety disorders and comorbid medical illness. Gen Hosp Psychiatry 2008; 30: 208-225
    CrossrefPubMedGoogle Scholar
  • 25 Delgado-Guay M, Parsons HA, Li Z et al. Symptom distress in advanced cancer patients with anxiety and depression in the palliative care setting. Support Care Cancer 2009; 17: 573-579
    CrossrefPubMedGoogle Scholar
  • 26 Kolva E, Rosenfeld B, Pessin H et al. Anxiety in terminally ill cancer patients. J Pain Symptom Manage 2011; 42: 691-701
    CrossrefPubMedGoogle Scholar
  • 27 Passik S, Kirsh K, Lloyd-Williams M. Anxiety and adjustment disorders. In: Lloyd-Williams M, ed. Psychosocial issues in palliative care. New York: Oxford University Press; 2008: 115-127
    CrossrefGoogle Scholar
  • 28 Levin T, Alici Y. Anxiety Disorders. In: Holland J, Breitbart W, Jacobsen P, et al., eds. Psycho-Oncology. New York: Oxford University Press; 2010: 324-331
    CrossrefGoogle Scholar
  • 29 Massie MJ. Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr 2004; 57-71
    PubMedGoogle Scholar
  • 30 Pessin H, Evcimen YAA, Breitbart W. Diagnosis, assessment, and treatment of depression in palliative care. In: Lloyd-Williams M, ed. Psychosocial issues in palliative care. New York: Oxford University Press; 2008
    CrossrefGoogle Scholar
  • 31 Wasteson E, Brenne E, Higginson IJ et al. Depression assessment and classification in palliative cancer patients: a systematic literature review. Palliat Med 2009; 23: 739-753
    CrossrefPubMedGoogle Scholar
  • 32 O’Connor M, White K, Kristjanson LJ et al. The prevalence of anxiety and depression in palliative care patients with cancer in Western Australia and New South Wales. Med J Aust 2010; 193 (Suppl. 05) S44-47
    PubMedGoogle Scholar
  • 33 Lo C, Zimmermann C, Rydall A et al. Longitudinal study of depressive symptoms in patients with metastatic gastrointestinal and lung cancer. J Clin Oncol 2010; 28: 3084-3089
    CrossrefPubMedGoogle Scholar
  • 34 Mellor D, McCabe MP, Davison TE et al. Barriers to the Detection and Management of Depression by Palliative Care Professional Carers Among Their Patients: Perspectives From Professional Carers and Patients’ Family Members. Am J Hosp Palliat Care 2012; 30: 11-20
    PubMedGoogle Scholar
  • 35 Chochinov HM, Wilson KG, Enns M et al. Prevalence of depression in the terminally ill: effects of diagnostic criteria and symptom threshold judgements. Am J Psychiatry 1994; 151: 537-540
    CrossrefPubMedGoogle Scholar
  • 36 Breitbart W, Bruera E, Chochinov H et al. Neuropsychiatric syndromes and psychological symptoms in patients with advanced cancer. J Pain Symptom Manage 1995; 10: 131-141
    CrossrefPubMedGoogle Scholar
  • 37 Rodin G, Lo C, Mikulincer M et al. Pathways to distress: the multiple determinants of depression, hopelessness, and the desire for hastened death in metastatic cancer patients. Soc Sci Med 2009; 68: 562-569
    CrossrefPubMedGoogle Scholar
  • 38 Solano JP, Gomes B, Higginson IJ. A Comparison of Symptom Prevalence in Far Advanced Cancer, AIDS, Heart Disease, Chronic Obstructive Pulmonary Disease and Renal Disease. J Pain Symptom Manage 2006; 31: 58-69
    CrossrefPubMedGoogle Scholar
  • 39 Miller K, Massie MJ. Depressive Disorders. In: Holland J, Breitbart W, Jacobsen P, et al., eds. Psycho-Oncology. New York: Oxford University Press; 2010: 311-318
    CrossrefGoogle Scholar
  • 40 de Figueiredo JM, Frank JD. Subjective incompetence, the clinical hallmark of demoralization. Compr Psychiatry 1982; 23: 353-363
    CrossrefPubMedGoogle Scholar
  • 41 de Figueiredo JM. Depression and demoralization: phenomenologic differences and research perspectives. Compr Psychiatry 1993; 34: 308-311
    CrossrefPubMedGoogle Scholar
  • 42 Kissane DW, Clarke DM, Street AF. Demoralization syndrome – a relevant psychiatric diagnosis for palliative care. J Palliat Care 2001; 17: 12-21
    PubMedGoogle Scholar
  • 43 Clarke DM, Kissane DW. Demoralization: its phenomenology and importance. Aust N Z J Psychiatry 2002; 36: 733-742
    CrossrefPubMedGoogle Scholar
  • 44 Robinson S, Kissane DW, Brooker J et al. A Review of the Construct of Demoralization: History, Definitions, and Future Directions for Palliative Care. Am J Hosp Palliat Care 2014; DOI: 10.1177/1049909114553461.
    PubMedGoogle Scholar
  • 45 Robinson S, Kissane DW, Brooker J et al. A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research. J Pain Symptom Manage 2015; 49: 595-610
    CrossrefPubMedGoogle Scholar
  • 46 Breitbart W, Rosenfeld B, Gibson C et al. Impact of treatment for depression on desire for hastened death in patients with advanced AIDS. Psychosomatics 2010; 51: 98-105
    CrossrefPubMedGoogle Scholar
  • 47 Rosenstein DL. Depression and end-of-life care for patients with cancer. Dialogues Clin Neurosci 2011; 13: 101-108
    PubMedGoogle Scholar
  • 48 Henderson JM, Ord RA. Suicide in head and neck cancer patients. J Oral Maxillofac Surg 1997; 55: 1217-1221
    CrossrefPubMedGoogle Scholar
  • 49 Druss B, Pincus H. Suicidal ideation and suicide attempts in general medical illnesses. Arch Intern Med 2000; 160: 1522-1526
    CrossrefPubMedGoogle Scholar
  • 50 Akechi T, Okamura H, Yamawaki S et al. Why do some cancer patients with depression desire an early death and others do not?. Psychosomatics 2001; 42: 141-145
    CrossrefPubMedGoogle Scholar
  • 51 Akechi T, Okamura H, Nishiwaki Y et al. Predictive factors for suicidal ideation in patients with unresectable lung carcinoma. Cancer 2002; 95: 1085-1093
    CrossrefPubMedGoogle Scholar
  • 52 Rasic DT, Belik S, Bolton JM et al. Cancer, mental disorders, suicidal ideation and attempts in a large community sample. Psychooncology 2008; 17: 660-667
    CrossrefPubMedGoogle Scholar
  • 53 Akechi T, Okamura H, Nakano T et al. Gender differences in factors associated with suicidal ideation in major depression among cancer patients. Psychooncology 2010; 19: 384-389
    CrossrefPubMedGoogle Scholar
  • 54 Khan L, Wong R, Li M et al. Maintaining the Will to Live of Patients With Advanced Cancer. Cancer J 2010; 16: 524-531
    CrossrefPubMedGoogle Scholar
  • 55 Pessin H, Olden M, Jacobson C et al. Clinical assessment of depression in terminally ill cancer patients: a practical guide. Palliat Support Care 2005; 3: 319-324
    PubMedGoogle Scholar
  • 56 Cassem EH. Depression and anxiety secondary to medical illness. Psychiatr Clin North Am 1990; 13: 597-612
    PubMedGoogle Scholar
  • 57 Endicott J. Measurement of depression in patients with cancer. Cancer 1984; 53 (Suppl. 10) 2243-2249
    CrossrefPubMedGoogle Scholar
  • 58 Mehnert A, Müller D, Lehmann C et al. Die deutsche Version des NCCN Distress-Thermometers. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie 2006; 54: 213-223
    CrossrefPubMedGoogle Scholar
  • 59 Kelly B, McClement S, Chochinov HM. Measurement of psychological distress in palliative care. Palliat Med 2006; 20: 779-789
    CrossrefPubMedGoogle Scholar
  • 60 Osborn RL, Demoncada AC, Feuerstein M. Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med 2006; 36: 13-34
    CrossrefPubMedGoogle Scholar
  • 61 Faller H, Schuler M, Richard M et al. Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol 2013; 31: 782-793
    Google Scholar
  • 62 Watson M, Kissane DW eds. Handbook of Psychotherapy in Cancer Care. West Sussex: John Wiley & Sons; 2011
    CrossrefGoogle Scholar
  • 63 Schulz-Kindermann F. Psychoonkologie: Grundlagen und psychotherapeutische Praxis. Weinheim: Beltz; 2013
    Google Scholar
  • 64 Goodwin PJ, Leszcz M, Ennis M et al. The effect of group psychosocial support on survival in metastatic breast cancer. New Engl J Med 2001; 345: 1719-1726
    CrossrefPubMedGoogle Scholar
  • 65 Kissane D. Beyond the psychotherapy and survival debate: the challenge of social disparity, depression and treatment adherence in psychosocial cancer care. Psychooncology 2009; 18: 1-5
    CrossrefPubMedGoogle Scholar
  • 66 Lederberg M, Holland J. Supportive psychotherapy in cancer care: an essential ingredient of all therapy. In: Watson M, Kissane DW, eds. Handbook of Psychotherapy in Cancer Care. West Sussex: John Wiley & Sons; 2011: 3-14
    CrossrefGoogle Scholar
  • 67 Meyer TJ, Mark MM. Effects of psychosocial interventions with adult cancer patients: a meta-analysis of randomized experiments. Health Psychol 1995; 14: 101-108
    CrossrefPubMedGoogle Scholar
  • 68 Redd WH, Montgomery GH, DuHamel KN. Behavioral intervention for cancer treatment side effects. J Natl Cancer Inst 2001; 93: 810-823
    PubMedGoogle Scholar
  • 69 Horne D, Watson M. Cognitive-Behavioral Therapies in Cancer Care. In: Watson M, Kissane DW, eds. Handbook of Psychotherapy in Cancer Care. West Sussex: John Wiley & Sons; 2011: 15-26
    CrossrefGoogle Scholar
  • 70 Lewis EJ, Sharp DM. Relaxation and Image Based Therapy. In: Watson M, Kissane DW, eds. Handbook of Psychotherapy in Cancer Care. West Sussex: John Wiley & Sons; 2011: 49-58
    CrossrefGoogle Scholar
  • 71 Payne D. Mindfulness Interventions for Cancer Patients. In: Watson M, Kissane DW, eds. Handbook of Psychotherapy in Cancer Care. West Sussex: John Wiley & Sons; 2011: 39-47
    CrossrefGoogle Scholar
  • 72 Nissim R, Freeman E, Lo C et al. Managing Cancer and Living Meaningfully (CALM): a qualitative study of a brief individual psychotherapy for individuals with advanced cancer. Palliat Med 2012; 26: 713-721
    CrossrefPubMedGoogle Scholar
  • 73 Lo C, Hales S, Jung J et al. Managing Cancer And Living Meaningfully (CALM): phase 2 trial of a brief individual psychotherapy for patients with advanced cancer. Palliat Med 2014; 28: 234-242
    CrossrefPubMedGoogle Scholar
  • 74 Breitbart W, Rosenfeld B, Pessin H et al. Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer. J Clin Oncol 2015; 33: 749-754
    CrossrefPubMedGoogle Scholar
  • 75 Chochinov HM, Kristjanson LJ, Breitbart W et al. Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial. Lancet Oncol 2011; 12: 753-762
    CrossrefPubMedGoogle Scholar
  • 76 Chochinov HM, McKeen NA. Dignity therapy. In: Watson M, Kissane DW, eds. Handbook of Psychotherapy in Cancer Care. West Sussex: John Wiley & Sons; 2011: 79-88
    CrossrefGoogle Scholar
  • 77 Chochinov HM, Hack TF, McClement S et al. Dignity in the terminally ill: a developing empirical model. SocSci Med 2002; 54: 433-443
    CrossrefPubMedGoogle Scholar
  • 78 Kissane DW, McKenzie M, Bloch S et al. Family focused grief therapy: a randomized, controlled trial in palliative care and bereavement. JAMA Psychiatry 2006; 163: 1208-1218
    PubMedGoogle Scholar
  • 79 Weißflog G, Mehnert A. Die familienzentrierte Trauertherapie – ein geeignetes Modell für die Palliativversorgung von Krebspatienten und ihren Familien?. Psychother Psychosom Med Psychol 2015; DOI: 10.1055/s-0035-1548834.
    PubMedGoogle Scholar
  • 80 Temel JS, Greer JA, Admane S et al. Longitudinal perceptions of prognosis and goals of therapy in patients with metastatic non-small-cell lung cancer: results of a randomized study of early palliative care. J Clin Oncol 2011; 29: 2319-2326
    CrossrefPubMedGoogle Scholar
  • 81 Temel JS, Greer JA, Muzikansky A et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010; 363: 733-742
    CrossrefPubMedGoogle Scholar
  • 82 Rodin G, Zimmermann C. Psychoanalytic reflections on mortality: a reconsideration. J Am Acad Psychoanal Dyn Psychiatry 2008; 36: 181-196
    CrossrefPubMedGoogle Scholar
  • 83 Chochinov HM. Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care. BMJ 2007; 335: 184-187
    CrossrefPubMedGoogle Scholar
  • 84 MacLeod R. Setting the context: What do we mean by psychosocial care in palliative care?. In: Lloyd-Williams M, eds. Psychosocial issues in palliative care. New York: Oxford University Press; 2008: 1-20
    CrossrefGoogle Scholar