Stoffliche und nichtstoffliche Süchte

Zusammenfassung

Patienten mit bekannter Abhängigkeitserkrankung wie Alkohol- oder Opiatabhängigkeit weisen in erhöhtem Maße andere Verhaltensweisen auf, die sehr an das Suchtverhalten erinnern. In der psychotherapeutischen Praxis wird daher oftmals von „Suchtstrukturen” und „Suchtverlagerung” gesprochen. Auch in der Biografie dieser Patienten finden wir häufiger als bei anderen Patienten Verhaltensstörungen, die man den Suchterkrankungen im weitesten Sinne zuordnen könnte wie z. B. Essstörungen und pathologisches Spielen.

In der folgenden Literaturübersicht zu der Komorbidität von stofflichen und nichtstofflichen Suchterkrankungen soll zum einen die Relevanz der Thematik herausgestellt werden, zum anderen die eng gefasste Definition der Abhängigkeitserkrankungen des ICD-10 im Hinblick auf die Definition des DSM-IV für den Praktiker geöffnet werden, um so diesen Patienten eine umfassende Therapie anbieten zu können.

Abstract

In patients with addictive disorders like alcohol or opiate dependencies other behavioural dependencies are common, which are similar to their addictive behaviour. Therefore psychotherapist or psychiatrists are often speaking about „addictive condition” and „addictive” shift in these patients. These patients also often have a history of behavioural dependencies like bulimia or anorexia nervosa and pathological gambling.

There are two main issues in the following literature review about comorbidity of behavioural and substance dependencies: first to remark the importance and relevance of this kind of comorbidity and second to open up the ICD-10-definition of additive disorders according to DSM-IV classification of dependence. This could be of great support for the clinicians and therapists to offer these patients an intensive and comprehensive treatment.

Schlüsselwörter

abhängiges Verhalten - Komorbidität - Abhängigkeit - Sucht - Essstörung - Kleptomanie - pathologisches Spielen - Trichotillomanie - Kaufsucht - Internet-Abhängigkeit - Arbeitssucht - sensation seeking - Impulsivität - gesteigerter Appetit

Key words

Behavioural dependence - comorbidity - dependence - addiction - bulimia - kleptomania - pathological gambling - trichotillomania - compulsive buying - internet addiction - workaholism - sensation seeking - impulsivity - excessive appetite

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1 Definition des Begriffes Komorbidität von Wittchen (1992): Komorbidität wird verstanden als das Auftreten von mehr als einer spezifisch diagnostizierbaren Störung in einem bestimmten Zeitintervall [7].