Herausforderungen der ambulanten Behandlung von Patienten mit bipolar-affektiven Störungen

Zusammenfassung

Der Verlauf bipolar-affektiver Erkrankungen umfasst ein weites Spektrum. Dieses kann von einer einzigen leichten Episode in fünf Jahren bis hin zu ausgeprägten Stimmungsschwankungen innerhalb eines Tages variieren. In der ambulanten Betreuung von Menschen mit bipolarer-affektiver Störung tauchen neben der Frage der medikamentösen Therapie verschiedene krankheitsspezifische Schwierigkeiten auf, die es zu berücksichtigen gilt. Klinisch im Vordergrund steht dabei häufig eine oftmals unzureichende funktionelle Genesung. Diese steht wiederum in engen Zusammenhang mit kognitiven Defiziten, Therapieabbrüchen sowie einer hohen Rückfallhäufigkeit.

Abstract

The course of bipolar illness comprises a wide range, which may vary between one single episode once every five years and a severe ultra rapid cycling course with mood changes within days. Even with optimal pharmacological treatment the functional outcome in bipolar patients is still poor. Underlying pathomechanisms are not fully understood yet. This article addresses three possible illness specific-aspects: cognitive defects, high relapse frequency and poor adherence. Causes as well as therapeutic interventions for these therapeutic pitfalls are summarised.

Schlüsselwörter

bipolar - funktionelle Genesung - ambulante Betreuung - therapeutische Allianz

Key words

bipolar - functional recovery - outpatient treatment - treatment alliance

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