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Therapie von psychischen und Verhaltenssymptomen bei Demenz

Therapy of psychological and behavioral symptoms in dementia

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Zusammenfassung

Psychische und Verhaltenssymptome bei Demenz stellen eine erhebliche Belastung für Erkrankte und Pflegende dar. Ursächlich sind krankheitsbedingte neurobiologische Veränderungen, die zu einer erhöhten Vulnerabilität für diese Symptome führen, und externe Faktoren. Die externen Faktoren (u. a. Kommunikation, Milieu) sind primäres Ziel der Behandlung und der Prävention von psychischen und Verhaltenssymptomen. Psychosoziale Interventionen zur Modifikation externer Faktoren beziehen sich auf den Erkrankten oder die Pflegenden. Medikamentöse Therapien werden eingesetzt, wenn psychosoziale Maßnahmen keine ausreichende Wirkung zeigen oder nur begrenzt angewendet werden können. Pharmakologische Therapien sind bei psychischen und Verhaltenssymptomen weniger gut untersucht als pharmakologische Therapien zur Behandlung von Kognition und Funktion bei Demenz. Trotzdem können Empfehlungen gegeben werden. Der folgende Übersichtsartikel orientiert sich an der S3-Leitlinie Demenzen (DGPPN, DGN), die ein besonderes Gewicht auf psychische und Verhaltenssymptome legt.

Summary

Behavioral and psychological symptoms of dementia (BPSD) represent a severe burden for patients and caregivers. The causes are disease-related neurobiological changes which increase the vulnerability to respond to external triggers with BPSD. Consequently, external factors (e.g. communication, milieu) are the primary target for treatment and also prevention of BPSD. Psychosocial interventions with the focus on the patient or on the caregivers are the core elements of BPSD therapy. If psychosocial interventions are not efficacious or only insufficiently applicable, pharmacological treatment may need to be initiated. Pharmacological treatment of BPSD has been less intensely investigated as treatment of cognition and function in dementia. However, recommendations can be given. This review follows the S3 guidelines on dementia published by the German Societies for Psychiatry and Psychotherapy (DGPPN) and Neurology (DGN) which address BPSD extensively.

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Authors and Affiliations

  1. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Sigmund-Freud-Straße 25, 53105, Bonn, Deutschland

    F. Jessen & A. Spottke

  2. Klinik und Poliklinik für Neurologie, Universitätsklinikum Bonn, Bonn, Deutschland

    A. Spottke

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  1. F. Jessen
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  2. A. Spottke
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Correspondence to F. Jessen.

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Jessen, F., Spottke, A. Therapie von psychischen und Verhaltenssymptomen bei Demenz. Nervenarzt 81, 815–822 (2010). https://doi.org/10.1007/s00115-010-3002-z

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