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neuropsychiatrie

, Volume 32, Issue 2, pp 57–68 | Cite as

Diagnose, Differentialdiagnose und Behandlung von Abhängigkeitserkrankungen im Allgemeinkrankenhaus (allgemeiner Teil)

  • Anton Schmick
  • Josef Jenewein
  • Sönke Böttger
übersicht

Zusammenfassung

Abhängigkeitserkrankungen sind ein hoch relevantes Problem im Allgemeinkrankenhaus und sind deshalb ein zentrales Thema für die Konsiliar- und Liaisonpsychiatrie.

Im Allgemeinkrankenhaus können sie den Krankheitsverlauf der Betroffenen deutlich erschweren und stellen eine häufige Herausforderung dar. Die vielfachen psychotropen Effekte unterschiedlicher Substanzen verursachen eine Reihe diverser psychiatrischer Probleme. So können z. B. eine Alkoholintoxikation depressive oder manische Symptome, eine Cannabisintoxikation dagegen ein psychotisches Krankheitsbild suggerieren, während eine Intoxikation mit Inhalativa oder Aufputschmitteln als eine Angststörung imponieren kann. Die Erfassung von Doppeldiagnosen, d. h. die gemeinsame Erfassung substanzinduzierter und nicht-substanzinduzierter Psychopathologien, stellt eine besondere klinische Herausforderung dar. Abhängigkeitserkrankungen sind auch gesellschaftlich relevant, da durch sie bedingte bleibende neurologische und neuropsychiatrische Schäden die Kosten für das öffentliche Gesundheitssystem erheblich steigern.

Die Zielsetzung des Artikels ist es, die in der Konsiliar- und Liaisonpsychiatrie relevanten Abhängigkeitserkrankungen, die dazugehörige Psychopathologie, Pathophysiologie und Diagnostik sowie Therapieansätze systematisch darzustellen.

Schlüsselwörter

Abhängigkeitserkrankungen Konsultation- und Liasionpsychiatrie Alkohol Cannabis Stimulanzien Kokain Opium Allgemeinkrankenhaus 

Diagnosis, differential diagnosis and therapy of substance use disorders in general hospital (general section)

Summary

Substance use disorders are becoming an increasingly significant problem in general hospitals and hence play a key role in consultation- and liaison psychiatry. Diverse psychotropic effects of various substances mimic psychiatric disorders. An alcohol intoxication can present depressive or manic symptoms, a cannabis delirium can present as a psychosis while stimulants use can suggest the diagnosis of an anxiety disorder. Obtaining dual diagnoses by identifying substance-induced and non-substance-induced psychopathologies is clinically challenging.

The aim of this article is to systematically describe the psychopathology, pathophysiology and therapeutic options of substance-use disorders particularly relevant for consultation and liaison psychiatry.

Keywords

Substance use disorders Alcohol Opiates Cannabis General hospital psychiatry 

Notes

Interessenkonflikt

A. Schmick, J. Jenewein und S. Böttger geben an, dass kein Interessenkonflikt besteht.

Supplementary material

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Copyright information

© Springer-Verlag GmbH Austria, ein Teil von Springer Nature 2017

Authors and Affiliations

  1. 1.UniversitätsSpital Zürich, Klinik für Psychiatrie und Psychotherapie, Abteilung für Konsiliar- und LiaisonpsychiatrieUniversität ZürichZürichSchweiz

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