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Polymorbidität

  • J. Wertheimer
Chapter
Part of the Psychiatrie der Gegenwart book series (GEGENWART)

Zusammenfassung

Schon beim ersten Kontakt mit einem älteren Kranken wird der Arzt sich im Rahmen seiner diagnostischen Überlegungen fragen, ob es sich um das Vorhandensein mehrerer Krankheiten handle. Er wird Zeichen und Symptome vermuteter Störungen suchen, zerstreute Stücke eines Puzzles zusammensetzen, um damit schließlich im Idealfall zu einem Gesamtbild zu kommen, das die konstituierenden Elemente widerspiegelt. Diese Momentaufnahme wird dann die Hauptelemente enthalten und Kausalverknüpfungen aufzeigen, im Sinne von Folgen oder im Sinne einer Kontextualität. Mit dem Fortschreiten der Beobachtung im Rahmen der sukzessiven Konsultationen wird sich dieses Bild bewegen und die Anfangshypothese entweder bestätigen oder widerlegen; es werden sich neue Interpretationsmöglichkeiten aufzeigen oder andere ausgeschaltet werden, neue Verknüpfungen werden geschaffen oder andere verworfen. Was zuerst als Puzzle sich darstellt, wird durch das Bild eines Kaleidoskops überhöht, dessen farbige Fragmente sich beständig organisieren und auflösen. In diesem Kapitel soll versucht werden, den Stand unserer heutigen Kenntnisse über diese äußerst komplexen Interaktionen zwischen körperlichen und psychiatrischen Tönen im Rahmen der psychogeriatrischen Klinik darzustellen.

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© Springer-Verlag Berlin Heidelberg 1989

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  • J. Wertheimer

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