Zusammenfassung
Klinisches Management bedeutet im medizinischen Fachjargon eine strukturierte, sowohl individualisierte als auch leitliniengerechte medizinische Versorgung. „Manager“ ist in diesem Fall der behandelnde Facharzt. Seine Tätigkeit umfasst eine Vielzahl von Bestandteilen aus psychiatrischer Diagnostik, Klärung psychosozialer Kontextfaktoren und somatischer Komorbidität, Berücksichtigung von Patientenpräferenzen und Arbeit an der Therapieadhärenz sowie schließlich strukturell-organisatorische Maßnahmen. In klinischen Studien zur Wirksamkeit von Medikamenten oder spezifischen psychotherapeutischen Verfahren wird das klinische Management verstanden als die Summe der nichtspezifischen therapeutischen Faktoren, gegen die u. a. eine spezifische Therapie getestet wird. Es konnte sowohl für die Psychotherapie als auch für die medikamentöse antidepressive Therapie gezeigt werden, dass das klinische Management, das neben der Gabe eines Antidepressivums oder der Anwendung eines psychotherapeutischen Manuals durchgeführt wurde, selbst eine hohe Effektivität besitzt.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Literatur
Abu-Omar K, Rütten A (2006) Sport oder körperliche Aktivität im Alltag? Zur Evidenzbasierung von Bewegung in der Gesundheitsförderung. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz 49(11):1162–1168
Alexopoulos GS, Raue PJ, McCulloch C, Kanellopoulos D, Seirup JK, Sirey JA, Banerjee S, Kiosses DN, Arean PA (2016) Clinical case management versus case management with problem solving therapy in low-income, disabled elders with major depression: a randomized clinical trial. Am J Geriatr Psychiatry 24(1):50–59
Amann U, Schmedt N, Garbe E (2012) Prescribing of potentially inappropriate medications for the elderly: an analysis based on the PRISCUS list. Dtsch Arztebl Int 109(5):69–75
Angermeyer MC, Matschinger H, Schomerus G (2013) Attitudes towards psychiatric treatment and people with mental illness: changes over two decades. Br J Psychiatry 203(2):146–151
Arean PA (2012) Personalizing behavioral interventions: the case of late-life depression. Neuropsychiatry (London) 2(2):135–145
Bao Y, Alexopoulos GS, Casalino LP, Ten Have TR, Donohue JM, Post EP, Schackman, BR, Bruce ML (2011) Collaborative depression care management and disparities in depression treatment and outcomes. Arch Gen Psychiatry 68(6):627–636
Blanchard MR, Waterreus A, Mann A (1999) Can a brief intervention have a longer-term benefit? The case of the research nurse and depressed older people in the community. Int J Geriatr Psychiatry 14(9):733–738
Boehlen FH, Herzog W, Maatouk I, Saum KU, Brenner H, Wild B (2016) Behandlungswünsche von älteren Menschen mit psychischen Erkrankungen. Z Gerontol Geriatr 49(2):120–125
Cohen A, Houck PR, Szanto K, Dew MA, Gilman SE, Reynolds CF 3rd (2006) Social inequalities in response to antidepressant treatment in older adults. Arch Gen Psychiatry 63(1):50–56
Cornman JC, Goldman N, Glei DA, Weinstein M, Chang MC (2003) Social ties and perceived support: two dimensions of social relationships and health among the elderly in Taiwan. J Aging Health 15(4):616–644
Dodel R (2014) Multimorbidität: Konzept, Epidemiologie, Versorgung. Nervenarzt 85(4):401–408
Gallo JJ, Hwang S, Joo JH, Bogner HR, Morales KH, Bruce ML, Reynolds CF 3rd (2016) Multimorbidity, depression, and mortality in primary care: randomized clinical trial of an evidence-based depression care management program on mortality risk. J Gen Intern Med 31(4):380–386
Gerrits MM, van Marwijk HW, van Oppen P, van der Horst H, Penninx BW (2013) The role of somatic health problems in the recognition of depressive and anxiety disorders by general practitioners. J Affect Disord 151(3):1025–1032
Gilbody S, Whitty P, Grimshaw J, Thomas R (2003) Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA 289(23):3145–3151
Glaeske G, Schicktanz C (2013) BARMER GEK Arzneimittelreport 2013. Asgard Verlagsservice GmbH, Siegburg
Goldberg D (2010) The detection and treatment of depression in the physically ill. World Psychiatry 9(1):16–20
Gühne U, Stein J, Riedel-Heller S (2016) Depression im Alter – Herausforderung langlebiger Gesellschaften. Psychiatr Prax 43(2):107–110
Gum AM, Arean PA, Hunkeler E, Tang L, Katon W, Hitchcock P, Steffens DC, Dickens J, Unützer J (2006) Depression treatment preferences in older primary care patients. Gerontologist 46(1):14–22
Gum AM, Iser L, King-Kallimanis BL, Petkus A, DeMuth A, Schonfeld L (2011) Six-month longitudinal patterns of mental health treatment utilization by older adults with depressive symptoms. Psychiatr Serv 62(11):1353–1360
Gustafsson M, Sandman PO, Karlsson S, Isaksson U, Schneede J, Sjolander M, Lovheim H (2015) Reduction in the use of potentially inappropriate drugs among old people living in geriatric care units between 2007 and 2013. Eur J Clin Pharmacol 71(4):507–515
Hautzinger M, Welz S (2008) Kurz- und längerfristige Wirksamkeit psychologischer Interventionen bei Depressionen im Alter. Z Klin Psychol Psychother 37:52–60
Hegel MT, Arean PA (2003) Problem-solving treatment for primary care (PST-PC): a treatment manual for depression. Dartmouth Medical School, University of California, San Francisco CA
Hegeman JM, de Waal MW, Comijs HC, Kok RM, van der Mast RC (2015) Depression in later life: a more somatic presentation? J Affect Disord 170:196–202
Holt S, Schmiedl S, Thurmann PA (2010) Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int 107(31–32):543–551
Hunkeler EM, Meresman JF, Hargreaves WA, Fireman B, Berman WH, Kirsch AJ, Groebe J, Hurt SW, Braden P, Getzell M, Feigenbaum PA, Peng T, Salzer M (2000) Efficacy of nurse telehealth care and peer support in augmenting treatment of depression in primary care. Arch Fam Med 9(8):700–708
Johansson T, Abuzahra ME, Keller S, Mann E, Faller B, Sommerauer C, Hock J, Loffler C, Kochling A, Schuler J, Flamm M, Sonnichsen A (2016) Impact of strategies to reduce polypharmacy on clinically relevant endpoints – a systematic review and meta-analysis. Br J Clin Pharmacol. 82(2):532–48
Joo JH, Hwang S, Abu H, Gallo JJ (2016) An innovative model of depression care delivery: peer mentors in collaboration with a mental health professional to relieve depression in older adults. Am J Geriatr Psychiatry 24(5):407–416
Kasckow J, Klaus J, Morse J, Oslin D, Luther J, Fox L, Reynolds C, Haas GL (2014) Using problem solving therapy to treat veterans with subsyndromal depression: a pilot study. Int J Geriatr Psychiatry 29(12):1255–1261
Katona C, Livingston G (2000) Impact of screening old people with physical illness for depression? Lancet 356(9224):91–92
Kilbourne AM, Williams M, Bauer MS, Arean P (2012) Implementation research: reducing the research-to-practice gap in depression treatment. Depress Res Treat:476027
Kunisch R (2012) Medizinsoftware für die Kitteltasche: Medikamenten-Apps. Dt Arztebl 109(9):A440
Levine S, Unützer J, Yip JY, Hoffing M, Leung M, Fan MY, Lin EH, Grypma L, Katon W, Harpole LH, Langston CA (2005) Physicians' satisfaction with a collaborative disease management program for late-life depression in primary care. Gen Hosp Psychiatry 27(6):383–391
Leykin Y, Derubei RJ, Gallop R, Amsterdam JD, Shelton RC, Hollon SD (2007) The relation of patients' treatment preferences to outcome in a randomized clinical trial. Behav Ther 38(3):209–217
Lohman M, Dumenci L, Mezuk B (2016) Depression and frailty in late life: evidence for a common vulnerability. J Gerontol B Psychol Sci Soc Sci 71(4):630–640
Luck-Sikorski C, Stein J, Heilmann K, Maier W, Kaduszkiewicz H, Scherer M, Weyerer S, Werle J, Wiese B, Moor L, Bock JO, König HH, Riedel-Heller SG (2016) Treatment preferences for depression in the elderly. Int Psychogeriatr 28:1–10 [Epub ahead of print]
Lyness JM, Yu Q, Tang W, Tu X, Conwell Y (2009) Risks for depression onset in primary care elderly patients: potential targets for preventive interventions. Am J Psychiatry 166(12):1375–1383
Mead S, Hilton D, Curtis L (2001) Peer support: a theoretical perspective. Psychiatr Rehabil J 25(2):134–141
Mechakra-Tahiri SD, Zunzunegui MV, Preville M, Dube M (2010) Gender, social relationships and depressive disorders in adults aged 65 and over in Quebec. Chronic Dis Can 30(2):56–65
Mitchell AJ, Rao S, Vaze A (2010) Do primary care physicians have particular difficulty identifying late-life depression? A meta-analysis stratified by age. Psychother Psychosom 79(5):285–294
Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B (2007) Depression, chronic diseases, and decrements in health: results from the world health surveys. Lancet 370(9590):851–858
Müller S, Heinz A (2013) Stigmatisierung oder Entstigmatisierung durch Biologisierung psychischer Krankheiten? Nervenheilkunde 32(12):955–961
Peerenboom, L, Collard RM, Naarding P, Comijs HC (2015) The association between depression and emotional and social loneliness in older persons and the influence of social support, cognitive functioning and personality: a cross-sectional study. J Affect Disord 182:26–31
Pfaff JJ, Almeida OP (2005) A cross-sectional analysis of factors that influence the detection of depression in older primary care patients. Aust N Z J Psychiatry 39(4):262–265
Pitt V, Lowe D, Hill S, Prictor M, Hetrick SE, Ryan R, Berends L (2013) Consumer-providers of care for adult clients of statutory mental health services. Cochrane Database Syst Rev 3:CD004807
Repper J, Carter T (2011) A review of the literature on peer support in mental health services. J Ment Health 20(4):392–411
Riepe MW (2015) Clinical preference for factors in treatment of geriatric depression. Neuropsychiatr Dis Treat 11:25–31
Rodic D, Meyer AH, Meinlschmidt G (2015) The association between depressive symptoms and physical diseases in Switzerland: a cross-sectional general population study. Front Public Health 3:47
Rutherford BR, Tandler J, Brown PJ, Sneed JR, Roose SP (2014) Clinic visits in late-life depression trials: effects on signal detection and therapeutic outcome. Am J Geriatr Psychiatry 22:1452–1461
Schwarzbach M, Luppa M, Forstmeier S, Konig HH, Riedel-Heller, SG (2014) Social relations and depression in late life-a systematic review. Int J Geriatr Psychiatry 29(1):1–21
Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Friedman SJ, Meyers BS (2001) Stigma as a barrier to recovery: Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatr Serv 52(12):1615–1620
Unützer J, Powers D, Katon W, Langston C (2005) From establishing an evidence-based practice to implementation in real-world settings: IMPACT as a case study. Psychiatr Clin North Am 28(4):1079–1092
Utschakowski J, Sielaff G, Schulz G (2015) Aus Erfahrung wird Wissen und Kompetenz. Ausbildung von Experten durch Erfahrung. Nervenheilkunde 34(4):271–274
van den Bussche H, Koller D, Kolonko T, Hansen H, Wegscheider K, Glaeske G, von Leitner EC, Schafer I, Schon G (2011) Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany. BMC Public Health 11:101
van’t Veer-Tazelaar PJ, van Marwijk HW, van Oppen P, van der Horst HE, Smit F, Cuijpers P, Beekman AT (2011) Prevention of late-life anxiety and depression has sustained effects over 24 months: a pragmatic randomized trial. Am J Geriatr Psychiatry 19(3):230–239
Williams JW Jr, Katon W, Lin EH, Noel PH, Worchel J, Cornell J, Harpole L, Fultz BA, Hunkeler E, Mika VS, Unützer J, Investigators I (2004) The effectiveness of depression care management on diabetes-related outcomes in older patients. Ann Intern Med 140(12):1015–1024
Wolter DK (2016) Depressionen im höheren Lebensalter, Teil 1: Entstehung, klinische Symptome, Diagnose und Wechselwirkung zwischen Depression und Demenz. Z Gerontol Geriatr 49(4):335–348
Zeeh J (2012) Polypharmazie im Alter: Des Guten zu viel? MMW Fortschr Med 154(21):46–49
Zimmermann TM, Clouth J, Elosge M, Heurich M, Schneider E, Wilhelm S, Wolfrath A (2013) Patient preferences for outcomes of depression treatment in Germany: a choice-based conjoint analysis study. J Affect Disord 148(2–3):210–219
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer-Verlag GmbH Deutschland
About this chapter
Cite this chapter
Gutzmann, H., Berghöfer, A. (2017). Klinisches Management. In: Fellgiebel, A., Hautzinger, M. (eds) Altersdepression. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53697-1_9
Download citation
DOI: https://doi.org/10.1007/978-3-662-53697-1_9
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-53696-4
Online ISBN: 978-3-662-53697-1
eBook Packages: Medicine (German Language)