Rösche J
Klinik und Poliklinik für Neurologie, Universität Rostock, Gehlsheimer Strasse 20, Rostock.
Fortschr Neurol Psychiatr. 2009 Aug;77 Suppl 1:S58-60. doi: 10.1055/s-0028-1109603. Epub 2009 Aug 14.
Quality management in German health care services is demanded by law. If a monitoring of treatment results using scientifically established scores is performed as a part of quality management, the data may also be used for research on the course and the outcome of chronic disease and even for basic research. Using a multimodal therapy monitoring on a neuropsychiatric ward for patients with refractory epilepsy it could be shown that comprehensive treatment strategies were able to enhance cognitive abilities, mood and coping-strategies. The introduction of selective serotonin reuptake inhibitors (e. g. citalopram, sertraline) did not result in an increased burden of seizures. Interesting for understanding the multiple causes of depression was the finding that folic acid serum levels in the lower normal range or below were associated with a higher risk of depressive mood.
德国医疗服务中的质量管理是法律要求的。如果作为质量管理的一部分,使用科学确定的评分对治疗结果进行监测,这些数据也可用于慢性病病程和结局的研究,甚至用于基础研究。在一个难治性癫痫患者的神经精神科病房进行多模式治疗监测发现,综合治疗策略能够提高认知能力、情绪和应对策略。引入选择性5-羟色胺再摄取抑制剂(如西酞普兰、舍曲林)并未导致癫痫发作负担增加。血清叶酸水平处于正常范围下限或更低与抑郁情绪风险较高相关,这一发现对于理解抑郁症的多种病因很有意义。