Köhler Stephan, Sterzer Philipp, Normann Claus, Berger Mathias, Brakemeier Eva-Lotta
Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Deutschland.
Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg, Deutschland.
Nervenarzt. 2016 Jul;87(7):701-7. doi: 10.1007/s00115-015-0034-4.
Chronic depression poses a particular challenge for the psychiatric and psychotherapeutic care system. Owing to high rates of psychiatric comorbidities and multiple pharmacological and psychotherapeutic treatment resistance, novel treatment strategies are urgently required.
In this article, we describe the clinical characteristics of chronic and treatment-resistant depression and review the pharmacological and psychotherapeutic treatment options currently available. We focus on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), the first specific psychotherapy approach to chronic depression. Finally, we discuss the role of psychotherapeutic inpatient programs and stepped care concepts in chronic and treatment-resistant depression.
慢性抑郁症给精神科和心理治疗护理系统带来了特殊挑战。由于精神疾病共病率高以及多种药物和心理治疗耐药性，迫切需要新的治疗策略。
在本文中，我们描述慢性和难治性抑郁症的临床特征，并综述目前可用的药物和心理治疗选择。我们重点关注认知行为分析心理治疗系统（CBASP），这是第一种针对慢性抑郁症的特异性心理治疗方法。最后，我们讨论心理治疗住院项目和阶梯式护理概念在慢性和难治性抑郁症中的作用。
