Boerner R J
Psychiatrische Klinik und Poliklinik Nervenklinik Universität München.
Z Gerontol Geriatr. 1995 Nov-Dec;28(6):435-43.
Anxiety disorders in elderly patients have up to now represented a neglected gerontopsychiatric field of medical research, although they represent epidemiologic quite significant disorders also on this age. Diagnosis of an anxiety disorder in the elder age group may be more difficult than in other age groups, as anxiety symptoms may manifest more on the somatic base or they are unclear as in the phobic disorder. An integrative disorder model, in which the etiologic relevant biologic and psychologic causes are united, seems to be more effective under theoretic-heuristic as well as therapeutic aspects than the present monoetiologic anxiety models. The present experiences in the pharmacologic, psychotherapeutic and especially behaviour therapeutic treatment of anxiety disorders can be effective in the older age. A casuistic with a combined treatment of pharmaco- and behaviour therapy is presented and discussed. It is clearly shown that a comprehensive psychiatric-psychological point of view of anxiety disorders may be helpful above all the development of age appropriative therapy concepts.
尽管焦虑症在老年患者中是流行病学上相当重要的疾病,但到目前为止,它一直是老年精神病学研究中一个被忽视的领域。老年组焦虑症的诊断可能比其他年龄组更困难,因为焦虑症状可能更多地体现在躯体基础上,或者像在恐惧症中那样不明确。一种整合性障碍模型,即将病因相关的生物学和心理学原因结合起来,从理论启发和治疗方面来看,似乎比目前的单病因焦虑模型更有效。目前在焦虑症的药物治疗、心理治疗尤其是行为治疗方面的经验对老年人可能是有效的。本文展示并讨论了一个药物治疗与行为治疗相结合的病例。很明显,对焦虑症采取全面的精神-心理学观点,对于制定适合老年人的治疗方案最为有用。