Behandlungsmanual zur psychotherapie von akuten und posttraumatischen belastungsstörungen nach ICD-mehrfachschocks Treatment manual for psychotherapy of acute and posttraumatic stress disorders after multiple ICD shocks
Description
Angesichts der steigenden Zahl implantierter Defibrillatoren in allen Industrienationen wächst auch die Zahl derjenigen Menschen, die sog. Mehrfachschocks („electrical storm“, ES) erleiden. Häufige Beschwerden sind starke und ständig wiederkehrende massive Ängste, Panikattacken, Todesangst, Hilf- und Hoffnungslosigkeit, Depressionen, Nervosität und Gereiztheit, sowie Rückzugs- und ausuferndes Vermeidungsverhalten, Intrusionen, Albträume, Flashbacks, Schlaflosigkeit und die Unfähigkeit der Gefühlsempfindung sowie eine eingeschränkte Zukunftsperspektive. Da Menschen mit einem ICD häufig körperlich (sehr) krank und nach den ICD-Mehrfachschocks zusätzlich massiv verunsichert sind, scheint es wesentlich, dass die stationäre Behandlung in einer Einrichtung durchgeführt wird, die über eine enge Anbindung an und räumliche Nähe zu einer kardiologischen Abteilung verfügt. Basis der Diagnostik ist die klinische Anamnese und die systematische Exploration der traumatischen Situation und der resultierenden Beschwerden. Als zusätzliche diagnostische Elemente sollten testpsychologische Verfahren zur Erfassung der Kernsymptomatik zum Einsatz kommen (Angst, Depression, Traumasymptome). Zur Diagnostik sollte eine testpsychologische Untersuchung gehören, damit am Ende der Behandlung auch für den Patienten sichtbar wird, welche Veränderungen eingetreten sind. Im Mittelpunkt der stationären Behandlung steht die tägliche intensive Psychotherapie. In ihrem Rahmen finden Elemente tiefenpsychologisch fundierter Psychotherapie und verhaltenstherapeutisch orientierte Angsttherapie sowie kognitive Umstrukturierung und Elemente des EMDR ihren Platz. Eine Nachuntersuchung innerhalb von 4 Monaten nach den Mehrfachschocks ist angeraten, weil PTSD Symptome zuweilen erst mit großer Latenz auftreten.
In view of the inceasing number of implanted defibrillators in all industrial nations, the number of people who have suffered so-called multiple shocks (electrical storm, ES) also increases. Common complaints are severe and continuously recurrent massive anxiety, panic attacks, fear of death, helplessness and hopelessness, depression, nervosity and irritability as well as reclusive and uncontrollable avoidance behaviour, intrusions, nightmares, flashbacks, sleeplessness and the inability to show feelings and limitation of future perspectives. Because people with an ICD are often physically (very) ill and after multiple ICD shocks are additionally very insecure, it would seem logical if the inpatient treatment would be carried out in an institution which has close connections and is also spatially close to a cardiology department. The basis of the diagnostics is the clinical anamnesis and a systematic exploration of the trauma situation and the resulting complaints. As an additional diagnostic element psychological test procedures should be implemented to determine the core symptomatic (anxiety, depression, trauma symptoms). Psychological test procedures should be included in the diagnostics so that at the end of treatment it is obvious even to the patient which alterations have occurred. The core element of inpatient treatment is daily intensive psychotherapy and includes deep psychologically well-founded psychotherapy and behavioral therapeutic-oriented anxiety therapy as well as cognitive restructuring and elements of eye movement desensitization and reprocessing (EMDR). A follow-up examination within 4 months of the multiple shocks episode is recommended because symptoms of posttraumatic stress disorder often occur after a long latent time period.
In view of the inceasing number of implanted defibrillators in all industrial nations, the number of people who have suffered so-called multiple shocks (electrical storm, ES) also increases. Common complaints are severe and continuously recurrent massive anxiety, panic attacks, fear of death, helplessness and hopelessness, depression, nervosity and irritability as well as reclusive and uncontrollable avoidance behaviour, intrusions, nightmares, flashbacks, sleeplessness and the inability to show feelings and limitation of future perspectives. Because people with an ICD are often physically (very) ill and after multiple ICD shocks are additionally very insecure, it would seem logical if the inpatient treatment would be carried out in an institution which has close connections and is also spatially close to a cardiology department. The basis of the diagnostics is the clinical anamnesis and a systematic exploration of the trauma situation and the resulting complaints. As an additional diagnostic element psychological test procedures should be implemented to determine the core symptomatic (anxiety, depression, trauma symptoms). Psychological test procedures should be included in the diagnostics so that at the end of treatment it is obvious even to the patient which alterations have occurred. The core element of inpatient treatment is daily intensive psychotherapy and includes deep psychologically well-founded psychotherapy and behavioral therapeutic-oriented anxiety therapy as well as cognitive restructuring and elements of eye movement desensitization and reprocessing (EMDR). A follow-up examination within 4 months of the multiple shocks episode is recommended because symptoms of posttraumatic stress disorder often occur after a long latent time period.
Format
Journal
Language
German
Original Work Citation
Jordan, J., Titscher, G., & Kirsch, H. (2011, September). [Treatment manual for psychotherapy of acute and posttraumatic stress disorders after multiple ICD shocks]. Herzschrittmachertherapie & Elektrophysiologie, 22(3), 189-201. doi:10.1007/s00399-011-0148-8. German
Citation
“Behandlungsmanual zur psychotherapie von akuten und posttraumatischen belastungsstörungen nach ICD-mehrfachschocks Treatment manual for psychotherapy of acute and posttraumatic stress disorders after multiple ICD shocks,” Francine Shapiro Library, accessed April 28, 2024, https://francineshapirolibrary.omeka.net/items/show/21077.