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Übersichtsarbeit

Psychotherapie der Zwangsstörung bei Kindern und Jugendlichen - eine Übersicht

Published Online:September 01, 2006https://doi.org/10.1024/1422-4917.31.3.213

Abstract

Zusammenfassung: Nach einem Überblick über die empirische Befundlage zur Psychotherapie der Zwangsstörung im Erwachsenen- sowie im Kindes- und Jugendalter wird das kognitiv-verhaltenstherapeutische Vorgehen anhand der folgenden Behandlungsblöcke beschrieben: Psychoedukation, Exposition mit Reaktionsverhinderung, familienorientierte Interventionen und schließlich kognitive und metakognitive Techniken. Neben der Pharmakotherapie mit Serotoninwiederaufnahmehemmern gilt die Verhaltenstherapie, speziell die Expositionsbehandlung mit Reaktionsverhinderung, als effektive Behandlungsmethode. Die «Gedankenstopp-Technik» zur Behandlung von Zwangsgedanken kann nicht empfohlen werden. Vergleichende Therapiestudien sind notwendig, um die differentielle Wirksamkeit, die Wirkmechanismen, Indikationen und Kontraindikationen für Exposition mit Reaktionsverhinderung, Kognitive Therapie und Pharmakotherapie sowie entsprechende Kombinationstherapien zu überprüfen.


Psychotherapy of obsessive-compulsive disorders in children and adolescents - A review

Summary: The literature on evaluated methods of psychotherapy for the treatment of obsessive-compulsive disorders (OCD) in children and adolescents is reviewed and the following cognitive-behavioral treatment modules are described: psychoeducation, exposure with response prevention, family-based interventions, and cognitive as well as meta-cognitive techniques. Behavior therapy, especially exposure with response prevention, has been shown to be an effective treatment. Severe cases require a combined therapy with serotonin-reuptake inhibitors, while «thought stopping» cannot be recommended as an effective therapy for obsessions. New cognitive and meta-cognitive approaches should be evaluated to determine whether they might advance treatment. Controlled therapy studies are needed in order to evaluate the different effects and underlying efficacy factors of, as well as the indications and contraindications for different strategies of treatment for obsessive-compulsive disorder in childhood and adolescence.

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