Abstract
Depressive Störungen bilden nach den Herz- Kreislauferkrankungen in Europa mittlerweile die zweitwichtigste Ursache für den Verlust gesunder Lebensjahre. Angesichts der mit dieser Entwicklung verbundenen sozialen und ökonomischen Konsequenzen muss der Förderung der psychischen Gesundheit und der Primär-, Sekundär- und der Tertiärprävention psychischer Erkrankungen in Zukunft ein besonderer Stellewert eingeräumt werden. Im Rahmen des vorliegenden Beitrags werden die Grundlagen der Prävention psychischer Erkrankungen und der Förderung psychischer Gesundheit vorgestellt und hinsichtlich ihrer Bedeutung für die Entwicklung von Gesundheitsförderungsprogrammen diskutiert. An einem Entwicklungsmodell der Entstehung psychischer Erkrankung werden dabei die Ansatzpunkte präventiver und gesundheitsfördernder Strategien modellhaft dargestellt. In einer kritischen Bestandsaufnahme werden Ansätze der universellen, selektiven, indikativen, sowie der tertiären Prävention vorgestellt und hinsichtlich der vorliegenden Evidenz für ihre Wirksamkeit und Effizienz verglichen. Als Ergebnis dieser Bestandsaufnahme zeigen sich für viele Programme kurz- und mittelfristige Effekte auf einzelne Ergebnisparameter. Aufgrund kurzer Studiendauern und kleiner Untersuchungsstichproben konnten bislang allerdings kaum Belege für eine langfristige Reduzierung der Inzidenz und der Prävalenz psychischer Erkrankungen erbracht werden. Auch hinsichtlich der gesundheitsökonomischen Auswirkungen psychiatrischer Präventionsprogramme liegen bislang kaum aussagekräftige Ergebnisse vor. Es besteht deshalb auf allen Ebenen der Prävention psychischer Erkrankungen ein dringender Bedarf an Langzeitstudien zur Effektivität und zur Kosten-Effektivität präventiver Maßnahmen.
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Kilian, R., Becker, T. (2006). Die Prävention psychischer Erkrankungen und die Förderung psychischer Gesundheit. In: Kirch, W., Badura, B. (eds) Prävention. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28954-2_26
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