Abstract
Wir wissen, dass chronisch erkrankte Patienten mit höherer Wahrscheinlichkeit an Depression leiden, und dass depressive Personen umgekehrt auch mit erhöhter Wahrscheinlichkeit chronisch erkranken. Auf der Basis eines gemeinsamen Projekts von TU Chemnitz und Klinikum Chemnitz untersuchen wir anhand von mehr als 400 chronisch erkrankten Patienten, worauf dieser Zusammenhang zurückzuführen ist. Insbesondere nehmen wir an, dass depressive Personen auf ungünstigere Formen der Krankheitsbewältigung zurückgreifen und subjektiv ein geringeres Ausmaß an sozialer Unterstützung erhalten. Aufgrund von Regressionsanalysen lässt sich innerhalb der vorliegenden Studie die kausale Bedeutung dieser verschiedenen Faktoren der Krankheitsbewältigung und sozialen Unterstützung erfassen. Die Ergebnisse bestätigen, dass die geringere Lebenszufriedenheit bei depressiven, chronisch erkrankten Patienten tatsächlich auf ungünstigere Formen der Krankheitsbewältigung und subjektiv geringere soziale Unterstützung zurückzuführen ist. Die Ergebnisse werden diskutiert im Hinblick auf zukünftige Maßnahmen zur Sekundärprävention, insbesondere (1) günstige Formen der Krankheitsbewältigung; (2) etwaige zukünftige Interventionen im medizinischen Bereich sowie (3) im sozialen Kontext von chronisch erkrankten Patienten.
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Literatur
Abramson, L. Y., Seligman, M. E. P., Teasdale, J. (1978). Learned helplessness in humans: Critique and reformulation. Journal of abnormal Psychology, 86, 78–97
American Heart Association (2005). Heart Disease and Stroke Statistics — 2005 Update
Anderson R. J., Freedland K. E., Clouse R. E., & Lustman P. J. (2001). The prevalence of comorbid depression in adults with diabetes: A meta-analysis. Diabetes Care, 24, 1069–1078
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182
Beck, A. T. (1974). The development of depression. A cognitive model. In R. J. Friedman, & M. M. Katz (Eds.), The psychology of depression. New York: Wiley
Berkman, L. F., Blumenthal, J., Burg, M., Carney, R. M., Catellier, D., Cowan, M. J., Czajkowski, S. M., DeBusk, R., Hosking, J., Jaffe. A., Kaufmann, P. G., Mitchell, P., Norman, J., Powell, L. H, Raczynski, J. M., & Schneiderman, N. (2003). Patients Investigators (ENRICHD). Effects of treating depression and low perceived social support on clinical events after myocardial infarction: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA: The Journal of the American Medical Association, 289, 3106–3116
Black, S. A. (1999). Increased health burden associated with comorbid depression in older diabetic Mexican Americans. Results from the Hispanic Established Population for the Epidemiologic Study of the Elderly survey. Diabetes Care, 22, 56–64
Blehar, M. C., & Oren, D. A. (1997). Gender Differences in Depression. Medscape Womens Health, 2, 3
Blumenthal, J. A., Lett, H. S., Babyak, M. A., White, W., Smith, P. K., Mark, D. B., Jones, R., Mathew, J. P., & Newman, M. F. (2003). Depression as a risk factor for mortality after coronary artery bypass surgery. Lancet, 23, 604–609
Brewin, C. R. (1985). Depression and causal attributions: What is their relation? Psychological Bulletin, 98, 297–309
Burg M. M., Benedetto M. C., Rosenberg R., & Soufer R (2003). Presurgical depression predicts medical morbidity 6 months after coronary artery bypass graft surgery. Psychosomatic Medicine, 65, 111–118
Cameron, R, & Meichenbaum, D. (1982). The nature of effective co** and the treatment of stress related problems: A cognitive-behavioral perspective. In L. Goldberg & S. Breznitz (Eds.), Handbook of stress. New York: Free Press
Carney, C. (1998). Diabetes mellitus and major depressive disorder: an overview of prevalence, complications, and treatment. Depression and Anxiety, 7, 149–157
Carney, R. M., & Freedland, K. E. (2003). Depression, mortality, and medical morbidity in patients with coronary heart disease. Biological Psychiatry, 54, 241–247
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd edn). Hillsdale, NJ: Erlbaum
Connell, C. M., Davis, W. K., Gallant, M. P., & Sharpe, P.A. (1994). Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes. Health Psychology, 13, 263–273
Coyne, J. C., Aldwin, C., & Lazarus, R. S. (1981). Depression and co** in stressful episodes. Journal of Behavioral Medicine, 4, 381–406
De Groot, M., Anderson, R., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001). Association of depression and diabetes complications: a meta-analysis. Psychosomatic Medicine, 63, 613–619
Diener, E., Emmons, R, A., Larsen, R, J. (1985). The Satisfaction With Life Scale. Journal of Personality Assessment, 49, 71–75
Eaton W. W., Armenian H., Gallo J., Pratt L., & Ford D. E. (1996). Depression and risk for onset of type II diabetes. A prospective population-based study. Diabetes Care, 19, 1097–1102
Ellis, A. (1977). Die rational emotive Therapie. München: Pfeiffer
ENRICHD Investigators (2000). Enhancing recovery in coronary heart disease patients (ENRICHD): Study design and methods. American Heart Journal, 139, 1–9
Everson-Rose S. A, Meyer P. M., Powell L. H., Pandey D, Torrens J. I., Kravitz H. M., Bromberger J. T., & Matthews K. A. (2004). Depressive symptoms, insulin resistance, and risk of diabetes in women at midlife. Diabetes Care, 27, 2856–2862
Felton, B. J., Revenson, T. A., & Hinrichsen, G. A. (1984). Stress and co** in the explanation of psychological adjustment among chronically ill adults. Social Science and Medicine, 18, 889–98
Filipp, S. H., Ferring, D., Freudenberg, E., & Klauer, T (1988). Affektivmotivationale Korrelate von Formen der Krankheitsbewältigung — Erste Ergebnisse einer Längsschnittstudie mit Krebspatienten. Psychotherapie, Psychosomatik, Medizinische Psychologie, 38, 37–42
Franco-Bronson, K. (1996). The management of treatment-resistant depression in the medically ill. Psychiatric Clinics of North America, 19, 329–350
Frasure-Smith N., & Lesperance F. (2003). Depression and other psychological risks following myocardial infarction. Archives of General Psychiatry, 60, 627–636
Frasure-Smith, N, Lesperance, F, Talajic, M. (1993). Depression following myocardial infarction. Impact on 6-month survival. JAMA: The Journal of the American Medical Association, 270, 1819–1825
Fuller, R. G. What happens to mental patients after discharge from hospital. Psychiatric Quarterly, 9, 95–104
Gavard J. A., Lustman P. J., & Clouse R. E. (1993). Prevalence of depression in adults with diabetes. An epidemiological evaluation. Diabetes Care, 16, 1167–1178
Gil, K. M., Carson, J. W., Sedway, J. A., Porter, L. S., Schaeffer, J. J., & Orringer, E. (2000). Follow-up of co** skills training in adults with sickle cell disease: Analysis of daily pain and co** practice diaries. Health Psychology, 19, 85–90
Glazer, K. M., Emery, C. F, Frid, D. J., & Banyasz, R. E. (2002). Psychological predictors of adherence and outcomes among patients in cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation, 22, 40–46
Goodnick, P. J., Henry, J. H., & Buki, V. M. V. (1995). Treatment of depression in patients with diabetes mellitus. Journal of Clinical Psychiatry, 56, 128–36
Gracia, E., & Herrero, J (2004). Determinants of social integration in the community: An exploratory analysis of personal, interpersonal and situational variables. Journal of Community and Applied Social Psychology, 14, 1–15
Gunthert, K. C., Cohen, L. H., & Armeli, S. (2002) Unique effects of depressive and anxious symptomatology on daily stress and co**. Journal of Social and Clinical Psychology, 21, 583–609
Hautzinger, M. (1983). Kognitive Veränderungen als Folge, nicht als Ursache von Depression. Zeitschrift für Personenzentrierte Psychologie und Psychotherapie, 2, 377–387
Hautzinger, M. (1988). Die CES-D Skala: Ein Depressionsmesinstrument für Untersuchungen in der Allgemeinbevölkerung. Diagnostica, 34, 167–173
International Diabetes Federation (2005). Diabetes Atlas, Second Edition.
Jiang W., Krishnan R.R., & O’Connor C. M. (2002). Depression and heart disease: Evidence of a link, and its therapeutic implications. CNS drugs, 16, 111–127
Johnson, J. G., Metalsky, G. I., & Rabkin, J. G. (2000). Attributional style, self-esteem, and human immunodeficiency virus: A test of the hopelessness and self-esteem theories of depression. Journal of Psychopathology and Behavioral Assessment, 22, 23–46
Joynt, K. E., Whellan, D. J., & O’Connor, C. M. (2003). Depression and cardiovascular disease: mechanisms of interaction. Biological Psychiatry, 54, 248–261
Kaholokula, J. K., Haynes, S. N., Grandinetti, A., & Chang, H. K. (2003). Biological, psychosocial, and sociodemographic variables associated with depressive symptoms in persons with type 2 diabetes. Journal of Behavioral Medicine, 26, 435–458
Kawakami N, Takatsuka N, Shimizu H, & Ishibashi H. (1999). Depressive symptoms and occurrence of type 2 diabetes among Japanese men. Diabetes Care, 22, 1071–1076
Klauer, T., Filipp, S, & Ferring, D. (1989) Der „Fragebogen zur Erfassung von Formen der Krankheitsbewältigung“ (FEKB): Skalenkonstruktion und erste Befunde zu Reliabilität, Validität und Stabilität. Diagnostica, 35, 316–335
Kole-Snijders, A. M. J., Vlaeyen, J. W. S., Goossens, M. E. J. B. Journal of Consulting and Clinical Psychology, 67, 931–944
Kugler, J., Kruse, B., & Pöhlau, D. (2000). Psychoneuroimmunological effects of co** training in patients with multiple sclerosis. Psychologische Beitrage, 42, 50–59
Lane, D., Carroll, D., Ring, C., Beevers, D. G., & Lip, G. Y. (2001). Mortality and quality of life 12 months after myocardial infarction: Effects of depression and anxiety. Psychosomatic Medicine, 63, 221–230
Lepine, J. P., Gastpar, M., Mendlewicz, J., & Tylee, A. (1997). Depression in the community: the first pan-European study DEPRES (Depression Research in European Society). International Clincal Psychopharmacology, 12, 19–29.
Lesperance, F., Frasure-Smith, N., & Talajic, M. (1996). Major depression before and after myocardial infarction: its nature and consequences. Psychosomatic Medicine, 58, 99–110.
Lewinsohn, P. M., Hoberman, H. M., & Hautzinger, M. (1985). An integrative Theory of depression. In S. Reiss, & R. R. Bootzin (Eds.), Theoretical issues in behaviour therapy. New York: Academic Press
Lewinsohn, P. M., Hoberman, H. M., & Rosenbaum, M. (1988). A prospective study of risk factors for unipolar depression. Journal of Abnormal Psychology, 97, 251–264
Lewinsohn, P. M., Larson, D. W., Muñoz, R. F., & Ricardo, F. (1982). The measurement of expectancies and other cognitions in depressed individuals. Cognitive Therapy and Research, 6, 435–458
Lloyd, G. G., & Cawley, R. H. (1983) Distress or illness? A study of psychological symptoms after myocardial infarction. British Journal of Psychiatry, 142, 120–125
Lustman, P. J, Griffith, L. S., Freedland, K. E., Kissel S. S., & Clouse, R. E. (1998). Cognitive behavior therapy for depression in type 2 diabetes mellitus. A randomized, controlled trial. Annals of Internal Medicine, 129, 613–621
Lustman, P. J., Anderson, R. J., Freedland, K. E., de Groot, M., Carney, R. M., & Clouse, R. E. (2000). Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care, 23, 934–942
Lyness J. M., King D. A., Conwell Y., Cox C., & Caine E. D. (2000). Cerebrovascular risk factors and 1-year depression outcome in older primary care patients. American Journal of Psychiatry, 157, 1499–1501
Malzberg, B. (1937). Mortality among patients with involution melancholia. American Journal of Psychiatry, 93, 1231–1238
Mayou, R. A., Gill, D., Thompson, D. R., Day, A., Hicks, N., Volmink, J, & Neil, A. (2000). Depression and anxiety as predictors of outcome after myocardial infarction. Psychosomatic Medicine, 62, 212–219
Musselman, D. L., Betan, E., Larsen,H., & Phillips, L. S. (2003). Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment. Biological Psychiatry, 54, 317–329
Musselman, D. L., Evans, D. L., & Nemeroff, C. B. (1998). The relationship of depression to cardiovascular disease: Epidemiology, biology, and treatment. Archives of General Psychiatry, 55, 580–592
Palinkas L. A., Barrett-Connor E., & Wingard D. L. (1991). Type 2 diabetes and depressive symptoms in older adults: a population-based study. Diabetic Medicine, 8, 532–539
Petersen, S., Peto, V., Rayner, M., Leal, J., Luengo-Fernandez, R. & Gray, A. (2005) European cardiovascular disease statistics. BHF: London
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401
Rajala U., Keinanen-Kiukaanniemi S., & Kivela S. L. (1997) Non-insulin-dependent diabetes mellitus and depression in a middle-aged Finnish population. Social Psychiatry and Psychiatric Epidemiology, 32, 363–367
Ramm, C. R., & Hasenbring (2002). Die deutsche Adaption der Illness-specific Support Scale und ihre teststatistische Überprüfung beim Einsatz an Patienten vor und nach Knochenmarkstransplantation. Zeitschrift für Medizinische Psychologie, 11, 1–10
Rehm, L. P. (1977). A self-control model of depression. Behavior Therapy, 8, 787–798
Revenson, T. A., & Schiaffino, K. M. (1990). Development of a contextual social support measure for use with arthritis population. Paper presented at the Convention of the Arthritis Health Professionals Association
Rodin, G. & Voshart, K. (1986). Depression in the medically ill: An overview. American Journal of Psychiatry, 143, 696–705
Schleifer, S. J., Macari-Hinson M. M., Coyle D. A., Slater W. R., Kahn M., Gorlin, R, & Zucker H.D. (1989). The nature and course of depression following myocardial infarction. Archives of Internal Medicine, 149, 1785–1789
Schwartz, C. E. (1999). Teaching co** skills enhances quality of life more than peer support: Results of a randomized trial with multiple sclerosis patients. Health Psychology, 18, 211–220
Schwarzer, R., & Leppin, A. (1991). Social support and health: A theoretical and empirical overview. Journal of Social and Personal Relationships, 8, 99–127
Seligman, M. E. P. (1974). Learned helplessness and depression. In R. J. Friedman, & M. M. Katz (Eds.), The psychology of depression. New York: Wiley
Smith, C. E., Fernengel, K., & Holcroft, C. (1994). Meta-analysis of the associations between social support and health outcomes. Annals of Behavioral Medicine, 16, 352–362
Sobel, M. E. (1982). Asymptotic intervals for indirect effects in structural equations models. In S. Leinhart (Ed.), Sociological methodology. San Francisco: Jossey-Bass
Stewart, A. L., Greenfield, S., Hays, R. D., Wells, K., Rogers, W. H., Berry, S. D., McGlynn, E. A., & Ware, J. E. Jr. (1989). Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. JAMA: The Journal of the American Medical Association, 18, 907–913
Talbot, F., & Nouwen, A. (2000). A review of the relationship between depression and diabetes in adults: is there a link? Diabetes Care, 23, 1556–1562
Talbot, F., Nouwen, A., & Gingras, J. (1999). Relations of diabetes intrusiveness and personal control to symptoms of depression among adults with diabetes. Health Psychology, 18, 537–542
Teasdale, J. (1982). Negativ thinking in depression. In P. C. Kendall (Ed.) Advances in Behavioral Research and Therapy. New York: Academic Press
Uehara, T., Sakado, K., & Sato, T. (2000). Co** measurement and the state effect of depression and anxiety in psychiatric outpatients. Psychopathology, 35, pp. 48–51
Wang, P. S., Bohn, R. L., Knight, E., Glynn, R. J., Mogun, H., & Avorn, J. (2002). Noncompliance with antihypertensive medications: the impact of depressive symptoms and psychosocial factors. Journal of General Internal Medicine, 17, 504–511
Werner, A. E., & Rehm, L. P. (1975). Depressive affect. A test of behavioral hypotheses. Journal of abnormal Psychology, 84, 221–227
World Health Organisation. (2004). The Atlas of Heart Disease and Stroke
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Fittig, E., Schweizer, J., Rudolph, U. (2006). Lebenszufriedenheit bei chronischen Erkrankungen: Zum wechselseitigen Einfluss von Strategien der Krankheits-bewältigung, Depression und Sozialer Unterstützung. In: Kirch, W., Badura, B. (eds) Prävention. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28954-2_28
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