Zusammenfassung
Chronische Rückenschmerzen haben eine enorme gesundheitspolitische und ökonomische Bedeutung für Industriestaaten, da eine kleine Gruppe von schwer chronifizierten Patienten für einen großen Anteil der medizinischen Kosten verantwortlich ist. Die Prävention chronischer Verläufe ist daher ein vorrangiges Ziel in der Behandlung von Patienten mit akuten Rückenschmerzen. Psychologische Faktoren zählen zu den Risikofaktoren für eine spätere Chronifizierung. In erster Linie zählen hierzu Depressivität und berufsbedingter Disstress sowie maladaptive Formen der Schmerzverarbeitung. Unklar sind bis heute vor allem die kognitiven Mechanismen, die an der Aufrechterhaltung und Verstärkung von Depressivität und schmerzbedingter Funktionsbeeinträchtigung beteiligt sind. In diesem Übersichtsartikel sollen die aktuellen Ergebnisse der Cognitive-bias-Forschung für den Zusammenhang zwischen chronischem Schmerz und Depressivität zusammengefasst und der Bezug zu theoretischen Modellen erläutert werden.
Abstract
Chronic back pain is of enormous health and economic relevance for industrialized countries because a small group of patients with chronic disease is responsible for a large proportion of medical costs. The prevention of chronic disease is therefore a primary goal in the treatment of patients with acute low back pain. Psychological factors are the central risk factors for later chronification. Above all, especially depressive symptoms and occupational distress, as well as various maladaptive forms of pain management are central risk factors. It remains unclear which exact cognitive mechanisms are involved in the maintenance and reinforcement of depression and pain-related disability. In this review, the current results of cognitive bias research and theoretical models are presented and summarized regarding the relationship between chronic pain and depression. Finally, the clinical implications and recommendations for clinical research will be presented.
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Die Arbeit von Adina C. Rusu an diesem Übersichtsartikel wurde unterstützt durch FORUM, Ruhr-Universität Bochum.
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A.C. Rusu und J. Hülsebusch geben an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Für die Durchführung der Studien wurde ein Ethikvotum der Ethikkommission der Medizinischen Fakultät der Ruhr-Universität Bochum eingeholt.
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Rusu, A.C., Hülsebusch, J. Cognitive-bias-Forschung und Depressivität bei chronischem Schmerz. Schmerz 32, 236–242 (2018). https://doi.org/10.1007/s00482-018-0289-3
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DOI: https://doi.org/10.1007/s00482-018-0289-3
Schlüsselwörter
- „Cognitive biases“ (dysfunktionale Informationsverarbeitungsprozesse)
- Depressivität
- Chronischer Schmerz
- Risikofaktoren