Opioid-Agonisten-Therapie bei Opioidabhängigkeit

2020 ◽  
Vol 77 (1) ◽  
pp. 29-36
Author(s):  
Patrick Köck ◽  
Johannes Strasser
Keyword(s):  
State Of The Art ◽  
Dsm V ◽  
Icd 10

Zusammenfassung. Die Indikation zur Durchführung einer Opioid-Agonisten-Therapie (OAT) ist einfach gestellt und orientiert sich einzig am Vorliegen eines Opioidabhängigkeitsyndroms gemäss ICD 10 (oder DSM-V). Für den Behandlungserfolg ist eine adäquate, individuelle Dosierung des Opioid-Agonisten entscheidend. Es stehen mehrere als gleichwertig zu betrachtende Opioide mit unterschiedlichen Nebenwirkungsprofilen zur Verfügung. Komorbide Erkrankungen sind häufig und haben Einfluss auf Lebensqualität sowie das Suchtverhalten. Sie sollten deshalb für die Behandlungsplanung und -umsetzung berücksichtigt und idealerweise ebenfalls behandelt werden. Im folgenden Artikel wird der State-Of-The-Art der OAT dargestellt, mit Fokus auf den deutschsprachigen Raum Europas. Er soll einen Überblick über Diagnostik, Behandlungsoptionen, Medikamente sowie spezifische Herausforderungen der OAT geben. Die Empfehlungen orientieren sich vorwiegend am Schweizer Modell. Somit muss die Behandlungsdurchführung gemäss der jeweiligen Landesgesetzgebung entsprechend modifiziert werden.

scholarly journals Ciberdependência: o papel das emoções na dependência de tecnologias digitais

2014 ◽  
Vol 7 (2) ◽  
pp. 148-161
Author(s):  
Jefferson Cabral Azevedo ◽  
Carlos Henrique Medeiros de Souza ◽  
Giovane do Nascimento
Keyword(s):  
Online Social Networks ◽  
Digital Technologies ◽  
Theoretical Research ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Internet Users ◽  
Dsm V ◽  
Compulsive Behaviors ◽  
Icd 10 ◽  
Statistical Results

RESUMO: O presente artigo visa utilizar conceitos de diversas áreas, proporcionando uma perspectiva multicausal e dialógica sobre os processos nosológicos de dependência de tecnologias digitais e as influências dos mecanismos motivacionais e emocionais sobre a aprendizagem de comportamentos compulsivos. A metodologia aplicada ao estudo é de caráter qualitativo e quantitativo, pois abrange tanto os fatores conceituais obtidos através de revisão bibliográfica como o desenvolvimento de resultados estatísticos através das análises dos resultados dos questionários aplicados no estudo em questão. Este breve constructo teórico busca evidenciar comportamentos patológicos na utilização das tecnologias digitais, principalmente dos usuários de internet e redes sociais digitais, utilizando os parâmetros da neuropsicologia, psicologia, psiquiatria e descrições presentes no DSM V, Manual Diagnóstico e Estatístico de Transtornos Mentais, e o CID 10, Compêndio Internacional de Doenças.PALAVRAS-CHAVE: dependência; tecnologias digitais; motivação; emoção; neuropsicologia; psicologia; psiquiatria.ABSTRACT: This research apply concepts from different areas, aiming to provide a multicausal and dialogical perspective on the nosologic process of dependence upon digital technologies and the influences of motivational and emotional mechanisms on learning compulsive behaviors. The data is approached both qualitatively and quantitatively, since its analysis covers the conceptual factors obtained from literature review and the development of statistical results obtained from the questionnaires applied. This brief theoretical research pursues to reveal pathological behaviors in the use of digital technologies, especially in the actions of internet users in online social networks. The parameters of neuropsychology, psychology, psychiatry are combined with descriptions contained in the DSM V, Diagnostic and Statistical Manual of Mental Disorders, and the ICD 10, International Compendium of Diseases.KEYWORDS: addiction, digital technologies; motivation; emotion; neuropsychology; psychology; psychiatry.

scholarly journals Zmiany kryteriów w diagnozowaniu zaburzeń związanych z hazardem oraz uzależnień chemicznych i czynnościowych

2017 ◽  
Vol 12 ◽  
pp. 91
Author(s):  
Iwona Niewiadomska ◽  
Agnieszka Palacz-Chrisidis
Keyword(s):  
Mental Disorders ◽  
Health Problems ◽  
Statistical Classification ◽  
Addictive Disorders ◽  
Statistical Manual ◽  
Dsm V ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
International Statistical Classification

Autorki poruszają kwestię zmian w kryteriach diagnostycznych dotyczących zaburzeń związanych z hazardem oraz uzależnień chemicznych i czynnościowych w literaturze przedmiotu. Prezentują też krótki przegląd kolejnych edycji podręczników międzynarodowych klasyfikacji, zarówno Diagnostics and Statistical Manual of Mental Disorders – DSM, jak i The International Statistical Classification of Diseases and Related Health Problems – ICD. W artykule przedstawiona jest również dyskusja badaczy na temat umiejscowienia zaburzeń związanych z hazardem w klasyfikacjach diagnostycznych. DSM-V umiejscawia zaburzenie hazardowe w kategorii „zaburzenia używania substancji i nałogów” (ang. Substance-Related and Addictive Disorders, DSM-V), w podkategorii „zaburzenia niezwiązane z substancjami” (ang. Non-Substace Related Disorders, DSM-V). Natomiast według nadal obowiązującego ICD-10, zaburzenie hazardowe pozostaje w obszarze zaburzeń kontroli i impulsów, pod nazwą „hazard patologiczny”.

Problemi di psicoterapia

2010 ◽  
pp. 53-66
Keyword(s):  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm V ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Dsm Iv

Vengono presentati i principali sistemi di diagnosi psichiatrica, e precisamente le ultime edizioni del Diagnostic and Statistical Manual (DSM) dell'American Psychiatric Association (il DSM-III del 1980, il DSM-III-R del 1987, il DSM-IV del 1994, il DSM-IV-TR del 2000, e il DSM-V previsto per il 2013), la 10a edizione dell'International Classification of Diseases (ICD-10) proposta nel 1992 dall'Organizzazione Mondiale della Sanitŕ (OMS), e il Manuale Diagnostico Psicodinamico (PDM) prodotto dalla comunitŕ psicoanalitica internazionale nel 2006. A proposito dei DSM, vengono discussi alcuni problemi metodologici quali le dicotomie validitŕ/attendibilitŕ, categorie/dimensioni e politetico/monotetico, e anticipati alcuni dibattiti critici a proposito del futuro DSM-V. Infine, vengono discusse le seguenti problematiche: la psicopatologia "descrittiva" e "strutturale"; la diagnosi come "difesa" del terapeuta; l'aspetto scientifico e l'aspetto filosofico della diagnosi; i tentativi di "sospensione" del giudizio e dei nostri preconcetti; la dicotomia nomotetico-idiografico.

scholarly journals Harmonisation of ICD–11 and DSM–V: opportunities and challenges

2009 ◽  
Vol 195 (5) ◽  
pp. 382-390 ◽  
Author(s):  
Michael B. First
Keyword(s):  
Diagnostic Criteria ◽  
Development Process ◽  
Prior Experience ◽  
International Communication ◽  
Tic Disorder ◽  
Parallel Development ◽  
Dsm V ◽  
Two Systems ◽  
Icd 10 ◽  
Dsm Iv

BackgroundDifferences in the ICD–10 and DSM–IV definitions for the same disorder impede international communication and research efforts. The forthcoming parallel development of DSM–V and ICD–11 offers an opportunity to harmonise the two classifications.AimsThis paper aims to facilitate the harmonisation process by identifying diagnostic differences between the two systems.MethodDSM–IV–TR criteria sets and the ICD–10 Diagnostic Criteria for Research were compared and categorised into those with identical definitions, those with conceptually based differences and those in which differences are not conceptually based and appear to be unintentional.ResultsOf the 176 criteria sets in both systems, only one, transient tic disorder, is identical. Twenty-one per cent had conceptually based differences and 78% had non-conceptually based differences.ConclusionsHarmonisation of criteria sets, especially those with non-conceptually based differences, should be prioritised in the DSM–V and ICD–11 development process. Prior experience with the DSM–IV and ICD–10 harmonisation effort suggests that for the process to be successful steps should be taken as early as possible.

scholarly journals Emotional disorders: Cluster 4 of the proposed meta-structure for DSM-V and ICD-11

2009 ◽  
Vol 39 (12) ◽  
pp. 2043-2059 ◽  
Author(s):  
D. P. Goldberg ◽  
R. F. Krueger ◽  
G. Andrews ◽  
M. J. Hobbs
Keyword(s):  
Risk Factors ◽  
Emotional Disorders ◽  
Task Force ◽  
Clinical Manifestations ◽  
Study Group ◽  
Good Reliability ◽  
Symptom Dimensions ◽  
Dsm V ◽  
Co Morbidity ◽  
Icd 10

BackgroundThe extant major psychiatric classifications DSM-IV, and ICD-10, are atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis would be greatly enhanced by an understanding of risk factors and clinical manifestations. In an effort to group mental disorders on the basis of aetiology, five clusters have been proposed. This paper considers the validity of the fourth cluster, emotional disorders, within that proposal.MethodWe reviewed the literature in relation to 11 validating criteria proposed by a Study Group of the DSM-V Task Force, as applied to the cluster of emotional disorders.ResultsAn emotional cluster of disorders identified using the 11 validators is feasible. Negative affectivity is the defining feature of the emotional cluster. Although there are differences between disorders in the remaining validating criteria, there are similarities that support the feasibility of an emotional cluster. Strong intra-cluster co-morbidity may reflect the action of common risk factors and also shared higher-order symptom dimensions in these emotional disorders.ConclusionEmotional disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.

Neurocognitive disorders: Cluster 1 of the proposed meta-structure for DSM-V and ICD-11

2009 ◽  
Vol 39 (12) ◽  
pp. 2001-2012 ◽  
Author(s):  
P. Sachdev ◽  
G. Andrews ◽  
M. J. Hobbs ◽  
M. Sunderland ◽  
T. M. Anderson
Keyword(s):  
Mental Disorders ◽  
Task Force ◽  
Cognitive Disorders ◽  
Neurocognitive Disorders ◽  
Study Group ◽  
Normal Brain ◽  
Dsm V ◽  
Co Morbidity ◽  
Icd 10 ◽  
Dsm Iv

BackgroundIn an effort to group mental disorders on the basis of aetiology, five clusters have been proposed. In this paper, we consider the validity of the first cluster, neurocognitive disorders, within this proposal. These disorders are categorized as ‘Dementia, Delirium, and Amnestic and Other Cognitive Disorders’ in DSM-IV and ‘Organic, including Symptomatic Mental Disorders’ in ICD-10.MethodWe reviewed the literature in relation to 11 validating criteria proposed by a Study Group of the DSM-V Task Force as applied to the cluster of neurocognitive disorders.Results‘Neurocognitive’ replaces the previous terms ‘cognitive’ and ‘organic’ used in DSM-IV and ICD-10 respectively as the descriptor for disorders in this cluster. Although cognitive/organic problems are present in other disorders, this cluster distinguishes itself by the demonstrable neural substrate abnormalities and the salience of cognitive symptoms and deficits. Shared biomarkers, co-morbidity and course offer less persuasive evidence for a valid cluster of neurocognitive disorders. The occurrence of these disorders subsequent to normal brain development sets this cluster apart from neurodevelopmental disorders. The aetiology of the disorders is varied, but the neurobiological underpinnings are better understood than for mental disorders in any other cluster.ConclusionsNeurocognitive disorders meet some of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster. Further developments in the aetiopathogenesis of these disorders will enhance the clinical utility of this cluster.

A Qualitative Analysis on What Brazilian Psychiatrists Want from Current Diagnostic Classifications

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
A. Santos Júnior ◽  
L.F.A.L. Silva ◽  
C.E.M. Banzato ◽  
M.E.C. Pereira
Keyword(s):  
Daily Practice ◽  
Diagnostic Systems ◽  
Diagnostic Categories ◽  
Frequent Use ◽  
Open Questions ◽  
Dsm V ◽  
The Everyday ◽  
Icd 10 ◽  
Axis I ◽  
Dsm Iv

Aims:To analyze the qualitative answers profile of an anonymous standardized survey, with qualitative and quantitative questions, about the Brazilian psychiatrists' perceptions on their use of the multiaxial diagnostic systems ICD 10 and DSM-IV and on their expectations about future revisions of these classifications (ICD-11 and DSM-V).Method:the questionnaire, elaborated by Graham Mellsop (New Zealand), was translated into Portuguese and sent through mail to 1050 psychiatrists affiliated to the Brazilian Psychiatry Association. The quantitative analysis is presented elsewhere.Results:One hundred and sixty questionaries returned (15,2%). From these, 71,1% of the open questions where answered. The most needed and/or desirable qualities in a psychiatric classification were found to be: simplicity, criteria clarity, objectivity, comprehensibility, reliability and ease to use. The axis I of the ICD-10 was reported to be the most used due to its instrumental character in addition to being the official classification, including for legal and bureaucratic purposes. The DSM-IV was also used in the everyday practice, mostly for education and research purposes, by psychiatrists with academic affiliations. The less frequent use of the multiaxial systems was justified by the lack of training and familiarity, the overload of information and by the fact they are not mandatory. It was evaluated that some diagnostic categories must be reviewed, like: mental retardation, eating disorders, personality disorders, sleeping disorders, child and adolescence disorders, affective and schizoaffective disorders.Conclusion:This material offers a systematic panorama about the psychiatrists' opinions and expectations concerning the diagnostic instruments used in the daily practice.

The 1-Month Prevalence of Generalized Anxiety Disorder According to DSM-IV, DSM-V, and ICD-10 Among Nondemented 75-Year-Olds in Gothenburg, Sweden

2012 ◽  
Vol 20 (11) ◽  
pp. 963-972 ◽  
Author(s):  
Johan Nilsson ◽  
Svante Östling ◽  
Margda Waern ◽  
Björn Karlsson ◽  
Robert Sigström ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Generalized Anxiety ◽  
Dsm V ◽  
Icd 10 ◽  
Dsm Iv

Personality problems and disorders

2017 ◽  
Author(s):  
Tom Burns ◽  
Mike Firn
Keyword(s):  
Mental Illness ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Team Work ◽  
Dimensional Approach ◽  
Outreach Workers ◽  
Dsm V ◽  
Icd 10

This chapter deals with the controversial issue of personality disorder, whether these are meaningful diagnoses and, if so, how they affect management. The classification is entirely pragmatic: the definitions and classification in both ICD-10 and DSM-V are outlined along with proposals to abandon categories in favour of a dimensional approach. The issue of treatability is explored, but we conclude that ignoring personality and personality disorders is not a viable alternative for outreach workers. Most of the chapter deals with the management of dissocial personality disorder (usually in men) and borderline personality disorder (usually in women). Specific psychotherapies are not dealt with here; the focus is on how to use team work to manage individuals with severe mental illness and disorders of personality.

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