Internationale Trendergebnisse für

ausgewählte psychische Störungen

Ilja Ruhl

Veränderungen in der Arbeitswelt

• erhöhte Konzentrationsanforderungen• verstärkte Emotionsarbeit • häufiger Wechsel von Aufgaben und

Zuständigkeiten• Zurückverfolgbarkeit von Fehlern durch

Qualitätsmanagement• hohe Informationsdichte

Veränderungen in Arbeitswelt II

• prekäre Arbeitsverhältnisse• Lohndumping (Gratifikationskrisen)• befristete Arbeitsverträge• Zunahme von Zeitarbeit

Auswirkungen auf die Freizeit

• Verschwimmen der Grenzen zwischen Arbeit und Privatleben

• „Pinnbrettfamilien“• stabiles, langfristiges Bezugssystem außerhalb

der Arbeitssphäre ist gefährdet

Gesamtgesellschaftliche Veränderungen

• Migration• Scheidungen• Wegfall des ideologisch-mentalen Rahmens• Abwendung von Religion• Individualisierung, Vereinzelung (Single-

Gesellschaft)

• Alkoholkonsum/-erkrankungen• Schizophrenie• Anorexia Nervosa und Bulimia Nervosa

Recherche: - Handsuche über Literaturverzeichnisse- Medline (Suchwörter: Time Trends, Secular

Trends)

Alkohol und Drogen

• insgesamt 30 Studien (Time Trends)• 20 Europa / 10 Nordamerika• Zeiträume: 1950-2002• Maße

- Pro-Kopf-Konsum- Abhängigkeitssymptome- Folgeerkrankungen und -probleme- Trinkmuster

Alkoholkonsum: Pro-Kopf-Verbrauch

• Pro-Kopf-Konsum in fast allen europäischen Ländern ab Mitte der 70er Jahre sinkend

• in einigen EU-Ländern Stagnation auf unterschiedlich hohen Niveaus

• Rückschlüsse auf individuelle Trinkmuster problematisch

(Ramstedt, M. (2001). Per capita alcohol consumption and liver cirrhosis mortality in 14 European countries. Addiction, 96 Suppl 1, 19-33.)

(Ramstedt, M. (2001). Per capita alcohol consumption and liver cirrhosis mortality in 14 European countries. Addiction, 96 Suppl 1, 19-33.)

(Ramstedt, M. (2001). Per capita alcohol consumption and liver cirrhosis mortality in 14 European countries. Addiction, 96 Suppl 1, 19-33.)

Alkoholkonsum: Trinkmuster

• Frequenz und Menge überwiegend zurückgehend

• Zunahme von Risikokonsum bei Jugendlichen• in Großbritannien Anstieg des Konsums bei

Frauen • Verschiebungen zwischen Bier-, Wein- und

Spirituosenkonsum (z.B. Frankreich)• in den USA Zunahme von Alkholmissbrauch und

Abnahme von Alkoholabhängigkeit bei Männern (1991-2002)

Alkoholkonsum: Folgeerkrankungen/-probleme

• wenig Studien über Entwicklung von Suchterkrankungen

• alkoholbedingte Erkrankungen zeigen bei Untersuchungen, die in die Mitte der 90er hineinreichen, keine Zunahme

• Abhängigkeitssymptome und Ausmaß sozialer Folgen aufgrund Alkoholkonsums steigen nicht an

Drogenkonsum

• USA: sinkender Konsum von Marihuana, Kokain und Heroin (1962-1989)

• Schweiz: Zunahme von Ecstasykonsum und der Lebenszeitprävalenz von Kokainkonsum (1993-2002)

• Deutschland: zunehmender Konsum von Ecstasy und Halluzinogenen (1990-1995)

Schizophrenie

• insgesamt 16 Studien (Time Trends)• 14 Europa / 2 Kanada• Zeiträume: 1952-1998• Maße: Inanspruchnahme

- Erstkontakt

- stationäre Erstaufnahmen

Schizophrenie

• 9 Studien: Abnahme• 6 Studien: Zunahme• 1 Studie keine Veränderung• keine Tendenz bezüglich Untersuchungs-

zeitraum und Länder

Schizophrenie

• Autoren relativieren Ergebnisse• methodische Einwände:

- regional begrenzte Studien

- sich veränderndes Aufsuchverhalten

- bessere Zugänglichkeit zum psychiatrischen System

- Wandel des diagnostischen Instrumentariums

Magersucht/Bulimie

• insgesamt 22 Studien (Time Trend)• 12 Europa / 6 USA / 4 Reviews• Zeiträume: 1931-2002• Maße:

- Inanspruchnahme (16 Studien)

- Befragung (2 Studien)

Magersucht/Bulimie

• Zunahme, z.T. mit erheblichen Peaks, bis Ende der 80er Jahre

• steigende Erkrankungszahlen der Bulimie aufgrund von Verschiebungen zwischen AN und BN

• überwiegend keine Zunahme der Anorexie feststellbar

• möglicher Anstieg in der Subgruppe der 15-24-jährigen Frauen

(Currin, L., Schmidt, U., Treasure, J., & Jick, H. (2005). Time trends in eating disorder incidence. British Journal of Psychiatry, 186, 132-135.)

Magersucht/Bulimie

• methodische Probleme:

- vor 1980 wurden Symptome der AN somatisch, nicht psychiatrisch behandelt

- verfeinerte Diagnostik

- Sensibilisierung von Allgemeinärzten

Zusammenfassung

• Zunahme der dargestellten Erkrankungen fraglich

• Welche protektiven Faktoren existieren?• Verbesserung der Methodik

Allardyce, J., Morrison, G., Van Os, J., Kelly, J., Murray, R. M., & McCreadie, R. G. (2000). Schizophrenia is not disappearing in south-west Scotland. British Journal of Psychiatry, 177, 38-41.

Bamrah, J. S., Freeman, H. L., & Goldberg, D. P. (1991). Epidemiology of schizophrenia in Salford, 1974-84. Changes in an urban community over ten years. British Journal of Psychiatry, 159, 802-810.

Bengtsson, C., Allebeck, P., Lissner, L., Björkelund, C., Hällström, T., & Sigurdsson, J. A. (1998). Alcohol Habits in Swedish Women: Observations from the Population Study of Women in Gothenburg, Sweden 1968 - 1993. Alcohol and Alcoholism, 33(5), 533-544.

Bloomfield, K. (1998). West German drinking patterns in 1984 and 1990. European Addiction Research, 4(4), 163-171.

Boydell, J., Van Os, J., Lambri, M., Castle, D., Allardyce, J., McCreadie, R. G., et al. (2003). Incidence of schizophrenia in south-east London between 1965 and 1997. 182, 45-49.

Brewin, J., Cantwell, R., Dalkin, T., Fox, R., Medley, I., Glazebrook, C., et al. (1997). Incidence of schizophrenia in Nottingham. A comparison of two cohorts, 1978-80 and 1992-94. British Journal of Psychiatry, 171, 140-144.

Castle, D., Wessely, S., Der, G., & Murray, R. M. (1991). The incidence of operationally defined schizophrenia in Camberwell, 1965-84. British Journal of Psychiatry, 159, 790-794.

Corrao, G., Ferrari, P., Zambon, A., Torchio, P., Arico, S., & Decarli, A. (1997). Trends of liver cirrhosis mortality in Europe, 1970-1989: age-period-cohort analysis and changing alcohol consumption. International Journal of Epidemiology, 26(1), 100-109.

Currin, L., Schmidt, U., Treasure, J., & Jick, H. (2005). Time trends in eating disorder incidence. British Journal of Psychiatry, 186, 132-135.

Der, G., Gupta, S., & Murray, R. M. (1990). Is schizophrenia disappearing? Lancet, 335(8688), 513-516.

Eagles, J. M., & Besson, J. A. (1985). Changes in the incidence of alcohol-related problems in north-east Scotland, 1974-1982. British Journal of Psychiatry, 147, 39-43.

Eagles, J. M., Easton, E. A., Nicoll, K. S., Johnston, M. I., & Millar, H. R. (1999). Changes in the presenting features of females with anorexia nervosa in northeast Scotland, 1965-1991. International Journal of Eating Disorders, 26(3), 289-294.

Eagles, J. M., Hunter, D., & McCance, C. (1988). Decline in the diagnosis of schizophrenia among first contacts with psychiatric services in north-east Scotland, 1969-1984. British Journal of Psychiatry, 152, 793-798.

Eagles, J. M., & Whalley, L. J. (1985). Decline in the diagnosis of schizophrenia among first admissions to Scottish mental hospitals from 1969-78. British Journal of Psychiatry, 146, 151-154.

Fichter, M. M., Quadflieg, N., Georgopoulou, E., Xepapadakos, F., & Fthenakis, E. W. (2005). Time trends in eating disturbances in young Greek migrants. International Journal of Eating Disorders, 38(4), 310-322.

Geddes, J. R., Black, R. J., Whalley, L. J., & Eagles, J. M. (1993). Persistence of the decline in the diagnosis of schizophrenia among first admissions to Scottish hospitals from 1969 to 1988. British Journal of Psychiatry, 163, 620-626.

George, D. T., Weiss, S. R., Gwirtsman, H. E., & Blazer, D. (1987). Hospital treatment of anorexia nervosa: a 25-year retrospective study from 1958 to 1982. International Journal of Eating Disorders, 6, 321-330.

Grant, B. F., Dawson, D. A., Stinson, F. S., Chou, S. P., Dufour, M. C., & Pickering, R. P. (2004). The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991-1992 and 2001-2002. Drug and Alcohol Dependence, 74(3), 223-234.

Greenfield, T. K., Midanik, L. T., & Rogers, J. D. (2000). A 10-year national trend study of alcohol consumption, 1984 - 1995: Is the period of declining drinking over? American Journal of Public Health, 90(1), 47-52.

Harrison, G., Cooper, J. E., & Gancarczyk, R. (1991). Changes in the administrative incidence of schizophrenia. British Journal of Psychiatry, 159, 811-816.

Haw, C., Hawton, K., Casey, D., Bale, E., & Shepherd, A. (2005). Alcohol dependence, excessive drinking and deliberate self-harm: trends and patterns in Oxford, 1989-2002. Social Psychiatry and Psychiatric Epidemiology, 40(12), 964-971.

Hilton, M. E. (1988a). Trends in drinking problems and attitudes in the United States: 1979-1984. British Journal of Addiction, 83(12), 1421-1427.

Hilton, M. E. (1988b). Trends in U.S. drinking patterns: further evidence from the past 20 years. British Journal of Addiction, 83(3), 269-278.

Hoek, H. W., Bartelds, A. I., Bosveld, J. J., van der Graaf, Y., Limpens, V. E., Maiwald, M., et al. (1995). Impact of urbanization on detection rates of eating disorders. American Journal of Psychiatry, 152(9), 1272-1278.

Lewis, G., & Wilkinson, G. (1993). Another British disease? A recent increase in the prevalence of psychiatric morbidity. Journal of Epidemiology and Community Health, 47(5), 358-361.

Lucas, A. R., Beard, C. M., O'Fallon, W. M., & Kurland, L. T. (1988). Anorexia nervosa in Rochester, Minnesota: a 45-year study. Mayo Clinic Proceedings, 63(5), 433-442.

Lucas, A. R., Crowson, C. S., O'Fallon, W. M., & Melton, L. J., 3rd. (1999). The ups and downs of anorexia nervosa. International Journal of Eating Disorders, 26(4), 397-405.

Mann, R. E., Smart, R. G., Rush, B. R., Zalcman, R. F., & Suurvali, H. (2005). Cirrhosis mortality in Ontario: effects of alcohol consumption and Alcoholics Anonymous participation. Addiction, 100(11), 1669-1679.

Michaud, P., Berchtold, A., Jeannin, A., Chossis, I., & Suris, J. (2006). Secular trends in legal and illegal substance use among 16 to 20 year old adolescents in Switzerland. Swiss Med Wkly, 136(19-20), 318-326.

Midanik, L. T., & Clark, W. B. (1994). The demographic distribution of US drinking patterns in 1990: description and trends from 1984. American Journal of Public Health, 84(8), 1218-1222.

Midanik, L. T., & Greenfield, T. K. (2000). Trends in social consequences and dependence symptoms in the United States: the National Alcohol Surveys, 1984-1995. American Journal of Public Health, 90(1), 53-56.

Milos, G., Spindler, A., Schnyder, U., Martz, J., Hoek, H. W., & Willi, J. (2004). Incidence of severe anorexia nervosa in Switzerland: 40 years of development. International Journal of Eating Disorders, 35(3), 250-258.

Monarca, S., Donato, F., Modolo, M. A., Brunelli, L., Spiazzi, R., Pasquale, L., et al. (1991). Drinking habits among high school students in Perugia, Italy, in 1981 and 1988: time trends and correlates. International Journal of the Addictions, 26(10), 1107-1122.

Munk-Jorgensen, P., & Jorgensen, P. (1986). Decreasing rates of first-admission diagnoses of schizophrenia among females in Denmark 1970-84. Acta Psychiatrica Scandinavica, 74(4), 379-383.

Munk-Jorgensen, P., & Mortensen, P. B. (1992). Incidence and other aspects of the epidemiology of schizophrenia in Denmark, 1971-87. British Journal of Psychiatry, 161, 489-495.

Nielsen, S. (1990). The epidemiology of anorexia nervosa in Denmark from 1973 to 1987: a nationwide register study of psychiatric admission. Acta Psychiatrica Scandinavica, 81(6), 507-514.

Oldehinkel, A. J., & Giel, R. (1995). Time trends in the care-based incidence of schizophrenia. British Journal of Psychiatry, 167(6), 777-782.

Osby, U., Correia, N., Brandt, L., Ekbom, A., & Sparen, P. (2000). Time trends in schizophrenia mortality in Stockholm county, Sweden: cohort study. BMJ, 321(7259), 483-484.

Pagsberg, A. K., & Wang, A. R. (1994). Epidemiology of anorexia nervosa and bulimia nervosa in Bornholm County, Denmark, 1970-1989. Acta Psychiatrica Scandinavica, 90(4), 259-265.

Poikolainen, K. (1980). Increase in alcohol-related hospitalizations in Finland 1969-1975. British Journal of Addiction, 75(3), 281-291.

Preti, A., & Miotto, P. (2000). Increase in first admissions for schizophrenia and other major psychoses in Italy. Psychiatry Research, 94(2), 139-152.

Pyle, R., A, H., PA, N., & JE, M. (1986). The increasing prevalence of bulimia in freshmen college students. International Journal of Eating Disorders, 5(4), 631-647.

Pyorala, E. (1990). Trends in alcohol consumption in Spain, Portugal, France and Italy from the 1950s until the 1980s. British Journal of Addiction, 85(4), 469-477.

Rahkonen, O., & Ahlstrom, S. (1989). Trends in drinking habits among Finnish youth from 1973 to 1987. British Journal of Addiction, 84(9), 1075-1083.

Ramstedt, M. (2001). Per capita alcohol consumption and liver cirrhosis mortality in 14 European countries. Addiction, 96 Suppl 1, 19-33.

Rossow, I., & Amundsen, A. (1997). Alcohol abuse and mortality: a 40-year prospective study of Norwegian conscripts. Social Science and Medicine, 44(2), 261-267.

Schuster, P., Lieb, R., Lamertz, C., & Wittchen, H. U. (1998). Is the use of ecstasy and hallucinogens increasing? Results from a community study. European Addiction Research, 4(1-2), 75-82.

Shajahan, P. M., & Cavanagh, J. T. O. (1998). Admission for depression among men in Scotland, 1980 - 95: retrospective study. (316).

Shinkwin, R., & Standen, P. J. (2001). Trends in anorexia nervosa in Ireland: A register study. Eur. Eat. Disorders Rev., 9, 263-276.

Soundy, T. J., Lucas, A. R., Suman, V. J., & Melton, L. J., 3rd. (1995). Bulimia nervosa in Rochester, Minnesota from 1980 to 1990. Psychol Med, 25(5), 1065-1071.

Sumskas, L., & Zaborskis, A. (2004). Alcohol consumption in Lithuanian school-aged children during 1994-2002. Medicina (Kaunas), 40(11), 1117-1123.

Thundal, K. L., Spak, F., & Allebeck, P. (2000). Drinking patterns among Swedish women: results from a 5-year follow-up of a population-based study. Alcohol and Alcoholism, 35(5), 520-524.

Veling, W., Selten, J. P., Veen, N., Laan, W., Blom, J. D., & Hoek, H. W. (2006). Incidence of schizophrenia among ethnic minorities in the Netherlands: A four-year first-contact study. Schizophr Res.

Willi, J., Giacometti, G., & Limacher, B. (1990). Update on the epidemiology of anorexia nervosa in a defined region of Switzerland. American Journal of Psychiatry, 147(11), 1514-1517.

Willi, J., Limacher, B., Grossmann, S., & Giacometti, G. (1989). [Long-term study of the incidence of anorexia nervosa]. Nervenarzt, 60(6), 349-354.

Williams, G. D., & Debakey, S. F. (1992). Changes in levels of alcohol consumption: United States, 1983-1988. British Journal of Addiction, 87(4), 643-648.

Woogh, C. (2001). Is schizophrenia on the decline in Canada? Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 46, 61-67.