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) (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

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