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Erschienen in: HNO 11/2023

13.09.2023 | Tinnitus | Leitthema

Chronischer Tinnitus im Wechselspiel somatischer und psychischer Faktoren

verfasst von: Dr. phil. Benjamin Boecking, Dr. phil. Petra Brueggemann, Prof. Dr. med. Matthias Rose, Prof. Dr. med. Birgit Mazurek

Erschienen in: HNO | Ausgabe 11/2023

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Zusammenfassung

Chronischer Tinnitus ist ein häufiges, mitunter stark belastendes Phänomen, das durch ein Wechselspiel körperlicher und psychologischer Faktoren ausgelöst und aufrechterhalten werden kann. Moderne HNO-Heilkunde integriert mit der klinischen Psychologie und psychosomatischen Medizin als Partnern sowohl medizinische (z. B. Hörverlust) als auch psychologische Einflüsse. Letztere umfassen z. B. Wechselwirkungen zwischen biographischen Erfahrungen, Persönlichkeitseigenschaften, der subjektiven Bewertung intrapsychischer und zwischenmenschlicher Reize, Gefühlszuständen, und intrapsychischen oder zwischenmenschlichen Emotionsregulationsstrategien. Beide Variablengruppen können die Intensität und den Verlauf einer chronischen Tinnitussymptomatik direkt und indirekt beeinflussen – wobei die Qualität und relativen Ausprägungsgrade psychologischer und körperlicher Anteile am Selbsterleben einer Person fluktuieren können. Vor diesem Hintergrund unterscheidet der vorliegende Artikel zwischen chronischer Tinnitussymptomatik mit oder ohne Hörverlust – und plädiert nachdrücklich für ein integriertes Verständnis des chronischen Tinnitus innerhalb eines ganzheitlichen psychologischen Bezugsrahmens. Nach einer kurzen Einführung in die Prinzipien psychosomatischer Medizin und Psychotherapie erörtert der Artikel die psychotherapeutische Fallkonzeptualisierung am Beispiel eines Vulnerabilitäts-Stress-Coping(VSC)-Modells, skizziert klinische Aspekte und Diagnostik einer chronischen Tinnitussymptomatik und schließt mit der Konzeptualisierung chronischen Tinnitusdistresserlebens als Funktion personenzentrierter VSC-Wechselwirkungen.
Fußnoten
1
Beispiel einer nomothetischen Fragestellung: Lassen sich interindividuelle Unterschiede in Tinnitusdistress durch interindividuelle Unterschiede in „Katastrophisierungsneigung“ erklären [24]?; Beispiel einer idiographischen Fragestellung: Welche katastrophisierenden Gedanken beschäftigen diese Person und – vor dem Hintergrund ihrer Biographie und Lebenssituation – weswegen?
 
2
Natürlich gibt es auch biopsychosoziale Varianten dieses Modelltyps [49].
 
3
Hierbei ist allerdings wichtig, psychiatrische Diagnosekategorien nicht als „Erkrankungseinheiten“ zu verstehen, sondern lediglich als vereinfachende Beschreibung komplexer psychologischer Wechselwirkungen, deren Ursprung und Bedeutung idiographisch exploriert werden müssen.
 
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Metadaten
Titel
Chronischer Tinnitus im Wechselspiel somatischer und psychischer Faktoren
verfasst von
Dr. phil. Benjamin Boecking
Dr. phil. Petra Brueggemann
Prof. Dr. med. Matthias Rose
Prof. Dr. med. Birgit Mazurek
Publikationsdatum
13.09.2023
Verlag
Springer Medizin
Erschienen in
HNO / Ausgabe 11/2023
Print ISSN: 0017-6192
Elektronische ISSN: 1433-0458
DOI
https://doi.org/10.1007/s00106-023-01370-2

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HNO 11/2023 Zur Ausgabe

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

HNO-Op. auch mit über 90?

16.04.2024 HNO-Chirurgie Nachrichten

Mit Blick auf das Risiko für Komplikationen nach elektiven Eingriffen im HNO-Bereich scheint das Alter der Patienten kein ausschlaggebender Faktor zu sein. Entscheidend ist offenbar, wie fit die Betroffenen tatsächlich sind.

Intrakapsuläre Tonsillektomie gewinnt an Boden

16.04.2024 Tonsillektomie Nachrichten

Gegenüber der vollständigen Entfernung der Gaumenmandeln hat die intrakapsuläre Tonsillektomie einige Vorteile, wie HNO-Fachleute aus den USA hervorheben. Sie haben die aktuelle Literatur zu dem Verfahren gesichtet.

Bilateraler Hörsturz hat eine schlechte Prognose

15.04.2024 Hörsturz Nachrichten

Die Mehrzahl der Menschen mit Hörsturz ist einseitig betroffen, doch auch ein beidseitiger Hörsturz ist möglich. Wie häufig solche Fälle sind und wie sich ihr Verlauf darstellt, hat eine HNO-Expertenrunde aus den USA untersucht.

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