{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T01:10:19Z","timestamp":1771031419294,"version":"3.50.1"},"reference-count":54,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fortschr Neurol Psychiatr"],"abstract":"Zusammenfassung<\/jats:title>\n Fremdk\u00f6rperingestionen (FKI) bei psychischen St\u00f6rungen sind ein h\u00e4ufiges und oft\n erheblich herausforderndes Versorgungsproblem. W\u00e4hrend internationale Leitlinien\n zur gastroenterologischen Akutversorgung von Erwachsenen mit FKI existieren, ist\n die Datenlage im psychiatrischen Kontext quantitativ und qualitativ sehr\n begrenzt. FKI kommen bei nahezu allen psychischen St\u00f6rungen, jedoch vermutlich\n am h\u00e4ufigsten bei Patienten mit Borderline-Pers\u00f6nlichkeitsst\u00f6rung vor. Scharfe\n und spitze, besonders gro\u00dfe (>2,5 cm Durchmesser) oder lange (>6 cm)\n Gegenst\u00e4nde sowie Batterien, insbesondere Knopfzellen, aber auch Magnete sind\n mit dem gr\u00f6\u00dften Risiko f\u00fcr FKI-assoziierte Komplikationen assoziiert. Dennoch\n werden etwa 80% aller Ingestate ohne Komplikationen nach 5 bis 6 Tagen f\u00e4kal\n ausgeschieden. Die psychiatrische Akutversorgung von FKI sollte eine Anamnese in\n Bezug auf Art und Anzahl ingestierter Fremdk\u00f6rper, Zeitpunkt der Ingestion und\n eine k\u00f6rperliche Untersuchung mit Fokus auf Allgemeinzustand, Abdomen,\n respiratorisches System und Vitalparameter umfassen. Nicht jedes Ingestat muss\n endoskopisch entfernt werden, weshalb auch im psychiatrischen Setting die\n Kenntnis gastroenterologischer Leitlinienempfehlungen erforderlich ist. Bei\n wiederholten FKI sollten interdisziplin\u00e4re Besprechungen erfolgen, die\n allgemeine und fallbezogene Aspekte bei der Akutversorgung adressieren. Dabei\n sollten Standards f\u00fcr die Kommunikation und Interaktion zwischen Team und\n Patient definiert werden, die auf eine Vermeidung von Verst\u00e4rkung\n dysfunktionaler Verhaltensweisen des Patienten abzielen. Zudem sollten Super-\n und Intervisionen durchgef\u00fchrt werden. Ein klinisches Ethikkomitee sollte in\n besonders komplexen F\u00e4llen einbezogen werden. Aus ethischen, medizinischen und\n haftungsrechtlichen Gr\u00fcnden kann nicht empfohlen werden, bei wiederholten FKI\n pauschal auf eine Endoskopie zu verzichten. In Einzelf\u00e4llen kann jedoch nach\n Nutzen-Risikoabw\u00e4gung sowie interdisziplin\u00e4rem Konsens die Gastroskopie\n verz\u00f6gert durchgef\u00fchrt oder vermieden werden, um dysfunktionale Verst\u00e4rkung\n sowie das Risiko f\u00fcr unerw\u00fcnschte Effekte und Komplikationen zu reduzieren. Wenn\n eine st\u00f6rungsspezifische Psychotherapie (z. B. DBT, MBT) nicht verf\u00fcgbar oder\n durchf\u00fchrbar ist, sind das Festlegen des weiteren Vorgehens in einem\n Therapievertrag, die Durchf\u00fchrung von Situationsanalysen und ein\n Kontingenzmanagement wichtige Elemente der Behandlung. Die genannten Aspekte\n sollten in einem interdisziplin\u00e4r konsentierten und dem Patienten kommunizierten\n Akutbehandlungsplan dokumentiert werden.<\/jats:p>","DOI":"10.1055\/a-2778-7790","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:29:18Z","timestamp":1771028958000},"source":"Crossref","is-referenced-by-count":0,"title":["Fremdk\u00f6rperingestionen bei psychischen St\u00f6rungen: Was wissen wir und\n was sollen wir tun?"],"prefix":"10.1055","author":[{"given":"Maximilian","family":"Gahr","sequence":"additional","affiliation":[{"name":"Krankenhaus f\u00fcr Psychiatrie Psychotherapie und\n Psychosomatische Medizin Schloss Werneck, Werneck, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Mischke","sequence":"additional","affiliation":[{"name":"Leopoldina Krankenhaus Schweinfurt, Schweinfurt,\n Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Kanzler","sequence":"additional","affiliation":[{"name":"Leopoldina Krankenhaus Schweinfurt, Schweinfurt,\n Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus Alexander","family":"K\u00f6lle","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Psychiatrie und Psychotherapie,\n Universit\u00e4tsklinik Bonn, Bonn, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Seem\u00fcller","sequence":"additional","affiliation":[{"name":"kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen,\n Fachklinik f\u00fcr Psychiatrie, Neuropsychiatrie, Psychotherapie und Psychosomatik,\n Garmisch-Partenkirchen, Deutschland"},{"name":"Klinik f\u00fcr Psychiatrie und Psychotherapie,\n Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alkomiet","family":"Hasan","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Psychiatrie, Psychotherapie und Psychosomatik, Medizinische\n Fakult\u00e4t, Universit\u00e4t Ausgsburg, Augsburg, Deutschland"},{"name":"DZPG (Deutsches Zentrum f\u00fcr Psychische Gesundheit), Partnerstandort\n M\u00fcnchen\/Ausgburg, Ausburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.ajem.2021.07.048","article-title":"Upper gastrointestinal foreign bodies in adults: A systematic review","volume":"50","author":"X Wang","year":"2021","journal-title":"Am J Emerg Med"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1016\/j.cgh.2010.07.013","article-title":"Intentional swallowing of foreign bodies is a recurrent and costly problem that\n rarely causes endoscopy complications","volume":"8","author":"B L Huang","year":"2010","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1086\/JCE201324202","article-title":"Repetitive foreign body ingestion: ethical considerations","volume":"24","author":"S Lytle","year":"2013","journal-title":"J Clin Ethics"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1055\/s-0042-100456","article-title":"Removal of foreign bodies in the upper gastrointestinal tract in adults:\n European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline","volume":"48","author":"M Birk","year":"2016","journal-title":"Endoscopy"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/j.gie.2010.11.010","article-title":"Management of ingested foreign bodies and food impactions","volume":"73","author":"Committee ASoP","year":"2011","journal-title":"Gastrointest Endosc"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.genhosppsych.2011.06.011","article-title":"Hard to swallow: a systematic review of deliberate foreign body ingestion","volume":"33","author":"B A Poynter","year":"2011","journal-title":"Gen Hosp Psychiatry"},{"key":"ref9","first-page":"869","article-title":"Swallowed foreign bodies in adults","volume":"109","author":"P Ambe","year":"2012","journal-title":"Dtsch Arztebl Int"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1067\/mge.2001.112709","article-title":"Esophageal food impaction: epidemiology and therapy. 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