{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:17:48Z","timestamp":1787699868180,"version":"build-2784847793"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychother Psychosom Med Psychol"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Hintergrund. Der ICD-11 beschreibt die Anpassungsst\u00f6rung (APS) als psychische\n                    Reaktion auf identifizierbare Belastungen, gekennzeichnet durch die Kernsymptome\n                    Pr\u00e4okkupation und Fehlanpassung. Trotz bekannter Heterogenit\u00e4t der Ausl\u00f6ser ist\n                    bislang unzureichend untersucht, ob sich unterschiedliche Stressor-Typen\n                    systematisch auf Symptomverlauf und sozialmedizinische Prognose auswirken.\n                    Methode. In einer multizentrischen, prospektiven Beobachtungsstudie wurden\n                    N=1028 Patient:innen psychosomatischer Rehabilitation zu Beginn und am Ende der\n                    Behandlung untersucht. APS-Symptome wurden mit dem ADNM-20 erhoben, depressive\n                    Symptome mit dem BDI-II und psychosoziale Funktionsf\u00e4higkeit mit dem HEALTH-49.\n                    Als Pr\u00e4diktor diente der prim\u00e4re Ausl\u00f6ser (arbeitsbezogen, famili\u00e4r, eigene\n                    schwere Erkrankung). Gruppenunterschiede und Verl\u00e4ufe wurden mittels\n                    Varianzanalysen mit Messwiederholung analysiert, sozialmedizinische Parameter\n                    mittels Chi-Quadrat-Tests. Ergebnisse. Berufliche Belastungen stellten den\n                    h\u00e4ufigsten APS-Ausl\u00f6ser dar (32,8%), gefolgt von eigener schwerer Erkrankung\n                    (22,7%) und famili\u00e4ren Konflikten (14,5%). Zu Reha-Beginn zeigten sich\n                    signifikante, jedoch \u00fcberwiegend kleine bis mittlere Unterschiede zwischen den\n                    Gruppen: Patient:innen mit eigener schwerer Erkrankung berichteten h\u00f6here Werte\n                    in Angst, Vermeidung und Fehlanpassung, w\u00e4hrend familienbezogene Belastungen mit\n                    geringerer wahrgenommener sozialer Unterst\u00fctzung assoziiert waren. \u00dcber den\n                    Behandlungsverlauf kam es zu signifikanten Verbesserungen in APS- und\n                    Depressionssymptomen (gro\u00dfe Effektst\u00e4rken), jedoch ohne signifikante\n                    Interaktionseffekte zwischen Zeit und Ausl\u00f6sergruppe. Sozialmedizinisch zeigten\n                    sich keine Nachteile f\u00fcr arbeitsbezogene APS; vielmehr wiesen Patient:innen mit\n                    eigener Erkrankung die ung\u00fcnstigsten Parameter hinsichtlich Arbeitsf\u00e4higkeit\n                    auf. Fazit. Das Ausl\u00f6seereignis beeinflusst spezifische psychosoziale Aspekte,\n                    jedoch entgegen unserer Ausgangshypothese nicht konsistent den\n                    Rehabilitationsverlauf. Bei APS als Reaktion auf eine k\u00f6rperliche Erkrankung\n                    erscheint eine differenzierte Betrachtung der Krankheitsverarbeitung f\u00fcr die\n                    sozialmedizinische Einsch\u00e4tzung sinnvoll.<\/jats:p>","DOI":"10.1055\/a-2916-8193","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:32:40Z","timestamp":1787697160000},"source":"Crossref","is-referenced-by-count":0,"title":["Ausl\u00f6ser der ICD-11-Anpassungsst\u00f6rung: Unterschiede in Symptomverlauf\n                    und sozialmedizinischer Prognose"],"prefix":"10.1055","author":[{"given":"Alexa","family":"Kupferschmitt","sequence":"additional","affiliation":[{"name":"Verhaltenstherapie und Psychosomatik, Reha-Zentrum Seehof, Teltow,\n                    Germany"},{"name":"Forschungsgruppe Psychosomatische Rehabilitation, Charit\u00e9\n                    Universit\u00e4tsmedizin Berlin Campus Benjamin Franklin, Berlin,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"K\u00f6llner","sequence":"additional","affiliation":[{"name":"Verhaltenstherapie und Psychosomatik, Reha-Zentrum Seehof, Teltow,\n                    Germany"},{"name":"Forschungsgruppe Psychosomatische Rehabilitation, Charit\u00e9\n                    Universit\u00e4tsmedizin Berlin Campus Benjamin Franklin, Berlin,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahel","family":"Bachem","sequence":"additional","affiliation":[{"name":"Kompetenzzentrum f\u00fcr Psychische Gesundheit, Professur f\u00fcr\n                    Psychopathologie und Psychotherapie, St. Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"ref1","volume-title":"International Classification of Diseases, 11th Revision (ICD-11)","author":"World Health 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