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Die Organtransplantation hat sich in den letzten 20 Jahren zu einem Standardverfahren in der Therapie schwerer, anders nicht mehr behandelbarer Organerkrankungen entwickelt. In Deutschland werden jährlich etwa 3000 Transplantationen durchgeführt. Über 13 000 Menschen stehen auf der Warteliste für einen solchen Eingriff. Sowohl die Wartezeit als auch die verschiedenen Phasen nach dem Eingriff fordern erhebliche psychische Anpassungsleistungen von Patienten und Angehörigen, was häufig zu psychischen Störungen führt. Das Transplantationsgesetz von 1997 fordert daher ausdrücklich eine psychosomatische Mitbetreuung in den Transplantationszentren. Trotz dieses Therapiebedarfs fehlt es bisher an empirisch gesicherten therapeutischen Strategien. In der Transplantationsmedizin ist ein methodenübergreifender Betreuungsansatz sinnvoll. Kognitiv-verhaltenstherapeutische Therapieelemente scheinen aufgrund ihres pragmatischen und lösungsorientierten Ansatzes für diese Patientengruppe besonders geeignet. Ziel dieses Artikels ist es, auf Basis klinischer Erfahrungen und der wissenschaftlichen Literatur eine Übersicht über die unterschiedlichen Phasen der Transplantation solider Organe, ihre spezifischen Belastungen und therapeutische Strategien für Patienten und ihre Angehörigen zu geben. Der Bedarf an empirischer Forschung auf diesem Gebiet, gerade was die Wirksamkeit verhaltensmedizinischer Interventionen angeht, wird deutlich. / About 3,000 patients per year receive a transplant in Germany and some 13,000 patients are on waiting lists. Waiting period and the different stages of recovery demand special coping strategies from patients and their families. Psychological disorders are frequent before and after the transplantation and psychological risk factors are relevant for the outcome of the transplantation. Therefore special psychosomatic care for patients and their families is necessary. However, evidence based knowledge on appropriate therapeutic interventions is still scarce. In transplantation medicine, an overall approach is reasonable. Cognitive-behavioral aspects seem to be especially promising. The article describes strategies and techniques for the psychosomatic assessment of patients before transplantation and psychotherapeutic interventions for patients and their families before and after solid organ transplantation. More research on the effects of psychotherapeutic interventions in this field is necessary. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

La teoria della mente (toM) è la capacità di attribuire stati mentali a se' e agli altri e di prevedere il comportamento sulla base di essi. recentemente gli studiosi della tom hanno adottato un'ottica life-span (che ha portato alla costruzione di nuovi strumenti per valutare la tom) e iniziato a studiare le differenze individuali in questa capacità (includendo la comprensione delle emozioni e i legami tra tom e funzionamento socio-emotivo). Il presente lavoro ha lo scopo di approfondire lo studio dello sviluppo della comprensione di stati mentali (epistemici ed emotivi) e i suoi legami con le difficoltà emotive nei bambini. Affronta così alcune nuove tematiche nell'ambito degli studi sulla tom, relative alla valutazione della tom in bambini con sviluppo tipico frequentanti la scuola primaria e la relazione tra tom e problemi internalizzanti. Viene presentato un nuovo compito avanzato di ToM e la sua validazione e standardizzazione su un campione italiano di bambini di 6.5-11.4 anni: il voice test. esso valuta l'abilità di comprendere stati mentali complessi da indici vocali. Infine, viene studiata la relazione tra tom e rischio psicologico e, in particolare, analizzato il legame tra la scarsa tom e le frequenti lamentele somatiche nei bambini in eta' scolare. / Theory of Mind (ToM) is the ability to impute mental states to the self e to the others as a way of making sense and predicting behaviour. Recently ToM researchers has been adopted a life span perspective, that leads to the construction of new instruments to assess ToM, and studied individual differences in ToM, including emotion understanding and the relationship between ToM and socio-emotional functioning. The present work is aimed to analyze deeper the development of mental states (both epistemic and emotional) understanding and its link with emotional difficulties, dealing with some novel topics within ToM studies, regarding ToM assessment in school age children and the relationship between ToM and internalizing problems. After reviewing ToM studies, it presents the Voice Test, a new advanced ToM instrument, and its validation and standardization on an Italian school age children sample aged 6,5-11,4 years; the test assesses the ability to understand a wide range of complex mental states from vocal cues. finally, it is studied the relationship between ToM and psychological risk and, in particular, it points out the link between poor ToM and frequent somatic complaints in a normal school age children population.