Frühinterventionen vor schizophrenen Ersterkrankungen

Zusammenfassung

Eine Reihe von Erkenntnissen hat in den letzten Jahren dazu beigetragen, dass eine Frühintervention bei schizophrenen Erkrankungen vor dem Auftreten erster psychotischer Symptomen begründet und aussichtsreich erscheint. Aus internationalen Studien gibt es erste Hinweise für die Effektivität einer Frühintervention bei Personen mit erhöhtem Psychoserisiko. In Erweiterung der internationalen Forschung wurde in den Interventionsstudien des Kompetenznetz Schizophrenie zwischen einem psychosenahen und einem psychosefernen Prodrom unterschieden und hierauf bezogene differenzielle Interventionen mit kognitiver Verhaltenstherapie im psychosefernen Prodrom und mit atypischem Antipsychotikum im psychosenahen Prodrom entwickelt. Obwohl die Datenlage abschließend noch nicht zu beurteilen ist, stimmen die Zwischenauswertungen der Interventionsstudien des Kompetenznetzes Schizophrenie und die vorliegenden Ergebnisse internationaler Studien optimistisch für die Entwicklung einer indizierten Prävention bei schizophrenen Störungen.

Summary

In recent years new clinical findings suggested that early intervention in the prodromal phase of schizophrenia may be possible. First pilot data from international studies indicated that early intervention in persons at ultra-high risk of developing psychosis may be effective. Asa further development of the international approaches within the German Research Network on Schizophrenia we defined an early anda late initial prodromal state and developeda related differential intervention. A comprehensive cognitive-behavioural therapy is evaluated in persons in the early initial prodromal whereas clinical management and atypical neuroleptics combined are explored in persons in the late initial prodromal state. Although we have to await the final results of the ongoing trials, the preliminary data and findings from international studies are suggesting that indicated prevention may become a new perspective in the treatment of schizophrenia.

Schlüsselwörter

Schizophrenie - Prodrom - Frühintervention - kognitive Verhaltenstherapie

Keywords

Schizophrenia - prodrome - early intervention - cognitive-behavioural therapy

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