Frühintervention bei Schizophrenie – ein Update

Zusammenfassung

In Deutschland werden Psychosen immer noch zu spät diagnostiziert. Die Dauer der unbehandelten Psychose (DUP) liegt im Durchschnitt bei einem Jahr. Daher sollte die Frühintervention einen höheren Stellenwert erhalten. Denn je kürzer die Dauer der DUP, desto höher ist die Wahrscheinlichkeit der dauerhaften Recovery sowie einer besseren Langzeitprognose. Aufklärungsarbeit in der Öffentlichkeit und spezialisierte Früherkennungszentren mit niedrigschwelligem Zugang können die Versorgung und damit die Perspektive der meist jungen Patientinnen und Patienten bereits in der Frühphase der Erkrankung verbessern. Notwendig sind dazu neben der antipsychotischen Therapie evidenzbasierte psychotherapeutische Verfahren, Angehörigen- und Peerarbeit sowie begleitende Angebote, durch die Patientinnen und Patienten individuell darin unterstützt werden, wieder im Arbeitsmarkt integriert zu werden oder zu verbleiben („Individual Placement and Support“, IPS). Während die Möglichkeit zur Frühintervention in einigen Ländern, z. B. Dänemark und Australien, bereits einen Teil der Regelversorgung darstellt, ist Deutschland noch nicht über Modellprojekte hinausgekommen. Dies zu ändern muss eines der wesentlichen Ziele der nächsten Jahre sein. Mit dieser Übersichtsarbeit möchten die Autoren daher zum Weiterdenken und Handeln anregen.

Abstract

In Germany, psychoses are still diagnosed too late. The average duration of untreated psychosis is (DUP) one year. Early intervention should, therefore, be given higher priority. The shorter the duration of the DUP, the higher the probability of permanent recovery and a better long-term prognosis. Public education work and specialised early detection centres with low-threshold access can improve care and thus the prospects of patients, mostly young, and already in the early phase of the disease. In addition to anti-psychotic therapy, evidence-based psychotherapeutic procedures, family and peer work, as well as accompanying offers are necessary to support patients individually in being or remaining reintegrated into the labour market ("Individual Placement and Support", IPS). While in some countries, such as Denmark and Australia, the possibility of early intervention is already part of standard care, Germany has not yet gone beyond model projects. Changing this must be one of the main objectives for the coming years. With this review, the authors would therefore like to encourage further thinking and action.

Schlüsselwörter

Schizophrenie - Frühintervention - Langzeitprognose - DUP

Key words

Schizophrenia - Early Intervention - Long-term Prognosis - DUP

Publication History

Received: 22 November 2018

Accepted: 25 April 2019

Article published online:
18 June 2020

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