Versorgungswege von erstmanifesten psychotischen Patienten – eine Übersicht internationaler Studien

Zusammenfassung

Eine längere Dauer der unbehandelten Psychose (DUP) und der unbehandelten Erkrankung (DUI) ist mit einem negativen Krankheitsverlauf von Psychosen assoziiert. Daher gibt es zunehmend Bemühungen, die DUP zu verkürzen und Betroffene frühzeitig einer adäquaten Therapie zuzuführen. Um frühe Hindernisse bei der Hilfesuche abzubauen, müssen diese zunächst identifiziert werden. Daher wird eine Übersicht initialer Hilfesuchkontakte und über Prädiktoren von Behandlungsverzögerungen bei psychotischen Erstmanifestationen gegeben. Die DUP weist über alle 25 identifizierten Studien eine ungünstige Länge von gut einem Jahr auf, wobei es im Vorfeld im Mittel zu drei Kontakten vor der Behandlungsaufnahme kam. Da Hindernisse in den Versorgungswegen auf allen relevanten Ebenen (Patient, Umwelt und Versorgungssystem) identifiziert wurden, liegen Optimierungsmöglichkeiten in der Vernetzung der Anlaufstellen und kontinuierlicher Aufklärungsarbeit der Bevölkerung und medizinisch-psychologischer Fachkräften.

Abstract

A longer duration of untreated psychosis (DUP) as well as of untreated illness (DUI) was found to be associated with a negative course of psychosis. Thus, increasing efforts are made to reduce the DUP and provide adequate treatment as early as possible. But, in order to overcome obstacles to early help-seeking, these have to be identified first. Thus, an overview on initial help-seeking behaviour and predictors of DUP is given. Across 25 identified studies, the DUP, at about one year on average, is still unfavourably long and includes on average of three help-seeking contacts prior to the initiation of adequate treatment. Since negative factors in pathways-to-care involve features on all relevant levels (patient, social environment and health-care system), an optimisation of pathways-to-care will require the integration of services and continuous awareness programmes targeting the general population and mental health-care professionals.

Schlüsselwörter

Psychose - Prodrom - Versorgungswege - Dauer der unbehandelten Psychose (DUP) - Behandlungsverzögerung - Hilfesuche

Keywords

psychosis - prodrome - pathways-to-care - duration of untreated psychosis (DUP) - treatment delay - help-seeking

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