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Themenschwerpunkt/Theme Articles

Der Stellenwert von Kombinationsbehandlung in der Versorgung schizophrener Störungen

Published Online:October 03, 2006https://doi.org/10.1024/1661-4747.54.3.173

Abstract

Zusammenfassung: Antipsychotika sind in der Behandlung schizophrener Störungen die evidenzbasierte Basisbehandlung. Dies gilt für eine Vielzahl von Zielsyndromen wie wahnhafte und halluzinatorische Symptomatik (Positivsymptomatik), kognitive Funktionsstörungen, Negativsymptomatik und depressive Syndrome im Verlauf. Werden die Antipsychotika falsch ausgewählt (Nebenwirkungen; Wirkungsdefizite) oder falsch dosiert, entstehen schwerwiegende Beeinträchtigungen von Compliance bzw. für die Entfaltung der sozialen und beruflichen Reintegrationschancen. Antipsychotika dienen nicht nur für die Akuttherapie und die Rückfallprophylaxe, sondern sind die Grundlage für jeden erfolgreichen Einsatz vielfältiger moderner störungs- und problemspezifischer kognitiv-verhaltenstherapeutischer und rehabilitativer Interventionen. Diese gehören durch ihre in den letzten Jahren belegte Wirksamkeit inzwischen zum evidenz-basierten Behandlungsrepertoire schizophrener Störungen. Die Ansatzpunkte psychotherapeutischer Interventionen sind vielfältig und werden für folgende Bereiche exemplarisch dargestellt: Ansätze im Rahmen der Frühintervention, Ansätze bei Behandlungsresistenz, Rückfallprävention sowie Compliance-Förderung. Im vorliegenden Beitrag wird eine Übersicht zum aktuellen Stand der Möglichkeiten der genannten Interventionsschwerpunkte gegeben, basierend auf dem aktuellen empirisch belegten Kenntnisstand.


Interactional Effects of Cognitive Behavior Therapy and Antipsychotics in the Treatment of Schizophrenia - What Matters?

Abstract: Pharmacological treatment focuses on positive symptoms, cognitive dysfunctioning, negative symptoms and depression in schizophrenia. High level of side effects or low efficacy of antipsychotic treatment causes high risks either for compliance and service engagement or successful social and vocational integration of people with schizophrenia. Consequences are a mostly worse psychosocial outcome and high rates of relapse and rehospitalisation. Cognitive behavioral interventions focus on early treatment of prodromal and early schizophrenia, treatment-refractory psychosis. Synergy aspects between psychopharmacological and psychotherapeutic interventions are presented and also risks factors for impeding effects of psychotherapy by a suboptimal pharmacological treatment regime.

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