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Fortschr Neurol Psychiatr 2013; 81(5): 276-283
DOI: 10.1055/s-0032-1330507
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Spezialisierte Behandlungsangebote für erstmals schizophren Erkrankte: Konzepte und Ergebnisse

Specialised Treatment in First Episode Schizophrenia: Concepts and Results
W. Wölwer
1   Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf
,
V. Toeller
1   Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf
,
S. Klingberg
2   Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen
,
W. Gaebel
1   Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf
› Author Affiliations
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Publication History

Publication Date:
21 May 2013 (online)

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Zusammenfassung

Vielfältige Evidenz legt nahe, dass Patienten in der frühen Phase einer psychotischen Erkrankung eine spezielle Behandlungsstrategie benötigen, die ihren speziellen Bedürfnissen und Problemen in dieser „kritischen“ Phase gerecht wird. Die vorliegende Übersicht fasst diese Evidenz zusammen und stellt Frühbehandlungsansätze vor, wie sie international bereits in sehr unterschiedlicher Ausgestaltung aufgebaut wurden, sich in Deutschland jedoch erst vereinzelt im Pilotstadium befinden. Bisherige Evaluationsergebnisse weisen auf eine überlegene Wirksamkeit solcher Frühbehandlungsansätze gegenüber herkömmlicher Standardbehandlung sowohl in Bezug auf das klinische Ergebnis als auch in Bezug auf die Gesamtkosten der Behandlung. Offene Fragen bestehen jedoch vor allem noch bezüglich der Spezifität und der Nachhaltigkeit solcher Effekte sowie der wirksamen Behandlungskomponenten. Bevor ähnliche Angebote in Deutschland auf breiter Basis aufgebaut werden, sollte eine Konsentierung der unverzichtbaren Charakteristika und somit zu entsprechenden Qualitätsindikatoren erfolgen.

Abstract

Multifaceted evidence suggests that patients in the early phase of a psychotic disorder need a specific treatment strategy meeting their specific needs and problems in this “critical” phase of the disorder. The present review summarises this evidence and presents early treatment approaches according to already internationally established different models, while in Germany comparable concepts are only in a pilot stage. Previous evaluation studies showed a superior efficacy of such early treatment approaches compared to conventional standard treatment in terms of both clinical outcome and in relation to the total costs of treatment. Questions remain, however, especially with regard to the specificity and durability of such effects, and with regard to the effective treatment components. Before similar programmes can be broadly established in Germany, a consensus on their indispensable characteristics and appropriate quality indicators should be achieved.

Schlüsselwörter

Schizophrenie - kritische Phase - Frühbehandlung - Adhärenz - Erstmanifestation

Key words

schizophrenia - critical period - early intervention - adherence - first episode psychosis
 

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