Von der Pathophysiologie zur Entwicklung von Leitlinien und neuen Behandlungskonzepten der Schizophrenie

Zusammenfassung

Psychotische Erkrankungen sind mit einer Jahresprävalenz von bis zu 4 % nicht selten. Die Schizophrenie trägt mit direkten, aber auch indirekten Kosten (Arbeitsunfähigkeit) substanziell zu den Belastungen durch psychische Erkrankungen bei. Die ungünstige Prognose der Schizophrenie wird durch Negativsymptomatik und die damit verbundenen kognitiven Defizite verursacht. Der zugrundeliegende pathophysiologische Mechanismus kann am ehesten als Störung regenerativer Kapazitäten des menschlichen Gehirns gewertet werden. Die Implementierung von Leitlinien, Qualitätsindikatoren und Behandlungspfaden verbessert die Behandlungsqualität bei schizophrenen Patienten, sollte aber nicht als Instrument für Sparmaßnahmen missbraucht werden. Eine Stratifizierung im Langzeitverlauf und eine Biomarkerentwicklung im Bereich der Genomik und Bildgebung können zeitnah die Behandlungsoptionen der Schizophrenie verbessern.

Abstract

Mental illnesses show an annual prevalence of up to 4 % and are therefore comparatively frequent. Schizophrenia substantially adds with direct as well as indirect costs (sick leave) to the overall burden of health costs caused by mental illness. The unfavourable prognosis of schizophrenia is caused by its negative symptoms and cognitive deficits. The underlying pathophysiological mechanism can most likely be regarded as a disorder of regenerative capacities of the human brain. The implementation of guidelines, quality indicators and treatment pathways improves the treatment quality in schizophrenia patients, but should, however not be abused as a tool for cost-cutting measures. A stratification in the long-term course as well as the development of biomarkers in the fields of genomics and imaging may help to promptly improve the treatment options for schizophrenia.

Schlüsselwörter

Schizophrenie - Behandlungsqualität - Leitlinien - Qualitätsindikatoren - Pathophysiologie

Key words

schizophrenia - treatment quality - guidelines - quality indicators - pathophysiology

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