Zusammenfassung
Bei der (Re-)Integration chronisch schizophren erkrankter Patienten
treten nicht selten Schwierigkeiten auf. Besonders die Gruppe, die einen langen
Verlauf aufweist und häufig stationär aufgenommen und behandelt wird,
lässt sich nur erschwert (re-)integrieren. Wir haben diese Gruppe von
Patienten auf einer Station mit einem besonders intensiven Behandlungskonzept
zusammengefasst und konnten fast 50 % davon in adäquat
höher strukturierte extramurale Einrichtungen vermitteln. Hierbei waren
überzufällig häufig schizophren erkrankte Patienten mit mehr
stationären Voraufenthalten vertreten, die ohne Familie lebten und
ausgeprägtere psychopathologische Auffälligkeiten zeigten, jedoch
mehr Compliance aufwiesen als die nicht vermittelbare Gruppe chronisch
schizophren Erkrankter. Als limitierende Größe stellte sich die
mangelnde Krankheitseinsicht heraus, ein Faktor, den es in der Zukunft noch
mehr zu bearbeiten gilt.
Abstract
There are many difficulties in (re)integrating patients with chronic
mental illness into the community. Especially schizophrenics with a long
standing course and severe dysfunctions often have to stay in psychiatric
hospitals. Sometimes their dysfunctions cause frequent readmissions. Therefore
we decided to establish a special ward for this group. Our aim was to
(re)integrate them into out-patient services with an adequate level of
psychiatric care, for example institutions offering a kind of full-time
occupation or sheltered homes etc. We investigated the effect of the treatment
in the special ward. The results showed that nearly 50 per cent of patients
with chronic schizophrenia and severe dysfunctions could be (re)integrated into
these institutions. This subgroup was especially characterized by three
factors: they lived without relatives, had more severe psychopathological
impairments and had better compliance than the others. Additionally, they had
more previous hospitalizations prior to the index episode. One important factor
which limited the effect of our efforts with some patients was a lack of
insight and acceptance of mental illness.
Schlüsselwörter
Schizophrenie - chronischer Verlauf - Reintegration - extramurale Einrichtungen
Key words
Schizophrenia - Impairments - (Re)integration - Community care
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Dr. med. Michael Grube
Klinik für Psychiatrie und Psychotherapie
Gotenstraße 6-8
65929 Frankfurt/M.
eMail: Psychiatrie@skfh.de
