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Psychiatrie und Psychotherapie up2date 2012; 6(02): 73-84
DOI: 10.1055/s-0031-1277002
Schizophrenien und andere psychotische Störungen

Komorbide somatische Erkrankungen bei Schizophrenie

Kurt-Wolfram Sühs
,
Kai G. Kahl
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Bei Patienten mit Schizophrenie finden sich häufig komorbide somatische Erkrankungen, die insbesondere die Morbidität und Mortalität bei Diabetes mellitus Typ 2 und Myokardinfarkt betreffen. Viele der zugrunde liegenden kardiovaskulären Risikofaktoren sind einer medikamentösen, verhaltenstherapeutischen oder psychoedukativen Intervention zugänglich.

Einige der kardiovaskulären Risikofaktoren werden durch die antipsychotische medikamentöse Therapie verstärkt. Im Kontext dieser Nebenwirkungen ist jedoch zu beachten, dass bei Patienten ohne eine Therapie das Risiko von Suiziden und Krankenhausaufnahmen sowie die Gesamtmortalität gegenüber behandelten Patienten erhöht ist. Der Verzicht auf eine antipsychotische Behandlung aus Angst vor einem negativen Gesamteffekt auf die Behandlung der Schizophrenie ist damit unberechtigt.

Verschiedene Faktoren, teils durch den Patienten selbst oder von außen bedingt, führen dazu, dass somatische Erkrankungen bei schizophrenen Patienten nicht frühzeitig erkannt oder aber nicht adäquat therapiert werden.

Um die verschiedenen relevanten Risikofaktoren überwachen zu können, sollten standardisierte, möglichst leicht in den klinischen Alltag integrierbare Routinen benutzt werden, Programme zum Ernährungsmanagement, Aufbau sportlicher Aktivitäten sowie Suchtmittelentwöhnung gefördert und die interdisziplinäre Zusammenarbeit ausgebaut werden.



Publication History

Publication Date:
07 February 2012 (online)

© Georg Thieme Verlag KG Stuttgart · New York

 

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