Kognitiv-verhaltenstherapeutische Behandlung von Negativsymptomatik bei schizophrenen Psychosen

S. Klingberg; K. Hesse; J. Herrlich; S. Kossow; G. Wiedemann; A. Wittorf; W. Wölwer; G. Buchkremer

doi:10.1055/s-0038-1627232

Nervenheilkunde, Table of Contents

Nervenheilkunde 2008; 27(11): 997-1006
DOI: 10.1055/s-0038-1627232

Originaler Artikel

Schattauer GmbH

Kognitiv-verhaltenstherapeutische Behandlung von Negativsymptomatik bei schizophrenen Psychosen

Hintergrund und Therapiekonzeption der TONES-Studie^[*] Cognitive behavioral therapy on negative symptoms of schizophrenia disordersbackground and therapy of the TONES-study

S. Klingberg

¹Universitätsklinik für Psychiatrie und Psychotherapie Tübingen

,

K. Hesse

¹Universitätsklinik für Psychiatrie und Psychotherapie Tübingen

,

J. Herrlich

²Universitätsklinik für Psychiatrie und Psychotherapie Frankfurt

,

S. Kossow

²Universitätsklinik für Psychiatrie und Psychotherapie Frankfurt

,

G. Wiedemann

³Klinik für Psychiatrie und Psychotherapie, Klinikum Fulda

,

A. Wittorf

¹Universitätsklinik für Psychiatrie und Psychotherapie Tübingen

,

W. Wölwer

⁴Universitätsklinik für Psychiatrie und Psychotherapie Düsseldorf

,

G. Buchkremer

¹Universitätsklinik für Psychiatrie und Psychotherapie Tübingen

› Author Affiliations

Abstract

Zusammenfassung

Der Artikel gibt einen kurzen Überblick über den aktuellen Stand der Forschung zu kognitiver Verhaltenstherapie (KVT) von Negativsymptomatik bei schizophrenen Psychosen. Es werden zugrunde liegende Modellvorstellungen beleuchtet und Studienergebnisse dargestellt. Das vorgestellte Konzept wird in einer multizentrischen, randomisierten klinischen Studie überprüft, das Studiendesign und das Therapiekonzept werden vorgestellt.

Die Therapie ist eine manualbasierte, individuell angepasste ambulante Einzeltherapie. Zusammen mit dem Patienten wird ein Fallkonzept und ein Therapieplan erstellt. Das Fallkonzept bildet die Grundlage für die individualisierte Therapie, die sich auf die Module „Initiative und Planung“, „Soziale Aktivitäten“, „Sprachliche Aktivitäten“, „Emotionale Beteiligung“ und „Emotionaler Ausdruck“ beziehen. Vorbereitend für diese Hauptphase der Therapie werden in den ersten Stunden ein bio-psycho-soziales Krankheitsmodell erarbeitet, die Behandlungskooperation unterstützt, die Belastungsbewältigung gefördert und der Umgang mit Krisen trainiert. Die einzelnen Module werden vorgestellt und an einem Fallbeispiel verdeutlicht.

Summary

This paper presents a short review of the current state of research on cognitive behavioral therapy (CBT) on negative symptoms of schizophrenia disorders. The underlying models are highlighted and the studies results are described. The treatment rational presented will be evaluated within a multicenter randomized clinical trial. The study design and the study treatment are presented. The therapy is a manual based, individually adapted outpatient treatment which is conducted in individual sessions. Together with the patient a case formulation and a therapy plan are developed. The case formulation is the basis for the individualized therapy which addresses “initiative and planning”, “social activities”, “verbal activities”, “emotional participation”, and “emotional expression”. Preparatory for this main phase of therapy a bio-psycho-social disease model is developed, the treatment compliance is fostered, stress management skills are enhanced, and the handling of crises is trained. The different modules are presented and clarified by means of a case vignette.

Schlüsselwörter

Schizophrenie - Negativsymptomatik - kognitive Verhaltenstherapie - Therapiekonzept

Keywords

Schizophrenia disorder - negative symptoms - cognitive behavioral therapy - therapy

Full Text

References

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