Welche Faktoren entscheiden mit über das Erreichen von Rehabilitationszielen in der Nachsorge chronisch schizophren Erkrankter?

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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