Langzeitbehandlung der Schizophrenie

Kernaussagen

Allein aufgrund der Komplexität des Krankheitsbildes mit seinen verschiedenen Symptomebenen kann es keine einheitliche Therapie der Schizophrenie geben.

Umso wichtiger ist jedoch die Berücksichtigung aller zur Verfügung stehenden Therapieoptionen mit dem Ziel, einen individuell möglichst guten Krankheitsverlauf zu erreichen.

Eine Reduktion der Positivsymptomatik ist dabei ein zwar wichtiger, aber nicht alleine ausreichender Schritt.

Insbesondere aufgrund des starken Einflusses von Kognition und Negativsymptomatik auf soziales Funktionsniveau und Lebensqualität des Patienten müssen auch diese Symptombereiche in der Therapie Beachtung finden.

Die oben genannten Therapieoptionen stellen dabei zumindest Möglichkeiten für eine individuelle, symptomzentrierte Behandlung dar. Eine breitere Verfügbarkeit bereits etablierter und nachweislich wirksamer Therapien wäre dabei wünschenswert.

Publication History

Publication Date:
09 February 2011 (online)

• Literatur

• Wobrock T, Gruber O. Pharmakotherapie der Schizophrenie – Leitliniengerecht und individuell.. Psychoneuro 2008; 34: 184-190
• Arato M, O’Connor R, Meltzer HY. ZEUS Study Group. A 1-year, double-blind, placebo-controlled trial of ziprasidone 40, 80 and 160 mg / day in chronic schizophrenia: the Ziprasidone Extended Use in Schizophrenia (ZEUS) study.. Int Clin Psychopharmacol 2002; 17: 207-215
• Beasley CM, Sutton VK, Hamilton SH. et al Olanzapine Relapse Prevention Study Group. A double-blind, randomized, placebo-controlled trial of olanzapine in the prevention of psychotic relapse.. J Clin Psychopharmacol 2003; 23: 582-594
• Pigott TA, Carson WH, Saha AR. et al Aripiprazole for the prevention of relapse in stabilized patients with chronic schizophrenia: a placebo-controlled 26-week study.. J Clin Psychiatry 2003; 64: 1048-1056
• Leucht S, Barnes TR, Kissling W. et al Relapse prevention in schizophrenia with new-generation antipsychotics: a systematic review and exploratory meta-analysis of randomized, controlled trials.. Am J Psychiatry 2003; 160: 1209-1222
• Schooler N, Rabinowitz J, Davidson M. et al Early Psychosis Global Working Group. Risperidone and haloperidol in first-episode psychosis: a long-term randomized trial.. Am J Psychiatry 2005; 162: 947-953
• Csernansky JG, Schuchart EK. Relapse and rehospitalisation rates in patients with schizophrenia: effects of second generation antipsychotics.. CNS Drugs 2002; 16: 473-484
• Gaebel W, Riesbeck M, Wölwer W. et al German Study Group on First-Episode Schizophrenia. Maintenance treatment with risperidone or low-dose haloperidol in first-episode schizophrenia: 1-year results of a randomized controlled trial within the German Research Network on Schizophrenia.. J Clin Psychiatry 2007; 68: 1763-1774
• Buchanan RW, Kreyenbuhl J, Kelly DL. et al Schizophrenia Patient Outcomes Research Team (PORT). The 2009 schizophrenia PORT psychopharmacological treatment recommendations and summary statements.. Schizophr Bull 2010; 36: 71-93
• Lieberman JA, Stroup TS, McEvoy JP. et al Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia.. N Engl J Med 2005; 353: 1209-1223
• McEvoy JP, Lieberman JA, Stroup TS. et al Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment.. Am J Psychiatry 2006; 163: 600-610
• Leucht S, Corves C, Arbter D. et al Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis.. Lancet 2009; 373: 31-41
• Rummel C, Kissling W, Leucht S. Antidepressants for the negative symptoms of schizophrenia.. Cochrane Database Syst Rev 2006; 3: CD005581
• Mishara AL, Goldberg TE. A meta-analysis and critical review of the effects of conventional neuroleptic treatment on cognition in schizophrenia: opening a closed book.. Biol Psychiatry 2004; 55: 1013-1022
• Harvey PD, Keefe RS. Studies of cognitive change in patients with schizophrenia following novel antipsychotic treatment.. Am J Psychiatry 2001; 158: 176-184
• Correll CU, Leucht S, Kane JM. Lower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies.. Am J Psychiatry 2004; 161: 414-425
• Gaebel W, Jänner M, Frommann N. et al First vs multiple episode schizophrenia: two-year outcome of intermittent and maintenance medication strategies.. Schizophr Res 2002; 53: 145-159
• Falkai P, Wobrock T, Lieberman J. et al WFSBP Task Force on Treatment Guidelines for Schizophrenia. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: long-term treatment of schizophrenia.. World J Biol Psychiatry 2006; 7: 5-40
• Tharyan P, Adams CE. Electroconvulsive therapy for schizophrenia.. Cochrane Database Syst Rev 2005; 2: CD000076
• Mobascher A, Arends M, Eschweiler GW. et al [Biological correlates of prefrontal activating and temporoparietal inhibiting treatment with repetitive transcranial magnetic stimulation (rTMS)].. Fortschr Neurol Psychiatr 2009; 77: 432-443
• Slotema CW, Blom JD, Hoek HW. et al Should we expand the toolbox of psychiatric treatment methods to include Repetitive Transcranial Magnetic Stimulation (rTMS)? a meta-analysis of the efficacy of rTMS in psychiatric disorders.. J Clin Psychiatry 2010; 71: 873-884
• Dlabac-de Lange JJ, Knegtering R, Aleman A. Repetitive transcranial magnetic stimulation for negative symptoms of schizophrenia: review and meta-analysis.. J Clin Psychiatry 2010; 71: 411-418
• Schaub A. Kognitiv-verhaltenstherapeutische Interventionen bei schizophrenen und verwandten Störungen.. In: Leibing E, Hiller W, Sulz SKD. Hrsg Lehrbuch der Psychotherapie, Band 3 Verhaltenstherapie.. München: CIP-Medien; 2003: 209-216
• Wiedemann G, Klingberg S. Psychotherapy of positive symptoms in the treatment of patients with schizophrenia psychosis.. Nervenarzt 2003; 74: 76-84
• DGPPN. S3-Praxisleitlinien in Psychiatrie und Psychotherapie. Band 1: Behandlungsleitlinie Schizophrenie.. Darmstadt: Steinkopff; 2006
• Jones C, Cormac I, Silveira da Mota Neto JI. et al Cognitive behaviour therapy for schizophrenia.. Cochrane Database Syst Rev 2004; 4: CD000524
• Wykes T, Steel C, Everitt B. et al Cognitive behavior therapy for schizophrenia: effect sizes, clinical models, and methodological rigor.. Schizophr Bull 2008; 34: 523-537
• Lynch D, Laws KR, McKenna PJ. Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials.. Psychol Med 2010; 40: 9-24
• Bäuml J, Pitschel-Walz G. Psychoedukation bei schizophrenen Erkrankungen.. Stuttgart: Schattauer; 2003
• Pekkala E, Merinder L. Psychoeducation for schizophrenia.. Cochrane Database Syst Rev 2002; 2: CD002831
• Lincoln TM, Wilhelm K, Nestoriuc Y. Effectiveness of psychoeducation for relapse, symptoms, knowledge, adherence and functioning in psychotic disorders: a meta-analysis.. Schizophr Res 2007; 96: 232-245
• Pharoah F, Mari J, Rathbone J. et al Family intervention for schizophrenia.. Cochrane Database Syst Rev 2006; 4: CD000088
• Zilles D, Gruber O. Kognitive Störungen bei schizophrenen Patienten: Ihre Relevanz in Wissenschaft und klinischer Praxis.. Psychoneuro 2008; 34: 191-199
• Green MF, Kern RS, Heaton RK. Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS.. Schizophr Res 2004; 72: 41-51
• McGurk SR, Twamley EW, Sitzer DI. et al A meta-analysis of cognitive remediation in schizophrenia.. Am J Psychiatry 2007; 164: 1791-1802
• Kurtz MM, Mueser KT. A meta-analysis of controlled research on social skills training for schizophrenia.. J Consult Clin Psychol 2008; 76: 491-504
• Weinmann S, Puschner B, Becker T. Innovative structuring in German care for schizophrenics.. Nervenarzt 2009; 80: 31, 33–34, 36–39
• Crowther R, Marshall M, Bond G. et al Vocational rehabilitation for people with severe mental illness.. Cochrane Database Syst Rev 2001; 2: CD003080
• Dixon LB, Dickerson F, Bellack AS. Schizophrenia Patient Outcomes Research Team (PORT). The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements.. Schizophr Bull 2010; 36: 48-70