Komorbide psychische Störungen bei Schizophrenie

 

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Die große Bedeutung der Therapie komorbider psychischer Erkrankungen für Krankheitsverlauf und Behandlungskosten, die Gefahr eines Rückfalls, die Morbidität und Mortalität der Patienten und ihre Lebensqualität ermahnen dazu, psychische Komorbiditäten nicht unentdeckt und untherapiert zu lassen. Das gilt auch im umgekehrten Fall, wenn das Auftreten einer nicht-psychotischen Erkrankung vor Erstmanifestation der Schizophrenie die Diagnose und Behandlung der Psychose verzögert und so ebenfalls zu einem schlechteren Krankheitsverlauf und Outcome beiträgt. Die Abklärung von Komorbiditäten sowie geeignete pharmako-, psycho- und soziotherapeutische Maßnahmen sollten daher routinemäßig in das Behandlungskonzept der Schizophrenie integriert werden.

Comorbid mental disorders have significant detrimental effects on the course of schizophrenia, leading to higher treatment costs, higher risk of relapse, significantly higher morbidity and mortality and lower quality of life. Due to diagnostic difficulties, comorbidities can be overlooked and remain untreated because they are seen as part of the psychotic syndrome. On the other hand, patients often are treated exclusively because of their comorbidities, and the unspecific prodromal phase of a psychotic illness remains undetected. These facts emphasize the enormous importance of diagnosis and treatment of psychiatric comorbidities for clinical day-to-day practice. The detection of comorbidities and the administration of appropriate pharmacotherapeutic, psychotherapeutic and sociotherapeutic measures should therefore be an integral component of the routine treatment concept for schizophrenia.

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Christian G. Huber

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