Behandlungsleitlinien für nichtschizophrene psychotische Störungen?

 

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Zusammenfassung

Anliegen Es soll eine Übersicht über Diagnostik, Verlauf und Therapie der „nichtschizophrenen psychotischen Störungen” gegeben werden. Methode Mithilfe von „Medline” und „Cochrane Database of Systematic Reviews” wurde eine Literatursuche durchgeführt. Ergebnisse Obwohl die „nichtschizophrenen psychotischen Störungen” im klinischen Alltag keine Rarität darstellen, gibt es hier bisher kaum evidenzbasierte Behandlungsempfehlungen. Schlussfolgerungen Es sind umfangreiche Therapiestudien für diese Patientengruppe oder die Etablierung von alternativen diagnostischen Ansätzen zu fordern.

Abstract

Objective To provide an overview of diagnostics, outcome and treatment of „non-schizophrenic psychotic disorders” (ICD-10: delusional disorders, acute and transient psychotic disorders and schizoaffective disorders). Methods Literature was identified by searches in „Medline” and „Cochrane Database of Systematic Reviews”. Results The frequency of „non-schizophrenic psychotic disorders” within the whole diagnostic group „schizophrenia, schizotypal and delusional disorders” (ICD-10) ranges between 22 % and 49 %. Patients with these disorders show a more favourable long-term outcome than those with schizophrenia. With regard to therapy, as yet only a small empirical database exists. The comparability of those studies is limited by the use of different diagnostic criteria. There are only few evidence-based treatment guidelines for these disorders. Conclusions There is a substantial need for controlled studies on the treatment of „non-psychotic schizophrenic disorders”. Alternatively, clinical guidelines could be based on a dichotomy of affective and schizophrenic disorders or on a dimensional approach.

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Dr. Markus Jäger

Klinik für Psychiatrie II der Universität Ulm, Bezirkskrankenhaus Günzburg

Ludwig-Heilmeyer-Straße 2

89312 Günzburg

Email: Markus.Jaeger@bkh-guenzburg.de