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Behandlung kognitiver Defizite bei Schizophrenie

Teil I: Diagnostik und psychologische Verfahren

Treatment of cognitive deficits in schizophrenia

Part 1: Diagnostic and psychological training

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Zusammenfassung

Kognitive Dysfunktionen stellen neben der Positiv- und Negativsymptomatik einen zentralen Symptomkomplex der Schizophrenie dar. Obwohl diese Defizite in den Bereichen Aufmerksamkeit, Gedächtnis und Exekutivfunktionen schon lange beschrieben worden sind, rückten sie erst in letzter Zeit in den Fokus der therapeutischen Bemühungen. Die Erkenntnis, dass kognitive Defizite bislang den besten bekannten Prädiktor für die Alltagsfunktionalität schizophrener Patienten bilden, erklärt das zunehmende Interesse an einer Erfassung und Therapie dieser Beeinträchtigungen.

Allgemeine Standards, wie durch die MATRICS-Initiative (Measurement and Treatment Research to Improve Cognition in Schizophrenia) vorgestellt, bilden die Grundlage einer verlässlichen Erfassung der Neurokognition bei schizophrenen Patienten.

Die im deutschen Sprachraum verbreitetsten kognitiven Trainingsverfahren bei schizophrenen Patienten stellen „CogPack“ und das „Integrierte Psychologische Therapieprogramm (IPT)“ dar. Vor allem im angloamerikanischen Sprachraum werden weitere kognitive Trainingsprogramme mit unterschiedlicher Schwerpunktsetzung eingesetzt. Insgesamt sind diesbezügliche Studienergebnisse als ermutigend zu bewerten. Eine Verbesserung der kognitiven Einschränkungen bei schizophrenen Patienten ist durch gezieltes Training möglich und kann auch eine Verbesserung des psychosozialen Funktionsniveaus mit sich bringen. Es sind jedoch weitere Studien nötig, um kognitives Training für Menschen mit Schizophrenien zu optimieren.

Summary

Cognitive dysfunction is a core feature of schizophrenia. Although cognitive deficits in the domains of attention, memory and executive functions have been described for many decades, the focus on therapeutic approaches is new. The recognition that cognitive deficits are the best known predictor of functional outcome in schizophrenic patients explains the increasing interest in the diagnosis and therapy of these impairments.

Standards for the reliable evaluation of neurocognitive deficits in schizophrenia have been put forward by the MATRICS initiative (Measurement and Treatment Research to Improve Cognition in Schizophrenia).

In German-speaking countries the most popular cognitive training programs for schizophrenic patients are „CogPack“ and „Integrated Psychological Therapy (IPT)“. Especially in Anglo-Saxon countries cognitive training has become more popular in recent years. Study outcomes can be considered encouraging. They show improvement of cognitive deficits and a positive impact on the functional outcome. Further studies are needed to optimize cognitive training for schizophrenic patients.

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Authors and Affiliations

  1. Klinik für allgemeine Psychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    U. Pfueller, D. Roesch-Ely, C. Mundt & M. Weisbrod

  2. Abteilung für Psychiatrie und Psychotherapie, SRH Klinikum Karlsbad-Langensteinbach, Guttmannstraße 1, 76307, Karlsbad, Deutschland

    U. Pfueller & M. Weisbrod

  3. Psychiatrisches Zentrum Nordbaden – PZN, Wiesloch, Deutschland

    U. Pfueller

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  1. U. Pfueller
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  2. D. Roesch-Ely
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  4. M. Weisbrod
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Correspondence to U. Pfueller.

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Pfueller, U., Roesch-Ely, D., Mundt, C. et al. Behandlung kognitiver Defizite bei Schizophrenie. Nervenarzt 81, 556–563 (2010). https://doi.org/10.1007/s00115-009-2923-x

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