Subjektive Befindlichkeit unter neuroleptischer Behandlung und ihre Bedeutung für Compliance und Krankheitsverlauf

 

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Zusammenfassung

Erst seit 5 - 10 Jahren bzw. eng verknüpft mit der Entwicklung der atypischen Antipsychotika, sind die Erfolgskriterien einer antipsychotischen Behandlung sehr viel umfassender definiert und zeigen eine stärkere Berücksichtigung der Negativsymptomatik und der kognitiven Störungen, beide für die Langzeitprognose von großer Bedeutung. Die deutlichste Veränderung aber ist die stärkere Berücksichtigung der Patientenperspektive, die für lange Zeit weitgehend vernachlässigt wurde. Die Lebensqualität und ein wichtiger Teilbereich, die subjektive Befindlichkeit, sind zunehmend von wissenschaftlichem Interesse und in zahlreichen Studien untersucht worden. Übereinstimmend wurde festgestellt, dass schizophrene Patienten sehr wohl in der Lage sind, Selbstbeurteilungen konsistent und reliabel auszufüllen und dass ihre Einschätzung zum Erfolg einer antipsychotischen Behandlung sich von der psychiatrischen Perspektive deutlich unterscheidet. Angesichts der Vielfalt der atypischen Antipsychotika und den daraus resultierenden Fragen zu Differenzialindikation ist für Compliance und Langzeitverlauf eine stärkere Berücksichtigung der Patientenperspektive sinnvoll und nötig.

Abstract

Since the introduction of atypical antipsychotics success criteria of an effective antipsychotic treatment are more comprehensive. For instance these criteria include negative symptoms as well as cognitive deficits which are both important for the long-term prognosis of schizophrenia. However, the most fundamental change was the inclusion of the patients' perspective with respect to the treatment. Quality of life assessments as well as evaluation of subjective well-being are of increasing scientific interest and have been assessed in numerous studies. Accordingly there has been ascertained that schizophrenic patients are indeed able to fill out self reports consistently and reliably and it has been shown that patients' perspective differs enormously from the evaluation of psychiatrists with regard to antipsychotic treatment. In consideration of the variety of atypical antipsychotics and different resulting effects for compliance and prognosis of schizophrenia it seems needful to strengthen patients' perspective as an important success criterion of antipsychotic treatment.

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Prof. Dr. Dieter Naber

Universitätsklinikum Hamburg-Eppendorf · Klinik für Psychiatrie und Psychotherapie

Martinistraße 52

20246 Hamburg

Email: naber@uke.uni-hamburg.de