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Schizophrenie

Überblick zu einer der schwerstwiegenden psychiatrischen Erkrankungen

Schizophrenia

Overview of one of the most severe psychiatric disorders

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Zusammenfassung

Die Schizophrenie stellt ein schwerwiegendes psychiatrisches Krankheitsbild dar. Weltweit sind ca. 21 Mio. Menschen von Schizophrenie betroffen. Im Jahr 2001 wurde die Erkrankung im Weltgesundheitsbericht als einer der 10 Hauptgründe für „durch Behinderung beeinträchtigte Lebensjahre“ genannt. Seit der Einführung des Schizophreniebegriffs im Jahr 1911 durch Bleuler hat sich das Krankheitskonstrukt im Zuge der Forschung beständig weiterentwickelt. Zwar konnte die Krankheitslast durch die Entwicklung von psychologischen und pharmakologischen Therapieoptionen erheblich gesenkt werden, bis heute konnten jedoch zentrale Aspekte der Erkrankung nicht abschließend geklärt werden. Die vorliegende Arbeit gibt einen grundlegenden Überblick zu Definition, Epidemiologie, Pathogenese und Therapie der Schizophrenie. Zudem werden Risikofaktoren für das Auftreten der Erkrankung sowie der Verlauf, die Prognose und die Prävention der Schizophrenie beleuchtet.

Abstract

Schizophrenia is a severe psychiatric disorder. Approximately 21 million people worldwide are affected by schizophrenia. In 2001, the disease was named in the World Health Report as one of the 10 main reasons for “disability-adjusted life years”. Since the introduction of the concept of schizophrenia by Beuler in 1911, the disease construct has undergone constant development in the course of research. Although the burden of disease has been considerably reduced by the development of psychological and pharmacological therapy options, central aspects of the disease have not yet been conclusively clarified. This article provides a basic overview of the definition, epidemiology, pathogenesis and therapy of schizophrenia. In addition, risk factors for the occurrence of the disease as well as the course, prognosis and prevention of schizophrenia are explained.

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Authors and Affiliations

  1. Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland

    E. Lammer, D. Klingelhöfer, M. H. Bendels, D. Ohlendorf, D. A. Groneberg & M. M. Spallek

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  1. E. Lammer
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  2. D. Klingelhöfer
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Correspondence to D. Klingelhöfer.

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E. Lammer, D. Klingelhöfer, M.H. Bendels, D. Ohlendorf, D.A. Groneberg und M.M. Spallek geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Redaktion

D.A. Groneberg, Frankfurt am Main

V. Harth, Hamburg

CME-Fragebogen

CME-Fragebogen

Welches der folgenden Symptome gehört zu den sog. Erstrangsymptomen nach Kurt Schneider?

Akustische Halluzinationen

Optische Halluzinationen

Wahneinfälle

Gedankeneingebung

Zönästhesien

Wie lange beträgt die nach ICD-10 geforderte Symptommindestdauer, damit die Diagnose Schizophrenie gestellt werden kann?

2 Wochen

1 Monat

2 Monate

3 Monate

6 Monate

Wie hoch ist der Anteil der erblichen Komponente der Schizophrenie laut Schätzungen?

Mindestens 5 %

Mindestens 8 %

Mindestens 50 %

Mindestens 70 %

Mindestens 80 %

Mit welchem der folgenden Betäubungsmittel sind Psychosen am stärksten assoziiert?

Cannabis

Morphin

Kokain

Heroin

LSD

Welche Aussage zum Erkrankungsauftreten der Schizophrenie trifft zu?

Der Erkrankungsgipfel der Schizophrenie liegt beim männlichen Geschlecht zwischen dem 20. und 24. Lebensjahr.

Frauen sind häufiger von der Erkrankung betroffen als Männer.

Die Inzidenz der Erkrankung ist weltweit gleich.

Bei Männern findet sich ein zweiter Erkrankungsgipfel jenseits des 40. Lebensjahres.

Frauen erkranken im Durchschnitt früher als Männer.

Die Erhöhung welches Neurotransmitters ist mit der Schizophrenie am stärksten assoziiert?

Serotonin

Glutaminsäure

Acetylcholin

γ‑Aminobuttersäure

Dopamin

Sie betreuen einen Patienten mit Schizophrenie, der mit Clozapin behandelt wird. Auf welche Nebenwirkung sollten Sie dabei besonders achten?

QT-Zeit-Verkürzung

Agranulozytose

Nierenfunktionsstörung

Hyperkalzämie

Gewichtsabnahme

Wie lange dauert die Prodromalphase in der Regel?

Etwa 1 Monat

Etwa 6 Monate

Etwa 2 Jahre

Etwa 5 Jahre

Etwa 8 Jahre

Die bei der Schizophrenie neuroradiologisch nachgewiesene Volumenreduktion findet sich v. a. im Bereich von …

präfrontalem und temporalem Zingulum.

Hippocampus und Amygdala.

Substantia nigra und Basalganglien.

Pons und Cerebellum.

Insula und Putamen.

Zu den Grundsymptomen nach Bleuler zählt:

Ambivalenz

Wahn

Halluzinationen

Mutismus

Katalepsie

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Lammer, E., Klingelhöfer, D., Bendels, M.H. et al. Schizophrenie. Zbl Arbeitsmed 68, 177–186 (2018). https://doi.org/10.1007/s40664-018-0274-9

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