Sowie das Konstrukt „schizoaffektive Störung“ als eigenständige psychiatrische Erkrankung umstritten und im Rahmen des ICD-10-Konzeptes vermutlich auch in Zukunft nicht zu klären ist (vgl. Berger 2004), gibt es auch keine einheitliche Vorstellung darüber, wie genau schizoaffektive Störungen entstehen. Es ist aber davon auszugehen, dass die Ursache bzw. die Entstehungsbedingungen für die schizoaffektive Störung ähnlich sind wie die ihrer jeweiligen Pole, denen sie ihre komplexe, zusammengesetzte Symptomatik verdankt. Die Basis-Informationen zur Thematik finden Sie in den Kapiteln zur Ätiologie von Schizophrenien und affektiven Störungen Depression und Manie.
Wie die Schizophrenien und die affektiven Störungen werden vermutlich auch die „schizoaffektive Störung“ durch bestimmte psychodynamische oder andere Stress- oder Belastungsfaktoren ausgelöst, eine genetische Bereitschaft dazu muss aber sicher vorhanden sein. Man geht derzeit davon aus, dass die genetische Disposition für die schizoaffektive Störung grösser ist als bei der Schizophrenie und den affektiven Störungen. In hormonellen Tests (Dexamathason und TRH-Test) scheint sich abzuzeichnen, dass die schizodepressive Störung neurobiologisch der Schizophrenie verwandter ist als der Depression. Aber diese wie auch andere hirnmorphologische, physiologische, neurochemische und andere Ergebnisse müssen vor dem Hintergrund der konzeptuellen Unsicherheiten sehr vorsichtig interpretiert werden.
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