Schizophrenie
Die Krankheit „Schizophrenie“ ist gekennzeichnet durch tiefgreifende Störungen des Denkens und der Wahrnehmung, verbunden mit einer Störung und oft auch Verflachung der Affekte. Den Betroffenen geht das Gefühl für ihre eigenen Grenzen verloren, sie fühlen sich oft in ihren Gedanken erkannt und manipuliert, glauben, dass sie verfolgt oder durch andere Menschen oder physikalische Prozesse (Strahlen etc.) beeinflusst werden. Die veränderten Wahrnehmungen oder Gedanken sind oft bizarr und ängstigend. Manche Patienten erleben sich selber als Schlüsselfigur, bei der die Fäden zusammenlaufen. Häufig sind Halluzinationen, v. a. akustischer Art in Form von „Stimmenhören“ und einer veränderten Wahrnehmung von Geräuschen. Aber auch Farben können verändert wahrgenommen werden. Bei einer Schizophrenie geht oft die Bedeutungs-Hierarchie alltäglicher Dinge verloren. Die Stimmung schizophrener Patienten wirkt im Kontakt meist flach oder zumindest unangemessen. Durch innere Ambivalenz und eine Antriebsstörung wirken die Patienten zudem oft träge, verlangsamt oder starr. Im Krankheitsverlauf können sich kognitive Defizite entwickeln, obwohl die intellektuellen Fähigkeiten bei der Schizophrenie eigentlich nicht beeinträchtigt sind.
Für die Diagnose einer „Schizophrenie“ werden nach ICD-10 folgende Symptome herangezogen:
- Gedankenlautwerden, Gedankeneingebung oder Gedankenentzug, Gedankenausbreitung
- Kontrollwahn, Beeinflussungswahn, Gefühl des Gemachten, deutlich bezogen auf Körper- oder Gliederbewegungen oder bestimmte Gedanken, Tätigkeiten oder Empfindungen; Wahnwahrnehmungen
- Kommentierende oder dialogische Stimmen, die über den Patienten und sein Verhalten sprechen, oder andere Stimmen, die aus einem Teil des Körpers kommen.
- Anhaltender, kulturell unangemessener oder völlig unrealistischer (bizzarer) Wahn, wie der, eine religiöse oder politische Persönlichkeit zu sein, übermenschliche Kräfte und Fähigkeiten zu besitzen (z. B. das Wetter kontrollieren zu können oder im Kontakt mit Ausserirdischen zu sein).
- Anhaltende Halluzinationen jeder Sinnesmodalität, begleitet entweder von flüchtigen oder undeutlich ausgebildeten Wahngedanken ohne deutliche affektive Beteiligung, oder begleitet von anhaltenden überwertigen Ideen, täglich über Wochen oder Monate auftretend.
- Gedankenabreissen oder Einschiebungen in den Gedankenfluss, was zu Zerfahrenheit, Danebenreden oder Neologismen führt.
- Katatone Symptome wie Erregung, Haltungsstereotypien oder wächserne Biegsamkeit (Flexibilitas cerea), Negativismus, Mutismus und Stupor
- „Negative“ Symptome, wie auffällige Apathie, Sprachverarmung, verflachte oder inadäquate Affekte, zumeist mit sozialem Rückzug und verminderter sozialer Leistungsfähigkeit. Diese Symptome dürfen nicht durch eine Depression oder eine neuroleptische Medikation verursacht sein.
- Eine eindeutige und durchgängige Veränderung bestimmter umfassender Aspekte des Verhaltens der betreffenden Person, die sich in Ziellosigkeit, Trägheit, einer in sich selbst verlorenen Haltung und sozialem Rückzug manifestiert.
Zur Diagnose einer „Schizophrenie“ müssen
- mindestens ein eindeutiges oder zwei oder mehr weniger eindeutige Symptome von 1-4 oder
- mindestens zwei Symptome von 5-8 v
- fast ständig über die Dauer von mindestens einem Monat vorliegen
Weiterführende Informationen zum Krankheitsbild „Schizophrenie“ finden Sie in der Rubrik „Psychische Krankheiten > Schizophrenie„
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