Früherkennungszentren für psychische Erkrankungen – ein Komplementärangebot der psychiatrischen Regelversorgung in Deutschland

Zusammenfassung

Anliegen: Psychische Erkrankungen werden häufig zu spät erkannt und behandelt, oft mit erheblichen negativen Konsequenzen. Potenziell vermeidbare Ursachen beinhalten Stigmatisierung, mangelnde Aufklärung und fehlende fachübergreifende sowie niederschwellige Diagnostik- und Behandlungsangebote.

Methode: Das Konzept des Früherkennungszentrums bietet niederschwellig, diagnoseunspezifisch und anonym Möglichkeiten für Diagnostik und Beratung an. Ein multiprofessionelles Team unter fachärztlicher Supervision führt Diagnostik und Beratung unter standardisierten Bedingungen durch.

Ergebnisse: Von den von Juli 2009 bis April 2012 mit dem Diagnostikprozedere vollständig Untersuchten 149 erfüllten 109 (73 %) die Kriterien für mindestens eine manifeste psychiatrische Erkrankung. Bei 49 (33 %) Personen lag eine (Ultra-) Hochrisikokonstellation für die Entwicklung einer Psychose und/oder bipolaren Störung vor.

Schlussfolgerungen: Die große Mehrheit der im Früherkennungszentrum evaluierten Klienten wiesen manifeste psychische Erkrankungen auf.

Abstract

Objective: Mental disorders are identified and treated too late, because of stigma, deficient information in the population and lack of specific supply in the public health systems. Another problem is the deficient cooperation between psychiatry and child psychiatry. Therefor early recognition centers were founded, in Germany primarily with focus on psychosis and in research settings.

Methods: The early recognition center in Dresden offers a low-threshold and anonym service for young people independent of diagnosis. The multiprofessional team including psychologists, psychiatrists and child psychiatrists applies defined standards. In addition to standard history taking and formally assessing psychopathology, early recognition instruments for psychosis and bipolar disorders are used as appropriate.

Results: In 167 out of 192 individuals a structured diagnostic procedure was recommended, 149 persons (89 %) completed the procedure. Thereof 78 (52 %) persons fulfilled criteria for one, 21 (14 %) persons for two and 10 (7 %) persons for three mental disorders. 49 (33 %) persons fulfilled criteria for (Ultra)high risk for psychosis and/or bipolar disorders.

Conclusions: In the majority of cases diagnostic criteria for at least one mental illness was already fulfilled. All diagnosis and stages from prodromal till chronic were represented. The high percentage of subjects fulfilling criteria for (ultra)high risk-constellations offers the chance for early interventions. The implementation of early detection centers for psychiatric disorders seems reasonable and necessary.

Schlüsselwörter

Prävention - Früherkennung - Versorgung - Hochrisiko

Keywords

prevention - early recognition - health care - high risk

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