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psychoneuro 2008; 34(4): 191-199
DOI: 10.1055/s-2008-1079315
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© Georg Thieme Verlag Stuttgart · New York

Kognitive Störungen bei schizophrenen Patienten - Ihre Relevanz in Wissenschaft und klinischer Praxis

Cognitive dysfunctions in schizophrenic patients - Their significance in science and clinical practiceDavid Zilles1 , Oliver Gruber1
  • 1Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Georg-August-Universität(Direktor: Prof. Dr. P. Falkai)
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Publication History

Publication Date:
09 May 2008 (online)

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Kognitive Störungen stellen neben Positiv- und Negativsymptomatik ein Hauptsymptom schizophrener Erkrankungen dar, wie es schon der von Kraepelin geprägte Begriff der 'Dementia praecox' nahelegt. Die große Bedeutung dieser Störungen kommt auch in Vorschlägen zum Ausdruck, kognitive Defizite als diagnostisches Kriterium in zukünftigen Klassifikationssystemen zu berücksichtigen. In der Gesamtgruppe schizophrener Patienten finden sich entsprechende Störungen für viele verschiedene kognitive Funktionen mit einem allerdings hohen Maß an interindividueller Heterogenität, was die vermutete Heterogenität in der Pathogenese und Pathophysiologie widerspiegelt. Klinische Relevanz kommt den kognitiven Beeinträchtigungen insofern zu, als sie den Verlauf der Erkrankung gerade im Hinblick auf das soziale Funktionsniveau und die Lebensqualität deutlich beeinflussen, einen Prädiktor des Outcomes darstellen und auch als Zielsymptom pharmakologischer und nichtpharmakologischer Therapien von Interesse sind. Die Erforschung verschiedener kognitiver Endophänotypen bietet darüber hinaus die Möglichkeit einer exakteren Charakterisierung von Patientensubgruppen mit dem Ziel einer spezifischeren und erfolgreicheren Behandlung.

Cognitive dysfunction - alongside positive and negative symptoms - is a core feature of schizophrenic disorders as already suggested by Kraepelin's concept of 'dementia praecox'. The significance of cognitive deficits is also evident from suggestions to include them as diagnostic criteria in future classification systems. Within the total group of schizophrenic patients, many different cognitive functions are disturbed. However, there is also a considerable degree of interindividual variability, which might reflect the assumed heterogeneity of the pathogenesis and pathophysiology of schizophrenia. Cognitive impairments are clinically relevant as they have a negative influence on patients' social functioning and quality of life, predict functional outcome, and represent targets for pharmacological as well as non-pharmacological therapies. Moreover, the investigation of different cognitive endophenotypes provides an opportunity to more accurately characterize subgroups of patients and, in this way, to enable a more specific and successful treatment.

Key words

Schizophrenia - cognition - cognitive dysfunction - endophenotype-therapy

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Korrespondenz

Dr. med. David Zilles 

Klinik für Psychatrie und Psychotherapie Universitätsmedizin Göttingen Georg-August-Universität

Von-Siebold-Straße 5

37075 Göttingen

Email: dzilles@gwdg.de