2011-07, Nischk, Daniel, Gasser, Miriam, Polaine, Karin, Rusch, Johannes, Schonauer, Klaus, Rockstroh, Brigitte

Hintergrund: In der vorliegenden Studie wurde ein kurzes psychoedukatives Programm (PE) für akut psychotische Patienten evaluiert. Das PE-Programm nahm besonders Rücksicht auf die in der Akutphase vorherrschenden neuropsychologischen Defizite und fokussierte darüber hinaus auf den Austausch über gegenwärtige psychotische Symptome.

Methode: 57 Probanden mit ICD-10-Diagnosen aus dem F2-Bereich wurden randomisiert einer Kontrollgruppe (KG: TAU) oder Experimentalgruppe (EG: TAU + PE) zugewiesen und vor der Intervention (t₁), danach (t₂) und vier Wochen später (t₃) hinsichtlich Wissenszuwachs, Einsicht und Krankheitskonzept untersucht.

Ergebnisse: Die EG wies im Vergleich zur KG einen signifikanten Wissenszuwachs und höhere globale Krankheitseinsicht zu t₂ und t₃ auf.

Diskussion: Auch Patienten mit relativ akuten psychotischen Symptomen können von PE profitieren, wenn die Maßnahmen neuropsychologische Einschränkungen berücksichtigen.

2008, Weber, Katja, Rockstroh, Brigitte, Borgelt, Jens, Awiszus, Barbara, Popov, Tzvetan G., Hoffmann, Klaus, Schonauer, Klaus, Watzl, Hans, Pröpster, Karl

Background:
Childhood stress and trauma have been related to adult psychopathology in different psychiatric disorders. The present study aimed at verifying this relationship for stressful experiences during developmental periods by screening stress load across life in adult psychiatric inpatients with different diagnoses compared to healthy subjects. In addition, a relationship between the amount of adverse experiences and the severity of pathology, which has been described as a 'building block' effect in posttraumatic stress disorder (PTSD), was explored for nontraumatic events in psychiatric disorders other than PTSD.

Methods:
96 patients with diagnoses of Major Depressive Disorder (MDD), schizophrenia, drug addiction, or personality disorders (PD) and 31 subjects without psychiatric diagnosis were screened for adverse experiences in childhood (before the age of six years), before onset of puberty, and in adulthood using the Early Trauma Inventory and the Posttraumatic Stress Diagnostic Scale. Effects of stress load on psychopathology were examined for affective symptoms, PTSD, and severity of illness by regression analyses and comparison of subgroups with high and low stress load.

Results:
High stress load in childhood and before puberty, but not in adulthood, was related to negative affect in all participants. In patients, high stress load was related to depressive and posttraumatic symptoms, severity of disorder, and the diagnoses of MDD and PD.

Conclusion:
Results support the hypothesis of stress-sensitive periods during development, which may interact with genetic and other vulnerability factors in their influence on the progress of psychiatric disorders. A 'dose' effect of stress load on the severity of psychopathology is not restricted to the relationship between traumata and PTSD.