Mehl Stephanie, Hesse Klaus, Moritz Steffen, Müller Daniel R, Kircher Tilo, Bechdolf Andreas
Universitätsklinik für Psychiatrie und Psychotherapie, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Deutschland.
Universitätsklinik für Psychiatrie und Psychotherapie Tübingen, Tübingen, Deutschland.
Nervenarzt. 2023 Mar;94(3):189-197. doi: 10.1007/s00115-022-01433-9. Epub 2023 Jan 25.
The analysis of the efficacy of evidence-based psychotherapy for patients with psychotic disorders has mostly been carried out in the outpatient field. In the inpatient field the efficacy is sometimes difficult to assess due to different healthcare systems.
The aim of this narrative review is to summarize international guidelines and meta-analyses on the efficacy of inpatient psychotherapeutic treatment strategies for patients with psychotic disorders. Based on this, recommendations for disorder-specific ward concepts for acute and postacute fields are formulated.
The German S3 guidelines, international guidelines, current meta-analyses and primary studies on psychological interventions in the treatment of psychotic disorders were included. Based on the results, recommendations for the inpatient psychotherapeutic treatment in various phases of treatment were formulated (acute phase and postacute phase).
In the acute phase a combination of cognitive behavioral therapy (CBTp) in the individual setting and family interventions in the group setting as well as metacognitive training (MCT acute) is effective and recommended. In the postacute phase, in addition to individual and group CBTp and family interventions, psychoeducation, social skills training and cognitive remediation have been shown to be effective and are recommended.
The suggested recommendations for concrete interventions in various treatment phases and the evidence base are critically discussed and recommendations for the structure of wards are presented.
针对精神障碍患者的循证心理治疗疗效分析大多在门诊领域开展。在住院领域，由于医疗体系不同，疗效有时难以评估。
本叙述性综述旨在总结关于住院精神障碍患者心理治疗策略疗效的国际指南和荟萃分析。在此基础上，针对急性和急性后期特定疾病的病房概念提出建议。
纳入德国S3指南、国际指南、当前关于精神障碍治疗中心理干预的荟萃分析和原始研究。根据结果，针对治疗各阶段（急性期和急性后期）的住院心理治疗提出建议。
在急性期，个体环境下的认知行为疗法（CBTp）与团体环境下的家庭干预以及元认知训练（MCT急性）相结合是有效的且被推荐。在急性后期，除了个体和团体CBTp以及家庭干预外，心理教育、社交技能训练和认知康复已被证明有效且被推荐。
对各治疗阶段具体干预措施的建议及证据基础进行了批判性讨论，并提出了病房结构的建议。
