Die Negativsymptomatik stellt einen der bedeutendsten Prädiktoren für Einschränkungen im Funktionsniveau von Menschen mit Schizophrenie dar. Allerdings wird dieser Symptombereich weitgehend als nicht behandelbar wahrgenommen. In diesem Artikel hinterfragen wir dieses Vorurteil, indem wir die Ergebnisse der existierenden Wirksamkeitsstudien für Behandlungsprogramme für Negativsymptomatik zusammenstellen. Wir beschränkten uns bei unserer systematischen Literatursuche ausschließlich auf Studien, die die Negativsymptomatik als primäres Behandlungsziel auswiesen, da vorherige Übersichtsarbeiten diesen Aspekt vernachlässigt hatten. Wir identifizierten 36 Studien, die gezielt die Wirksamkeit psychologischer Interventionen für Negativsymptomatik bei Störungen aus dem schizophrenen Formenkreis überprüften. Insgesamt stellten sich die Ergebnisse der Studien wie folgt dar: Der Behandlungseffekt für die motivationalen Komponenten der Negativsymptomatik war am größten in Studien, die kognitive Verhaltenstherapie und/oder soziale Kompetenztrainings verwendeten. Die größten Behandlungseffekte für die Affektverflachung ergaben sich in Studien zu nonverbalen Behandlungsansätzen wie der körperorientierten Psychotherapie. Auch für kognitive Remediation wurden positive Behandlungseffekte für die Negativsymptomatik gefunden, die allerdings nur teilweise mit einer Verbesserung der kognitiven Leistungsfähigkeit zusammenhingen. Obwohl es an methodisch guten Therapiestudien mangelt, zeigt unsere Literaturübersicht, dass die Negativsymptomatik psychotherapeutisch durchaus behandelbar ist. Unsere Zusammenstellung kann vor diesem Hintergrund als Entscheidungsstütze bei der Therapieplanung für Patienten mit Negativsymptomatik dienen.

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