Zusammenfassung
Wahnideen sind definiert als feste Überzeugungen, die trotz gegenteiliger Evidenz beibehalten werden. Eine Vielzahl von Studien belegt, dass Verzerrungen in der Informationsverarbeitung (z.B. voreiliges Schlussfolgern) bei der Entstehung und Aufrechterhaltung der (schizophrenen) Psychose beteiligt sind. Das Metakognitive Training (MKT) bei Psychose sowie die individualisierte Metakognitive Therapie (MKT+) sind niedrigschwellige Therapieangebote, die Betroffene für verzerrte Denkstile sensibilisieren und diese korrigieren sollen, um so die psychotische Symptomatik zu reduzieren. Die bisherige Studienlage spricht für die Wirksamkeit des MKT, wenngleich bei akuten Patienten die individualisierte Version, das MKT+, vorzuziehen ist. Neben dem MKT werden 2 Therapieprogramme mit ähnlicher Zielsetzung vorgestellt, das «Reasoning Training» und das «Social Cognition and Interaction Training», ebenso wie neue Techniken, die kognitive Verzerrungen mittels virtueller Realität (VR) reduzieren. VR-basierte Interventionen können dysfunktionale kognitive Verzerrungen realitätsnah erfahrbar machen und dadurch korrektive Prozesse erleichtern. Die vorgestellten niedrigschwelligen Therapieprogramme stellen eine leicht implementierbare Möglichkeit dar, um die Versorgungslücke von Menschen mit Psychosen zu verringern. Durch den normalisierenden Ansatz können auch Patienten mit geringer Krankheitseinsicht von den Interventionen profitieren.
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2017
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