Hintergrund: Die kognitive Verhaltenstherapie bei schizophrenen Störungen (cognitive-behavioral therapy for psychosis; CBT-p) wird für alle Phasen der Erkrankung empfohlen. Das Ziel der vorliegenden Pilotstudie war die Prüfung der Akzeptanz einer Implementierung sowie die Abschätzung der möglichen Wirksamkeit eines neuen CBT-p-Behandlungskonzepts zur Veränderung von Wahn, das auf Befunden der Grundlagenforschung zum Zusammenhang zwischen Depressivität und paranoidem Wahn basiert. Patienten und Methoden: 16 Patienten einer psychiatrischen Schwerpunktstation für Schizophrenie erhielten zusätzlich zur üblichen Behandlung eine manualisierte CBT zur Stimmungsstabilisierung im Einzelsetting. In einer Baseline- und einer Post-Messung wurden das Wahnerleben, die allgemeine Symptomatik, die Depressivität und die Chlorpromazin-Äquivalenzdosen erfasst und mit Messwiederholungsverfahren analysiert. Ergebnisse: Die Positiv- und Wahnsymptomatik reduzierten sich zwischen der Baseline- und der Post-Messung signifikant mit großen Effekten sowohl in Selbst- als auch in verblindeten Fremdratings (Effektstärken zwischen 0,69 und 1,19). Die depressive Symptomatik reduzierte sich ebenfalls signifikant mit großer Effektstärke (1,21). Schlussfolgerungen: Die Ergebnisse der vorliegenden Pilotstudie sprechen für die Wirksamkeit und Implementierbarkeit eines stimmungsstabilisierenden CBT-Konzepts für Patienten mit Schizophrenie im stationären Setting und zeigen, dass ein solches Konzept in Bezug auf Positivsymptome einer Schizophrenie sowie Wahn wirksam sein könnte. Um die Befundlage zu festigen und die vorgestellten Interventionen weiterentwickeln zu können, sollten diese Ergebnisse in einem randomisiert-kontrollierten Studiendesign repliziert werden.

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