Einleitung: Real-World-Studien stellen eine wichtige Ergänzung zu randomisierten, placebokontrollierten Studien dar. Funktionalität und gesundheitsbezogene Lebensqualität sind für den Patienten wichtige Endpunkte, die über die Abwesenheit von Symptomen hinausgehen.
Methode: Hier werden in einem narrativen Review Real-World-Studien betrachtet, in denen Patienten mit Schizophrenie mit Aripiprazol-Depot behandelt wurden und die Funktionalität und/oder Lebensqualität als Endpunkte erfasst wurden.
Ergebnisse: In einer Literaturrecherche wurden acht Artikel zu relevanten Studien gefunden. Die Funktionalität beziehungsweise Lebensqualität der Patienten besserte sich in diesen Studien signifikant und in klinisch relevantem Ausmass.
Schlussfolgerung: Unter Aripiprazol-Depot kann sich bei Patienten mit Schizophrenie, wie man ihnen im Behandlungsalltag begegnet, die Funktionalität und Lebensqualität deutlich verbessern.
Aggregating knowledge of this syndrome will add to the sparse literature regarding the triad and the additional manifestations of this uncommon disorder.
Schizophrenia is a complex and severe mental disorder and is characterized by a heterogenous set of different symptoms. Although the current diagnosis of schizophrenia is still based on clinical assessments and operationalized symptom criteria, magnetic resonance imaging (MRI) assessments are important for the differential diagnosis of brain pathologies and potential organic causes of psychosis. In schizophrenia research, MRI and other neuroimaging techniques are already indispensable and of utmost relevance to better understand disrupted brain networks and neurotransmitter systems as well as neuroanatomical signatures related to schizophrenia. This article aims to bridge the gap between the current clinical utility of MRI and recent advances from MRI research in identifying neural substrates related to the development and treatment of schizophrenia. We first describe the current evidence and recommendations for the clinical utility of structural MRI in the diagnostic workup of patients with psychotic symptoms. The second part of this article provides a brief overview of how recent functional MRI (fMRI) research extends our knowledge of dopamine and reward system dysfunction in schizophrenia over the last years. Collectively, these studies provide growing evidence that basic principles of information processing such as salience evaluation and context-dependent efficient neural adaptation are a) disrupted across different stages of the schizophrenia spectrum and b) may be fundamental underlying neural mechanisms in the development of psychosis. While these findings are an important contribution to understand neural basis of schizophrenia, they cannot yet be translated into individualized treatment. Future work should therefore capitalize on the manifold potential of multimodal MRI and further the development of MRI applications for diagnostics and individualized treatment in schizophrenia.
