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Biomedical subjects

M Musalek

Publications and source records attributed to M Musalek.

At least 19 recordsLinked to original sources
PubMed2005

[The history of schizophrenias: philosophical roots].

Although the term "schizophrenia" has been introduced in medical usage by E. Bleuler, all variations of schizophrenia developed afterwards trace back to E. Kraepelin. In his work on dementia praecox he intended to discover a yet unknown entity from nature definitely following the principles and maxima of positivism. In the following a great number of different concepts of schizophrenia were developed and the psychiatrist of the seventies and eighties of the last century was left confronted with an abundance of varying schizophrenic criteria. The upcoming globalization in diagnostic stopped this process of diversity and the ideas of Kraepelin reappeared in the ICD-10 criteria for schizophrenia with only a few modifications. The main problem of positivistic research approaches is that nature obviously is completely unimpressed by human made principles of rules and systems. Nature itself does not know these forms and categories invented by human beings. That is one of the reasons why positivistic schizophrenic research considering human made categories as natural has not been quite successful. A possible way out of this diagnostic dilemma -- insufficient categorical classification systems on the one hand and the necessity of apprehending psychopathological phenomena for an effective therapy on the other -- can be a change of paradigms from the usual categorical diagnostics based on the maxima of positivism to dimensional diagnostics developed in the frame of post-modern strategies of thinking. Such process-oriented diagnostic approaches considering the singular phenomenon as well as its significance for the individual and its pathogenesis as main foci of diagnostics provide the possibility for post-modern psychiatrists to start a new dialogue overcoming a positivism based monologue made by experts on the sufferers.

History, 19th Century↗
PubMed2003

Number of dementia sufferers in Europe between the years 2000 and 2050.

Several authors have pointed out that in the next few decades dementia will affect a considerably increasing number of the elderly. To our knowledge there exist no calculations of the number of demented persons for the whole European region. We made calculations on the number of dementia cases for the period 2000-2050 based on the population projections of the United Nations. For this purpose, we used the results of several meta-analyses of epidemiological studies. The number of prevalent dementia cases in the year 2000 was 7.1 million. Within the next 50 years, this number will rise to about 16.2 million dementia sufferers. The number of new dementia cases per year will increase from about 1.9 million in the year 2000 to about 4.1 million in the year 2050. Contrarily, the working-age population will considerably decrease during the next 50 years. In the year 2000, 7.1 million dementia cases faced 493 million persons in working-age. This equals a ratio of 69.4 persons in working-age per one demented person. Until the year 2050, this ratio will decrease to only 21.1. Thus, the financial and emotional burden placed by dementia on the working-age population will markedly rise.

Aged↗
PubMed1997

Induced hallucinatory psychosis (folie à deux hallucinatoire): pathogenesis and nosological position.

A rare case of a folie a deux in a married couple is presented. The inducing partner (IND) suffered from paranoid hallucinatory psychosis and induced similar symptomatology in his wife. Different from most cases reported in the literature, the induced partner (recipient, REC) also experienced auditory hallucinations (commenting and conversing voices). While the IND recovered fully with a combination of psychotherapeutic as well as neuroleptic treatment, the REC was cured by the psychotherapeutic intervention and the recovery of the IND alone. According to the criteria of current diagnostic systems (DSM, ICD), both patients should have been classified as schizophrenic, due to the presence of the described auditory hallucinations. We conclude that the presence of hallucinations is less specific for a certain diagnosis than implied by such categorical systems and should be regarded as nosologically non-specific symptoms. Modern neurocomputational models of psychopathology, dimensional approaches in the description of hallucinations, as the findings of new functional brain imaging studies support this view. We propose a multidimensional diagnostic process of hallucinations and to classify cases such as the one presented as 'induced hallucinatory psychosis' or 'folie a deux hallucinatoire'.

Adult↗
PubMed1994

[Artificial edema of the extremity].

Our report describes a 46-year-old woman with self-inflicted oedema of the left leg and the left arm. She induced leg oedema by an elastic bandage tourniquet and arm oedema by holding her arm dependent and immobile. A preexisting disorder of the affected leg (postthrombotic syndrome) and of the affected arm (hypoesthesia subsequent to surgical injury of the plexus brachialis) delayed the diagnostic proceedings. Our case report shows that: Confirmed presence of organic disease does not exclude limb oedema of self-inflicted origin. Oedema resulting from a tourniquet and "hysterical oedema" can be developed by one and the same patient. Effective care of such patients is only possible if dermatologist and psychiatrist work together all the time (liaison psychiatry).

Diagnosis, Differential↗
PubMed1994

[Carbamazepine poisoning: protracted course with development of intestinal atony and hepatic toxicity].

A 43 year-old female patient with a history of manic-depressive illness and prophylactic carbamazepine (CBZ) medication ingested a potentially lethal overdose of 20 g of the substance. Neurotoxic symptoms reached full intensity after about 24 hours. Subsequently, the patient developed a gastrointestinal atony, which proved to be refractory to treatment for several days. Moreover, there was an increase of bilirubin. Parallel to this we observed the persistence-and even intermittent re-increase--of toxic serum CBZ concentrations for one week with corresponding protracted clinical symptomatology.

Adult↗
PubMed1990

The frequency of shared delusions in delusions of infestation.

The phenomenon of shared delusions was found in 9 (8.4%) of 107 personally investigated patients suffering from delusions of infestation (88 females, 19 males). A greater number of females (ratio of females to males 3.5:1) "induced" others, whereas a gender ratio of 1:1 was evident in the group of affected patients. Since the ratio of blood relations to non-blood relations was 1:2.3, genetic factors seem to play a less important role than the direct impact of deluded patients on their environment. The rare occurrence of shared delusions of infestation leads to the conclusion that only persons with a paranoid predisposition (paranoide Bereitschaft) may be affected. Cases of induced delusions are also described in which attending physicians act as "inducers".

Austria↗
PubMed1990

Diagnosis of chronic alcoholism--classificatory problems.

Since Magnus Huss introduced the diagnosis of 'chronic alcoholism' into medical literature in 1849, two unsolved problems concerning classification have remained: (1) Differentiation between problem drinkers and chronic alcoholics fluctuates, whereby the cut point of differentiation between abuse and addiction remains differently defined by different authors. Some authors view alcohol-induced damage as a building-stone of diagnosis of chronic alcoholism whereas other authors define these damages as illnesses developed as a consequence of chronic alcohol intake. This fact is also mirrored in the different definitions of chronic alcoholism by different classification systems, like ICD-9, DMS-III or DMS-III-R. Valid and reliable questionnaires, like the Munich Alcoholism Test or the Problem Drinking Scale did not succeed in solving this problem of definition, either. (2) The fact that chronic alcoholics are sick--in the sense of a biological-medical approach--is undoubted. Our research group was able to prove that chronic alcoholic patients metabolize methanol in a different way from that of healthy persons. The biological, sociological and psychopathological heterogeneity of this illness has been stressed for more than a century. A prospective long-term study carried out over 4-7 years has led to the development of a new typology in chronic alcoholism that is able to differentiate subgroups of chronic alcoholic patients cross-sectionally in a clinical, biochemical and neurophysiological way. Diagnosis according to this typology qualitatively differentiates patients in many spheres other than drinking behavior. These subgroups also require correspondingly modified therapeutic strategies.

Alcohol Drinking↗
PubMed1990

A contribution to classification of hallucinations.

Proceeding from the hypothesis that auditory hallucinations in psychotic patients have another biological basis than hallucinations provoked by hypnotic suggestion in healthy persons, we performed a symptom-comparative study by means of 99mTc-HMPAO single photon emission computed tomography. The results confirm the importance of pathogenesis in symptom-oriented psychiatric research.

Adult↗
PubMed1990

The position of delusional parasitosis in psychiatric nosology and classification.

Discussions on the nosological position of delusional parasitosis (DP) have resulted in a wide range of opinions. In the present study in 34 patients with DP, the various and contradictory opinions concerning DP positioning in psychiatric nosology were examined through clinical, psychopathological, and polydiagnostic analyses using VRC, DSM-III, DSM-III-R and ICD-9. The psychopathological analyses with VRC as well as the polydiagnostic comparisons with other classification systems indicated that DP is neither a nosological entity nor due to a specific psychiatric illness. As our results showed, DP is a nosologically unspecific syndrome, which may occur superimposed on all psychiatric disorders.

Delusions↗
PubMed1989

[Drug therapy of delusional parasitosis. The importance of differential diagnosis for psychopharmacologic treatment of patients with delusional parasitosis].

In 34 patients suffering from delusional parasitosis the relevance of an accurate differential diagnosis with respect to pharmacological treatment was investigated. Under a psychopharmacological therapy of the delusion's additional psychiatric symptomatology in 17 patients (50%) a full remission and in other 5 patients an improvement of the delusional symptoms was observed. The unexpected high recovery-rate is explained by the fact that all of the patients with additional depression showed a reduction also of the delusional symptomatology after a treatment with antidepressants. In contrast to that, patients with organic brain syndromes underlying the delusions had a significant worse outcome, which seems to be caused by the considerable lack of effective psychopharmacological treatment of such states. The results indicate that an accurate psychiatric differential diagnosis is of great importance for the psychopharmacological therapy of patients suffering from delusional parasitosis. In this context the Viennese decision-tree for delusional syndromes is discussed.

Adult↗
PubMed1989

[Psychiatric and parasitologic aspects of dermatozoon delusion].

Patients suffering from delusional parasitosis are not only seen by psychiatrists, but more often by dermatologists and parasitologists. Previous results published by researchers of differing specialities led to somewhat contradictory opinions concerning these patients. The main goals of the present study were, on the one hand, to examine the various and partly controversial hypotheses, which were mostly based on single case observations in a substantial sample of 107 patients with delusional parasitosis and, on the other hand, to investigate possible differences between patients who consulted the parasitologist initially and those who saw the dermatologist first and were subsequently treated by a psychiatrist. Hence, 34 patients treated by one of the authors (M.M.) at a special outpatient clinic for patients with delusional parasitosis of the Second Dermatological University Department, Vienna, have been compared with 73 patients who consulted the other author (E.K.) at the Institute of Parasitology of the University of Veterinary Medicine, Vienna. Some similarities, but also marked differences were found between the two groups: the sex ratio was similar in both groups but they differed with regard to age, social background (size of household) localisation of "parasites" and the mode of "infection". The results demonstrate the necessity of developing differentiated medical care programmes which take into account these differences.

Adult↗
PubMed1989

Delusional theme, sex and age.

In a retrospective study of 865 delusional syndromes, connections were investigated between delusional themes and the sex of patients, and the ages in which these themes extensively occurred. According to previous reports, the results of this investigation indicated that differences exist between the ages of manifestation regarding the themes of hypochondria, persecution, love and jealously. Furthermore, differences could be observed between males and females in relation to the frequency of choice of particular themes, as well as the age of occurrence. Based on psychological studies concerned with the content's dependence on motives we conclude that the age distribution of delusional themes corresponds to the main existential concerns in different life periods.

Adolescent↗
PubMed1989

Medication and drug abuse in relation to road traffic safety.

Apart from alcohol, various other substances with a psychotropic effect have been discussed recently in relation to their association with road traffic safety. There has been a general lack of hard facts, however, on how much drug use and abuse influence this. In the absence of data on the frequency of such effects, a representative random sample (approx. 8000 persons) of the Austrian population was interviewed and questioned on their drug intake. A smaller sample (2007 persons) was also questioned as to their behaviour regarding road traffic participation. The results showed that those drugs taken most frequently belong to the 'analgesic' group, whilst the frequency in use of substances to which greater importance is attached currently regarding road safety is relatively low (tranquillizers by 4%; strictly 'psychotropic' drugs by 0.3% to 0.6% of the population). These findings are similar to those reported in English-speaking countries. Data analysis showed that socio-cultural factors (age, sex, marital status and profession) influence the frequency and type of drug intake. The definition of drug abuse and addiction used (increase of dosage, inappropriate use, effect changes) proved somewhat unreliable and called into question the criteria used for diagnosis and categorization of persons at risk. In view of the results of previous studies and the importance attached by critics, an unexpected finding of this survey was the minor influence exerted by tranquillizers on road traffic safety. However, the number of cases for individual drug classes was relatively small and there is a need for more broadly based studies of a similar design before reaching firm conclusions.

Accidents, Traffic↗
PubMed1988

The course of alcoholism. Long-term prognosis in different types.

The disease concept of alcoholism was first introduced into the medical literature by Magnus Huss in 1984. Since that time many authors have attempted to define therapy-related sub-groups of chronic alcoholics but have been unsuccessful until now because alcoholism represents a complex development and becomes apparent in various clinical pictures. As the method of cross-sectional investigations does not seem to be able to produce reliable results, we performed a prospective long-term study of 444 alcoholics. The methodological claims in literature were taken into consideration like selection criteria, programmes and goals of therapy, follow-up rate and time, etc. Careful observation of the pertinent parts of the pathogenetic pathway leading to chronic alcoholism enabled the authors to establish 4 sub-groups of alcoholics relevant for treatment.

Alcohol Drinking↗
PubMed1988

Neurophysiological aspects of auditory hallucinations. 99mTc-(HMPAO)-SPECT investigations in patients with auditory hallucinations and normal controls--a preliminary report.

In a symptom-oriented study 17 patients suffering from chronic auditory hallucinations were investigated by means of 99mTc-HMPAO-SPECT and compared with healthy controls. The results confirm the relative frontal hypoactivity in junction with a relative hyperactivity in the basal ganglia and mesial limbic structures in both hemispheres found in a previous pilot study in auditorily hallucinating patients. Our results should fortify the symptom-oriented approach in psychiatric research.

Adult↗
PubMed1988

[Psychopathology of patients with delusions of ectoparasitic infestation].

This paper presents a literature review as well as a study in 13 patients suffering from delusion of infestation. Symptoms found in MMPI are related to clinical experience. Our results suggest the distinction of three different groups of these patients: 1. Patients with predominantly hypochondric traits, with a distinct conviction to suffer from a severe, physical illness that is often looked at as incurable (hypochondriacal delusion of parasitosis). 2. Patients with paranoid symptoms and without hypochondric apprehensions. These patients usually hopelessly fight against their parasites, that impair their sphere of existence. Physical illness is denied. ("delusion of infestation"). 3. Patients with signs of both, hypochondrical as well as paranoid delusions ("hypochondriacal delusion of infestation").

Adult↗