Biomedical subjects
Publications and source records attributed to A Szecsey.
The documentation of the normal psychiatric interview has been omitted in the ICD 10 classification. Particularly, psychiatric consultants have to deal with the practical problem of adequate classification of patients with normal psychopathology. To use unspecific codes or to omit the coding of the findings are no suitable solutions. Future revision of the ICD 10 classification should integrate the normal psychiatric interview.
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There is no generally accepted treatment for tardive dyskinesia following intake of neuroleptics. Many compounds with effects on serotonine, GABA, cholinergic or dopamine receptors have been clinically useful. We report on a 71-year-old female patient suffering from orofacial tardive dyskinesia after treatment with haloperidol, which did not respond to monotherapy with antidyskinetic drugs. The syndrome disappeared almost completely within two weeks after a multidrug approach consisting of tetrabenazine, olanzapine and tiapride. A combination of antidyskinetic drugs should be considered in patients with severe tardive dyskinesia.
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Two case reports are presented of bradycardia in two elderly patients, which was resistant to atropine but which resolved immediately the acute bladder distension was treated. Generally, a sympathetic cardiac response is expected, and this paradoxical response may be due not only to lesions of the reflex loop involving both the vagal and the sympathetic nerves, but also to endocrinological factors. As acute urinary distension is not uncommon on geriatric wards, bradyarrhythmia due to bladder distension should be considered in elderly patients.
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An extensive battery of cognitive tests is conducted to detect dementia in geriatric patients. Based on the ICD-10 diagnostic criteria for dementia the diagnosis includes cognitive deficits such as memory impairment and other cognitive disturbances in various stages. To establish a profile of cognitive deficits and to detect early stages of dementia a combination of psychometric tests has proven to be effective and valid (MMSE, SKT, SIDAM, GDS/BCRS, clock drawing). To evaluate interrelations between these tests, correlations of total scores among 40 randomly chosen geriatric patients were calculated for all tests using the Spearman rank-order correlation. The cognitive test battery appears to be a reliable instrument for diagnosing people with dementia. Due to advantages and shortcomings of each test in evaluating various stages of dementia adequately, a combination of tests should be used.