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M Musalek

Publications and source records attributed to M Musalek.

31 records · Page 2Linked to original sources
PubMed1987

Psychopathological concepts of dysphoria.

Dysphoric conditions are increasingly postulated as representing independent mood disorders. However, despite much effort at clarification, their psychopathological definitions remain unclear and variable. This paper reviews some examples of these divergent definitions, most of which are based on quality of mood, as well as responsiveness to external stimuli. The paper then introduces a strategy in possible solution of the above-mentioned definition problems. Setting out from restriction of the term dysphoria to conditions of a morose, tense and irritated mood, as suggested by Snaith and Taylor, we support the opinion that dysphoria should be accepted as a third possibility of mood swing, as a psychopathological disturbance which can be well distinguished from stable and unstable mixed states.

Depressive Disorder↗
PubMed1987

Dysphoric states in the course of manic-depressive illness.

The purpose of the present study is to investigate the relationship between dysphoric states (episodes in which irritable mood is prominent and relatively persistent) and manic-depressive illness. A further purpose is to clarify the probable causal influence of chemotherapy and the social consequences concerning dysphoria. The observations carried out on 14 patients are illustrated by 2 case reports. A strong tie seems to exist between dysphoric state and manic-depressive illness, especially with respect to typical biorhythmic disturbances. Although the origin of such states is generally unknown, there are indications that neuroleptics and lithium may play a major role. Social consequences are on the whole minor, if the disturbances in mood and drive occur acutely and markedly. On the other hand, mild to moderate mood changes (especially when unaccompanied by drive changes) may lead to severe social impairment. The reason for this may be that the latter-mentioned states are misinterpreted by the entourage as personality traits rather than as expressions of an illness.

Affective Disorders, Psychotic↗
PubMed1986

[Chronic alcoholism--alcohol sequelae--causes of death].

In this study 444 chronic alcoholic patients, hospitalized at the beginning of this study, were followed up for 4 to 7 years (31). During this time 101 patients died (23.2%), with whom severeness of disease as well as the extent of social depravation could be identified as factors influencing mortality. Beginning in January of 1982 we investigated mortality of the population of a village with a similar socio-cultural background (working situation, rural population, wine-growing area). As it was possible to cooperate with the local general practitioner, who has been living and working in this village since 1946, knowing all the troubles and sorrows, we could get data of each person having died. We collected data on each dead of this village until we had 101 definitely not alcohol addicted cases as control group. For getting this number of cases we had to investigate data of 116 dead, because 15 of them met the diagnostic criteria for chronic alcoholism. Sociodemographic data, social development, diseases and causes of death were recorded in all groups of investigation. In the group of formerly hospitalized chronic alcoholic patients we found a preponderance of men as well as a significantly shorter life-time (alcoholic group: 50 +/- 9.8 years, control group 73.9 +/- 12.5 years). Besides alcohol misuse other factors influencing mortality could be elaborated (e. g. stressing or discriminating working situation, incontinuous and/or unsatisfying partnership, additional criminal acts etc.) separating the chronic alcoholic group (with former hospitalisation) from the control group in a significant way. Concerning the disease leading to death, chronic alcoholic patients more frequently had suffered from liver damage (with break of oesophagus blood vessels) as well as from auto-destructive behaviour patterns (like suicide, masked accidents) compared to the non-alcoholic group. This control group died significantly more frequent because of cardio-vascular diseases, often accompanied by cerebral deficits.

Adult↗
PubMed1986

Approaches to the assessment of schizophrenia in Europe.

All definitions of schizophrenia rely more or less on Kraepelin's hypothesis, Bleuler's theory or Schneider's pragmatic criteria. After a discussion on how these assumptions are referred to in classical and operational diagnostic systems in Europe, the results of a survey of 1983 literature are presented to show what kinds of assessments European workers currently employ. Lastly, guidelines are presented to enable psychopharmacological research to make the best use of the diagnostic systems to suit its purposes: essentially, which system or systems (the polydiagnostic approach for example) one should choose depends upon the symptoms the medication to be tested is supposed to treat, keeping in mind that patient sampling varies according to the system in question.

Europe↗
PubMed1986

Effect of biologically active light and partial sleep deprivation on sleep, awakening and circadian rhythms in normals.

The effects of biologically active light (BL) on subjective and objective quality of sleep and awakening, as well as circadian rhythms in cortisol, temperature and well-being were studied in 10 hospitalized normal female volunteers as compared with partial sleep deprivation (PSD). After 2 adaption days, three 24-hour periods were recorded before (baseline), during (intervention) and after (recovery) treatment with BL (exposure between 5.00-9.00 p.m. and 6.00-9.00 a.m.; light sensitivity: 2,800 lx at eye level) and PSD (1.30-6.00 a.m.). Somnopolygraphic investigations demonstrated a significant improvement in sleep maintenance both after BL and PSD, while sleep induction improved only after PSD. Subjectively experienced sleep quality increased after both treatments. However, subjective and objective awakening quality (objectivated by means of psychometric test battery) was improved by BL only, while PSD produced no changes or even a deterioration. Cortisol levels tended to be lowered by BL, while the troughs increased after PSD; there was also an earlier rise in cortisol levels after PSD than BL. No significant differences were found in regard to temperature. Subjectively experienced well-being tended to improve after both interventions. Our findings concerning the beneficial effect of BL on objective and subjective quality of sleep and awakening in normals encourages us to initiate a single-dose study with BL in depressed patients.

Adult↗
PubMed1986

Cognitive disturbances in chronic schizophrenia: formal thought disorder and basic symptoms.

We investigated 37 chronic schizophrenic patients with two objective rating scales (AMDP and Brief Psychiatric Rating Scale; BPRS) and compared the questioned symptoms with the Frankfurter Beschwerde Fragebogen (FBF), a questionnaire for subjective complaints which are close to the uncharacteristic 'basic' symptoms of schizophrenic patients. It was pointed out that the questions in the FBF relate mainly to uncharacteristic symptoms like disturbances of perception, concentration, attention, perceiving, and memory. These subjective symptoms of the FBF show a few correlations with the AMDP/BPRS rating. The total score of the FBF gave no further information about social functioning of patients with cognitive disturbances.

Brief Psychiatric Rating Scale↗
PubMed1985

[Therapy of organic psychosyndromes of cerebrovascular origin with a vasoactive drug combination].

Concrete cross-sectional studies of the organic brain syndrome, carried out periodically, attempt to establish for the parameters evaluation of substrate damage--and different noopsychopathological rating-scales for the measurement of brain capacity impairment. Beyond the level of the purely correlative-statistical point of view of the relationship between parameter and score changes, demanding for a quantitative model which could provide not only a description, but also an explanation for such a relationship. The fact that there can only be a question here of a "quantitative causality" embracing non-specificity of toxic substances and relative to acute and chronic diffuse organic brain syndromes. It results, that quantitative causality meets the requirements of an exponential function model and that one can validate such models through correlative-statistical methods. This has already been carried out by Ball and Taylor.

Adult↗
PubMed1985

[Social integration of long-term paraphrenic patients with low-dose depot neuroleptic medication].

All long-term patients with the diagnosis "paraphrenia systematica" out of one region were included in this study. 53 patients were treated in an in-patient psychiatric unit between 1979 and 1981 and were available in this study. Parenteral Fluphenacin-Decanoate (25-75 mg monthly) was given. Before, during and after Fluphenacin (each schedule lasting for at least 20 weeks) psychopathological and social evaluations were done. We used quantitative scales: NGI (Nurses Global Impressions) and BPRS (Brief psychiatric Rating Scale). Good Socialization showed a striking correlation to parenteral Fluphenacin-treatment. Differences in the present state psychopathology were not able to explain the social difference. During parenteral treatment 49 patients switched from badly socialized (NGI: more than 12 points) to well socialized (NGI less than 7 points). 18 patients stopped parenteral neuroleptic treatment for various reasons. 13 Patients out of this group had to be readmitted to the psychiatric hospital, while those staying on their parenteral neuroleptic drug-treatment stayed well socialized.

Adult↗
PubMed1983

[MAO-(monoamine oxidase-)inhibitor plus lithium. 1. Choice in psychopathologic rapidly changing bipolar manic-depressive patients (rapid cyclers)].

Patients resistant to therapy with lithium or lithium plus tricyclic antidepressants were included in our study. They had shown no curtailment of depression, no lessening of the depth of depression nor any improvement in the manic symptoms. Therapeutic medication with lithium, lithium plus tricyclics, neuroleptics and/or tranquilizer had been tried out for at last three years and the episodes of the manic-depressive illness were documented over this period. The diagnosis in the case of these patients was manic-depressive illness, type bipolar I or II. We report one case covering three years of treatment showing the following trend: Psychopathology did not change after quitting anciliary medication and tricyclic antidepressants while lithium intake was continued. A low-dose MAO inhibitor (tranylcypromine 13.7 mg/die) in addition to lithium led to shortened and less pronounced depressive and manic episodes and more prolonged normorhythmic periods. This trend emerged with even greater clarity during the course of the study.

Bipolar Disorder↗
PubMedDate not supplied

Regional brain function in hallucinations: a study of regional cerebral blood flow with 99m-Tc-HMPAO-SPECT in patients with auditory hallucinations, tactile hallucinations, and normal controls.

From the supposition that there exists a possible connection between certain psychopathological symptoms, and/or syndromes (e.g., hallucinations) and regional cerebral dysfunction, patients suffering from auditory and tactile hallucinations were investigated, in a symptom-oriented study, using the method of technetium-99m-Hexamethyl-propylenamine Oxime (99m-Tc-HMPAO)-Single Photon Emission Computed Tomography (SPECT) and compared with normal controls. The results support Jackson's hypothesis to the effect that hallucinatory phenomena will primarily occur when the normally inhibitive influence of the upper cortical centers over the lower brain structures diminishes, resulting in relative hyperactivity in the basal regions. In addition to the brain activity-changes generally observed in hallucinating patients, it was possible to identify regional cerebral blood flow (rCBF)-distribution patterns characteristic in certain forms of hallucinatory phenomena, i.e., a significant increase of activity in the hippocampal regions (including hippocampus, parahippocampus, and amygdala) only in patients with auditory hallucinations, and a significant reduction of rCBF in the inferior temporal regions in patients with tactile hallucinations.

Adult↗
PubMedDate not supplied

Dysphoria from a transnosological perspective.

The objective of our psychopathological analyses is to shed light on the position of irritable mood (dysphoria) in psychiatric diagnostics and nosology. In today's most commonly applied classification systems, the ICD-10 and the DSM-IV, dysphoria is mentioned mostly in the context of diagnostic criteria of personality and affective disorders. Other authors have emphasized the importance of dysphoric states in organic psychoses and delusional disorders. Summarizing the various publications on the nosological position, dysphoria is a nosological nonspecific syndrome which may occur in the course of all psychiatric disorders and illnesses. According to the results of our psychopathological analyses, the pathogenesis of dysphoria has to be considered as a multidimensional circular process in which various mental, physical and social factors act as predisposing, triggering and disorder-maintaining factors. Stressors induced by particular experiences and perceptions and by impaired health may lead to a dysphoric state if adequate coping mechanisms are missing. Dysphoria itself usually leads to a deterioration in the mental and physical state of the patient, and shows a clear impact on the patient's social network. The reactions of people close to the patient combined with the impaired mental and physical conditions of the patient cause the circle to restart. As contemporary diagnostic entities do not refer to pathogenesis, classical categorical diagnostics cannot provide the basis for effective pathogenesis-oriented therapy. A change of paradigm in diagnostics from a categorical to a dimensional approach thus becomes necessary. Following a dimensional diagnostic approach based on a dynamic model of vulnerability, a precise differential diagnosis of the complex constellation of conditions and their interactions becomes necessary in order to develop effective treatment strategies. Disorder-maintaining factors determine the treatment of the acute symptomatology, whereas predisposing and triggering factors serve as the basis for the prophylactic treatment.

Humans↗
PubMedDate not supplied

[Epidemiology of drug use and abuse. Physician's role].

Drug use in a given population, whether justified by a medical prescription or not, is a subject that is often emotionally rather than objectively discussed. In this study, objective data from the Austrian population are collected in order to provide a more comprehensible view of that complex phenomenon: drug use, abuse or addition seem to relate to various factors such as gender, age, profession and local differences. Physician's role in drug use in more or less important, depending on the nature of the substance. Indeed, tranquillizers and hypnotics are medically prescribed drugs although laxatives, geriatric and homeopathic medicines are rarely prescribed by a physician. However, these factors could account for only a part of this subject and other research should focus on the relations between physician, patient and the drug.

Adolescent↗