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Biomedical subjects

T Haenel

Publications and source records attributed to T Haenel.

At least 19 recordsLinked to original sources

[Historical notes on the therapy of depression].

Melancholy originally had another meaning from the present one. Only since the last century has melancholy taken on the meaning of severe depression. The Arabs were the first to introduce special wards for the mentally ill in their hospitals in the 8th and 9th centuries. In the West, mental wards in general hospitals have been known since the 13th century only. In the Renaissance dietary measures played an important part in the treatment of depression. Lean meat, fresh eggs, freshwater fish and particularly grapes were recommended. In the 17th and 18th centuries music therapy against depression came back into favour after being used in ancient times. In the 19th century opium was recommended and held its ground well into the middle of our century. Various methods and drugs were recommended and used for the therapy of depression in the 19th century, such as baths and massage, ferrous iodide, arsenic, ergot, strophantin, and cinchona. Actual antidepressants have been known only for approximately 30 years. The classic papers concerning therapy with lithium salts date back to the years 1948/49. It is a little known fact, however, that lithium salts had been used as prophylactic treatment against periodic depression 50 years earlier.

Depression

[Suicide].

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Depression

[Falling as a method of suicide--psychodynamic aspects].

After some reflections upon the phenomenon of falling/jumping, the fall from a height and its meaning in fairy tales, in literature and in history is discussed. Eight casuistics with fatal and non-fatal issue serve to shed light on the psychodynamics which precipitate such acts. Referring to world-famous buildings such as the Eiffel Tower in Paris or the Golden Gate Bridge in San Francisco, the fact is stressed that many suicidal persons are attracted by these constructions and choose the place for their suicidal act accordingly. The possibilities of suicide prevention and the treatment of patients who have survived their attempt are presented.

Adult

The psychiatric significance of dermatitis artefacta.

A total of 71 patients (12 males and 59 females) who attended the University Skin Clinic of Basle in the years 1956-1982, have been investigated by a dermatologist, a psychiatrist and a psychologist. Among 55 female patients (group I and II) 14 had a suicide attempt in their history. Of the 39 female patients of group I 25 (64%) had suffered from a stressful childhood event. Of group I (39 female patients) 19 (48.7%) had had psychiatric therapy in the past or at the time of investigation; 23 patients (59%) had suffered from depressions either in the past or at the time of investigation. Among group II (16 patients) 11 (68.7%) had had psychiatric therapy in the past or at the time of investigation. The psychological test investigation (Colour Pyramid Test and Rosenzweig Picture-Frustration Test) revealed artefact patients to be in a state of considerable depressive-aggressive tension without being able to handle their emotions and impulses in an adequate manner.

Adult

[Psychogenic psychoses].

The term psychogenic or reactive psychosis is used to describe a psychotic state which is experience-related and triggered by a precipitating event. Experimental studies have confirmed that under total sensory deprivation man responds by exhibiting psychotic reactions within a short time. Emotion psychoses, brief reactive psychoses are psychotic reactions due to an emotional shock. They usually go beyond the usual pathological psychoreactions in terms of quality, intensity and duration. Emotion psychoses show schizophrenia-like symptoms; the duration of illness varies from a few hours to several weeks. Emotion psychoses are observed in other cultural groups, too. Two case reports are mentioned. The differential diagnosis of emotion psychoses, of psychotic reactions induced by extreme situations, and the question whether chronic psychoses may have psychogenic causes, are discussed.

Adjustment Disorders

[Evaluation of the risk of suicide].

Before committing a suicidal act, many people consult a doctor because of somatic or functional complaints. Most of them do not express their suicidal thoughts, unless they are asked direct questions. The taking of a thorough history, possibly supplemented by information from relatives or friends, is the safest basis for an optimal assessment of the suicide risk. Predisposing factors are: 1. Depression 2. Alcohol or drug dependence 3. Old age and loneliness 4. Warnings or threats of suicide 5. Past suicide attempts The presuicidal syndrome, as described by Ringel, consists of the narrowing of mental functions, the turning of suppressed aggression against oneself and suicide phantasies. The concept of the suicidal syndrome, as well as the new concepts of narcissism give important insights into the dynamics of suicide. A verbal promise should be obtained from suicidal patients that they will not commit a suicidal act for a specific period of time, e.g. until the next consultation with the doctor or until a critical point in the near future has been overcome. In any case, a trustful doctor-patient-relationship plays an essential part in suicide prevention.

Crisis Intervention

[Superstition, faith, delusion].

The superstitious person makes use of various projective mechanisms and establishes a connection between two events or between an object and an event which are not causally related. Superstition can be understood as a narcissistic attempt at compensation by persons lacking self-confidence, who feel themselves to be under an existential threat. Religious belief can be defined as a commitment to an ultimate meaning in life. Absolute faith requires hope, in fact genuine faith is unthinkable without hope. A prerequisite, an underlying emotional substrate, of the development of faith is trust, in the sense of basic trust. A characteristic of genuine religious belief is orthopraxy, the practical application of faith in this world. The integrity of religious belief is in itself vulnerable, since, unlike delusion, it can be modified. Delusion is a disturbance of thought content which is maintained with absolute conviction. The deluded person is not capable of doubting or correcting the false belief. Transition from faith to superstition and vice versa is often fluid. Superstition can be the starting point for delusional ideas. It must be distinguished from delusion and in most cases it is easy to do so. The superstitious person feels secure in his world, while the deluded person breaks out of this security and places himself outside the community, outside the society that supports him.

Delusions

[Personality of patients with dermatologic artefacts].

35 female patients with dermatological artefacts being treated in the University Skin Clinic Basel have been investigated by a dermatologist, a psychiatrist, and a psychologist. The testpsychological examination with the Color Pyramid Test and the Rosenzweig Picture-Frustration Test yielded a striking uniform picture: The patients showed strong intrapsychic tension, severe depressivity, inhibition of aggression, affective inhibition, low frustration tolerance, weak ego-integration (with tendencies to break outs of impulses) and autoaggressive tendencies. These results point to a depressive and schizoid-narcissistic personality-structure. The manipulations at the skin have different functions: by causing pain to themselves the patients try to feel their body-boundaries and to avoid fragmentations in the body-self; on the tactile level emotional experiences of early childhood should be (re)-activated; the artefact should draw the attention of the surroundings to the emotional suffering of the patient. Concerning therapy, it is important that the doctor to whom the patients come first is ready to offer therapeutic talks. In these discussions the situation in which the artefact was done, with its psychodynamic background, should be explored and the therapist should help the patient to find other ways than artefacts to articulate his needs.

Adult

[The suicide problem in Stefan Zweig's works].

The life of the Vienna-born writer Stefan Zweig, whose centenary will be on November 28th, 1981, is portrayed in the light of some external data. His works - mainly novellas - in which the theme of suicide plays a central role, are briefly presented, and his preference for describing psychological borderline and extreme states is stressed. One of his first poems and his last one - more than forty years lie between them - are discussed with reference to his depression and suicidal tendencies. Zweig, who at least since the First World war had been periodically suffering from depressions, was looked after and in a sense also treated by his first wife Friderike von Winternitz, until he had to leave his home in Salzburg in 1935. In 1939, he divorced from his wife and married his sickly secretary, Lotte Altmann, who suffered from asthma and depression. After prolonged stays in England, North and South America he settled in Petropolis near Rio de Janeiro in Brasil, where he spent the last months of his life. Zweig was the second son of a dominating, self-willed mother and a dignified, almost "motherly" father. He felt his childhood to have been constricted and hemmed in. His narcissism, which has played an essential role in relation to his suicide, has its roots in his childhood. Direct as well as indirect hints at suicide were not lacking during the last two years of Zweig's life, which were increasingly filled with depression and anxiety. The preface to his autobiography "The World of Yesterday" may be interpreted as an indirect announcement of suicide. On February 22nd, 1942, Zweig committed suicide together with his second wife in Petropolis.

Austria