Psychische Veränderungen bei intensivbehandelten Patienten mit akutem Guillain-Barré-Syndrom - tiefenpsychologische Aspekte des Kommunikationsverlustes und seiner Bewältigung*

Abstract

Ten patients who had been hospitalized with acute Guillain-Barré-syndrome (GBS) were monitored during their course of treatment and were asked in short intervals through semi-structured interviews how they experienced their illness. States of anxiety were especially evident at the initial phase of the disease, during the dissemination and maximum intensity of paralysis. In contrast, depressive symptoms were primarily noticeable during the phase of remission. As a rule, the degree of anxiety correlated in intensity and duration with the degree of severity of the neurological deficit. Five patients experienced a temporary derealization, among those, three patients showed productive-psychotic symptoms (optical and acoustical hallucinations, delusional reactions). Frequently, dreams were reported, which were associated with elementary experiences of anxiety and in part took on an overwhelming realistic character. Finally, the psychic changes are interpreted in context with the extreme condition of the disease which does not only signify a situation of forced dependence and regression for the patient but also results in--through loss of mobility and communication (cranial nerve dysfunction, artificial respiration)--a fundamental change in the perception of reality.

Psychotic Symptoms and Emotional Distress in Patients with Guillain-Barré Syndrome

“…Our observations support the previous observations that psychological disturbances are frequent in patients suffering from GBS [5, 6, 8, 9, 11]. The main finding of this larger study is that 25% of the patients displayed brief reactive psychosis (DSM-IV 298.8, ICD-10 F23).…”

“…This paper aims at a description of the type and frequency of psychological disturbances in patients suffering from GBS. Although these disturbances seem to be a common experience in severely disabled GBS patients, little attention has been paid to those phenomena in the international scientific literature [2, 3, 4, 5, 6, 7]. Eisendrath et al [8], in a longitudinal study, observed visual hallucinations in 6 of 8 cases.…”