title: [Psychological changes in intensive care patients with acute Guillain-Barré syndrome--psychoanalytic aspects of loss of communication and adjustment].
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.
authors.affiliation: Institut für Psychotherapie und Medizinische Psychologie, Universität Würzburg.
authors.forename: H
authors.initials: H
authors.lastname: Weiss
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003142:Communication; D003422:Critical Care / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011129:Polyradiculoneuropathy / Q000523:psychology*; D012803:Sick Role
vernacular_title: Psychische Veränderungen bei intensivbehandelten Patienten mit akutem Guillain-Barré-Syndrom--tiefenpsychologische Aspekte des Kommunikationsverlustes und seiner Bewältigung.