Musalek M, Bach M, Gerstberger K, Lesch O M, Passweg V, Wancata J, Walter H
Psychiatrische Universitätsklinik, Wien.
Wien Med Wochenschr. 1989 Jul 15;139(13):297-302.
In 34 patients suffering from delusional parasitosis the relevance of an accurate differential diagnosis with respect to pharmacological treatment was investigated. Under a psychopharmacological therapy of the delusion's additional psychiatric symptomatology in 17 patients (50%) a full remission and in other 5 patients an improvement of the delusional symptoms was observed. The unexpected high recovery-rate is explained by the fact that all of the patients with additional depression showed a reduction also of the delusional symptomatology after a treatment with antidepressants. In contrast to that, patients with organic brain syndromes underlying the delusions had a significant worse outcome, which seems to be caused by the considerable lack of effective psychopharmacological treatment of such states. The results indicate that an accurate psychiatric differential diagnosis is of great importance for the psychopharmacological therapy of patients suffering from delusional parasitosis. In this context the Viennese decision-tree for delusional syndromes is discussed.
对34例患有妄想性寄生虫病的患者，研究了准确鉴别诊断对药物治疗的相关性。在17例患者（50%）中，针对妄想的附加精神症状进行心理药物治疗后，观察到完全缓解，另外5例患者的妄想症状有所改善。意外的高康复率可解释为，所有伴有附加抑郁的患者在接受抗抑郁药治疗后，妄想症状也有所减轻。与此相反，妄想背后存在器质性脑综合征的患者预后明显更差，这似乎是由于对此类状态缺乏有效的心理药物治疗。结果表明，准确的精神科鉴别诊断对患有妄想性寄生虫病患者的心理药物治疗非常重要。在此背景下，讨论了维也纳妄想综合征决策树。
