Continuity syndrome

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Classification according to ICD-10
F09 Unspecified organic or symptomatic mental disorder, including: Psychosis: organic onA, symptomatic onA
ICD-10 online (WHO version 2019)

Passage syndrome is a systematic term used in psychiatry for all physically based psychopathological symptoms that usually resolve spontaneously within hours to a few days without therapy. However, these symptoms must not be accompanied by a clouding of consciousness. In contrast to delirium, there is no clouding of consciousness ( qualitative disturbance of consciousness ). The collective name was introduced by Hans Heinrich Wieck . Transit syndromes represent a subgroup of the acute exogenous reaction types. Both are basic concepts of classical German psychiatry . They serve to delimit physically justifiable, i.e. H. exogenous acute psychoses of endogenous psychoses , see the triadic system of psychiatry .

Hans Heinrich Wieck counted the passage syndromes among the functional psychoses . With this functional designation, it should be left open which psychopathological syndrome and what cause of illness the disorder is based on. This should consciously guarantee an openness in the classification.

The term transit syndrome referred to reversible disorders in which the corresponding symptoms regress (hence "transit syndrome"). For this short-term organic psychosis , the term acute organic psychosyndrome , or in surgery of postoperative delirium , was also used synonymously .

Concerns about the use of the term

Today there are concerns about the use of the term passage syndrome. This is often associated with an outdated, imprecise and no longer used meaning for short-term delirium . The term transit syndrome was mostly used in postoperative patients and especially in intensive care patients who show a disease pattern that is very limited in time and, above all, reversible without therapy. Like any delirium, a transit syndrome must be carried out as early as possible, i.e. H. can be treated immediately with the diagnosis. However, since a possibly protracted (delayed) course cannot be predicted without appropriate diagnostics, for example whether delirium heals itself in a self-limiting manner without therapy or whether further diagnostics are necessary, waiting is now a treatment error . The term continuity syndrome does not represent a medical justification for failure of therapy or delayed diagnosis and should therefore no longer be used from a therapeutic point of view. It has only a descriptive and classificatory meaning, not a prognostic one. However, it must be emphasized that delirium in the strictly psychiatric sense of the definition given above is not a transitory syndrome, as it is associated with a clouding of consciousness. Delirium is one of Bonhoeffer's acute exogenous reaction types. It is precisely because of this diagnostic differentiation in German psychiatry that the concept of delirium has acquired a different meaning than, for example, in the French and English psychiatric literature. Delirium used to be used in Germany as a synonym for psychosis . Old terms such as chronic alcohol delirium (= Korsakov syndrome ) testify to this . The concept of continuity syndrome has become less popular in France and England.

causes

The term transit syndrome has been used in a number of inpatient treatments, in particular surgical interventions, as a concomitant disease in various forms. The delayed appearance is typical about two days after a surgical procedure.

Symptoms

Thinking disorders, memory disorders, (especially optical) hallucinations , delirious state pictures , lack of drive, but also restlessness, sudden mood swings and sleep disorders (often with nightmares) can occur. Conditions of complete confusion and temporal and spatial disorientation are also common.

See also

Individual evidence

  1. ↑ Möller; Laux; Kapfhammer (ed.): Psychiatry and psychotherapy . 3. Edition. tape 1 . Springer, 2008, p. 382 .
  2. ↑ Physically justifiable psychoses . In: Gerd Huber : Psychiatry. Systematic teaching text for students and doctors. FK Schattauer, Stuttgart 1974, ISBN 3-7945-0404-6 ; P. 38 ff.
  3. ↑ Norbert Boss (Ed.): Roche Lexicon Medicine . 2nd Edition. Hoffmann-La Roche and Urban & Schwarzenberg, Munich 1987, ISBN 3-541-13191-8 , Gesundheit.de/roche
  4. ^ A b Functional Psychosis and Delirium . In: Uwe Henrik Peters : Dictionary of Psychiatry and Medical Psychology . 3. Edition. Urban & Schwarzenberg, Munich 1984, pp. 203, 110
  5. ↑ Klaus Lieb, Sabine Frauenknecht, Stefan Brunnhuber: Intensive course in psychiatry and psychotherapy. Munich 2008, ISBN 978-3-437-42132-7 , p. 3.
  6. ^ E. Muhl: Delirium and passage syndrome. In: The surgeon. 2006/5, pp. 463-472. doi: 10.1007 / s00104-006-1153-z
  7. ↑ JF Spittler: Disorders of consciousness: the basis for ethical assessment In: Advances in Neurology-Psychiatry. Volume 67, Number 1, January 1999, pp. 37-47. ISSN  0720-4299 . doi: 10.1055 / s-2007-993736 . PMID 10065388 . (Review).
  8. ↑ Willibald Pschyrembel: Pschyrembel Clinical Dictionary. 261st edition. Berlin 2007, ISBN 978-3-11-018534-8 , p. 463.