P-449 - Prognostic factors regarding the treatment of dementia paralytica with malaria fever therapy: a historical cohort study
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文摘

Introduction

Dementia paralytica, a late neuropsychiatric complication of syphilis, was common in Europe at the beginning of the 20th century. In the course of the subsequent century, the number of patients decreased dramatically, partly due to improved treatment options. One of the great therapeutic breakthroughs was the discovery of malaria fever therapy by Wagner von Jauregg.

Aim

This retrospective cohort-study was designed to detect prognostic factors regarding the treatment of dementia paralytica with malaria fever therapy.

Methods

Inpatients of the Vincent van Gogh psychiatric hospital in Venray were included in this study if they had a discharge diagnosis of dementia paralytica (general paralysis of the insane) and had been treated with malaria fever therapy in the period from 1907 to 1970. Patients were identified using annual reports and death registries from the hospital. Each patient's clinical record was reviewed for demographic, clinical, therapeutical and laboratory data. We measured survival after malaria fever therapy. Treatment response was categorized as: complete remission, incomplete remission but no hospitalization required, incomplete remission and permanent hospitalization required, unimproved or death during or shortly after treatment. The cause of death was classified as related or not related to dementia paralytica.

Results

Preliminary results suggest that 70 % of the patients were male. Many patients died within 2 months of hospitalisation, but some survived for more than 20 years.

Conclusions

Further analysis is currently being done and definite results and conclusions will be presented at the meeting.

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