[Cost-effectiveness of syphilis screening in a clinical for general psychiatry]

The most important clinical picture of syphilis for psychiatry is that of progressive paralysis. It is an organic psychosis with varying psychopathology. Therefore, nearly all patients in psychiatric departments undergo lues screening (TPHA) on admission. A cost-benefit analysis is presented. In the examination period from 1 January 1983 to 30 September 1988, in all 8915 patients were newly admitted to the department of general psychiatry at the University Hospital of Essen: 98 of these patients were TPHA-positive, and 6 patients had to be treated with antibiotics. One patient had neurolues. It seems therefore, that lues screening in a department of general psychiatry is performed for traditional reasons at high cost but with minimal benefit. The 6 patients who underwent a specific therapy were analysed; a catalogue of indication criteria for TPHA screening was elaborated and is presented.