Health Scan: Caring for the other

researchers writing in the online journal Medical Humanities suggest that composer Frederic Chopin's real problem was epilepsy.

By JUDY SIEGEL-ITZKOVICH
Psychopaths and some individuals who have suffered frontal head injuries have something in common – an inability to feel empathy for others.
According to University of Haifa researcher Dr. Simone Shamay-Tsoory, who discovered this, the finding could lead to treatment for psychopathic behavior that is similar to that used for brain damage.
Psychopathy is a personality disorder that finds expression in extreme anti-social behavior and intentional harm to others, with a lack of compassion and empathy.
An existing explanation for such behavior suggests inability to comprehend the existence of emotions in others. However, the fact that many psychopaths act with sophistication and deceit indicates that they actually have a good grasp of the mental capacity of others, and are even capable of using that knowledge to cause them harm. Earlier research by Dr. Shamay-Tsoory examined people who have damage to parts of the brain responsible for emotional functioning, and who thus have difficulty showing empathy.
Having observed similar emotional deficiencies in psychopathic behavior, she set out to see if there is a similarity between the two cases.
In the new study, she assessed 17 people who had been diagnosed as psychotic but did not suffer from any known brain damage, and compared them with 25 people who had suffered frontal lobe injury. Each participant underwent a computerized test examining the ability to recognize feelings in another, the ability to demonstrate empathy for another’s emotions, and their capacity to understand another’s thoughts. The results of these tests showed that both groups demonstrated a similar difficulty in showing empathy, while two control groups of individuals with no known mental disorders or brain damage and individuals with non-frontal brain damage showed different results with positive empathy capabilities.
WHAT BUGGED CHOPIN?
The great 19th-century Polish virtuoso pianist and composer Frederic Chopin was renowned, among other things, for his frailty and sensitivity. He, as well as his students, friends and family, described his hallucinatory episodes, which 20th-century experts thought was due to bipolar disorder or clinical depression. Now researchers writing in the online journal Medical Humanities suggest that his real problem was epilepsy.
Chopin, who was plagued by poor health throughout his life, died at the age of 39 of chronic lung disease in 1849, which has been attributed to cystic fibrosis, based on the composer’s family history. A year before his death, during a performance in England of his Sonata in B flat minor, Chopin suddenly stopped playing and left the stage – an event recorded by the Manchester Guardian’s music critic. In a letter to a friend, Chopin described the moment during the performance when he saw creatures emerging from the piano, which forced him to leave the room to recover himself.
Hallucinations are a hallmark of several psychiatric disorders, such as schizophrenia and dissociative states, say the authors of the medical article, but they usually take the form of voices. Migraine can also produce hallucinations, but these can last up to half an hour, while Chopin’s were often brief; and migraine auras without headache mainly occur in patients over 50, they write.
After studying the evidence, they concluded that temporal lobe epilepsy is a more likely explanation, as it can produce visual hallucinations that are usually brief, fragmentary and stereotyped, just like those Chopin said he experienced.
The authors acknowledge that without modern tests, it is difficult to make a diagnosis, but comment: “A condition such as that described in this article could easily have been overlooked by Chopin’s doctors.”