Cohen D, Flament M, Dubos P F, Basquin M
Department of Child and Adolescent Psychopathology, La Salpétrière Hospital, Paris, France.
J Am Acad Child Adolesc Psychiatry. 1999 Aug;38(8):1040-6. doi: 10.1097/00004583-199908000-00021.
This article reviews all recent (1977-1997) reports on catatonic adolescents and summarizes the 9 consecutive cases seen at the authors' institution during the past 6 years. Catatonia occurs infrequently in adolescents (0.6% of the inpatient population), but it appears to be a severe syndrome in adolescents of both sexes. Diagnoses associated with catatonia are diverse, including in this series: schizophrenia (n = 6), psychotic depression (n = 1), mania (n = 1), and schizophreniform disorder (n = 1). Two patients had a previous history of pervasive developmental disorder. In the literature, catatonia was also reported in children with organic condition (e.g., epilepsy, encephalitis). Therapeutic management depends on the specific causes, but several points need to be stressed: (1) the frequency of neuroleptic-induced adverse effects; (2) the potential efficacy of sedative drugs on motor signs; (3) the possible use of electroconvulsive therapy; and (4) the necessity to manage family reactions and fears, which are frequent causes of noncooperation. It is concluded that catatonia is an infrequent but severe condition in young people. While symptomatology, etiologies, complications, and treatment are similar to those reported in the adult literature, findings differ with regard to the female-male ratio and the relative frequencies of associated mental disorders.
本文回顾了所有近期(1977 - 1997年)关于紧张症青少年的报告,并总结了作者所在机构在过去6年中连续收治的9例病例。紧张症在青少年中并不常见(占住院患者的0.6%),但在青少年男女中似乎都是一种严重的综合征。与紧张症相关的诊断多种多样,在本系列中包括:精神分裂症(n = 6)、精神病性抑郁症(n = 1)、躁狂症(n = 1)和精神分裂症样障碍(n = 1)。两名患者既往有广泛性发育障碍病史。在文献中,也有关于患有器质性疾病(如癫痫、脑炎)儿童的紧张症报道。治疗管理取决于具体病因,但有几点需要强调:(1)抗精神病药物所致不良反应的发生率;(2)镇静药物对运动症状的潜在疗效;(3)可能使用电抽搐治疗;(4)处理家庭反应和恐惧的必要性,这是不合作的常见原因。结论是,紧张症在年轻人中并不常见但很严重。虽然症状、病因、并发症和治疗与成人文献中报道的相似,但在男女比例和相关精神障碍的相对发生率方面存在差异。