紧张症的临床表现、诊断及经验性治疗
Clinical manifestations, diagnosis, and empirical treatments for catatonia.
作者信息
Bhati Mahendra T, Datto Catherine J, O'Reardon John P
机构信息
Department of Psychiatry, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
出版信息
Psychiatry (Edgmont). 2007 Mar;4(3):46-52.
OBJECTIVE
Review the medical literature on the history and clinical features of catatonia so as to provide a contemporary clinical guide for successfully diagnosing and treating the various clinical forms of catatonia.
DESIGN
RESULTS of MEDLINE computerized searches using search terms 'catatonia', 'treatment of catatonia', 'electroconvulsive therapy and catatonia', 'benzodiazepines and catatonia', clinical case reports, and book chapters covering the medical and psychiatric literature relevant to catatonia and its associated treatments were examined.
SETTING
Academic medical center.
PARTICIPANTS
None.
MEASUREMENTS
None.
RESULTS
Catatonia is a common but under-recognized clinical syndrome. No large-scale, controlled studies exist to determine the relative effectiveness of current treatments, including sedative-hypnotic medications (benzodiazepines or barbiturates), and electroconvulsive therapy (ECT).
CONCLUSION
Despite the lack of large-scale, controlled studies, benzodiazepines appear to be an effective first-line treatment for catatonia. ECT is now often reserved as a second-line treatment despite more than 60 years of documented efficacy and safety. However, ECT should be viewed as a first-line intervention in cases of severe or malignant catatonias.
目的
回顾关于紧张症历史和临床特征的医学文献，以便为成功诊断和治疗各种临床形式的紧张症提供当代临床指南。
设计
检查了利用搜索词“紧张症”、“紧张症的治疗”、“电休克治疗与紧张症”、“苯二氮䓬类药物与紧张症”进行的MEDLINE计算机检索结果、临床病例报告以及涵盖与紧张症及其相关治疗有关的医学和精神病学文献的书籍章节。
地点
学术医疗中心。
参与者
无。
测量
无。
结果
紧张症是一种常见但未得到充分认识的临床综合征。尚无大规模对照研究来确定当前治疗方法的相对有效性，这些治疗方法包括镇静催眠药物（苯二氮䓬类药物或巴比妥类药物）和电休克治疗（ECT）。
结论
尽管缺乏大规模对照研究，但苯二氮䓬类药物似乎是治疗紧张症的一种有效一线治疗方法。尽管有60多年的疗效和安全性记录，但ECT现在通常留作二线治疗。然而，在严重或恶性紧张症病例中，ECT应被视为一线干预措施。
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