Aggarwal Ashish, Sharma Dinesh Dutt, Kumar Ramesh, Sharma Ravi C
Department of Psychiatry, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
Indian J Psychol Med. 2010 Jan;32(1):61-4. doi: 10.4103/0253-7176.70542.
Mutism, defined as an inability or unwillingness to speak, resulting in an absence or marked paucity of verbal output, is a common clinical symptom seen in psychiatric as well as neurology outpatient department. It rarely presents as an isolated disability and often occurs in association with other disturbances in behavior, thought processes, affect, or level of consciousness. It is often a focus of clinical attention, both for the physician and the relatives. Mutism occurs in a number of conditions, both functional and organic, and a proper diagnosis is important for the management. We hereby present three cases, who presented with mutism as the presenting symptom and the differential diagnosis and management issues related to these cases are discussed. The authors also selectively reviewed the literature on mutism, including psychiatric, neurologic, toxic-metabolic, and drug-induced causes.
缄默症定义为无法或不愿说话，导致言语输出缺失或显著减少，是精神科和神经科门诊常见的临床症状。它很少作为孤立的障碍出现，常与行为、思维过程、情感或意识水平的其他紊乱相关。它常常是临床关注的焦点，无论是对医生还是亲属来说。缄默症在多种功能性和器质性疾病中都有发生，正确的诊断对治疗管理很重要。我们在此呈现三例以缄默症为首发症状的病例，并讨论与这些病例相关的鉴别诊断和治疗问题。作者还选择性地回顾了关于缄默症的文献，包括精神、神经、毒代谢和药物诱导等病因。
