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老年患者在综合医院联络精神病服务中出现紧张症的患病率和临床相关性。

Prevalence and clinical correlations of catatonia in older adults referred to a liaison psychiatry service in a general hospital.

机构信息

Mental Health Network of Gipuzkoa, Basque Health Service - Osakidetza, Arrasate - Mondragon, Country-Basque, Spain.

出版信息

Gen Hosp Psychiatry. 2013 Sep-Oct;35(5):512-6. doi: 10.1016/j.genhosppsych.2013.04.009. Epub 2013 May 15.

Abstract

AIM

To determine the frequency and clinical correlations of catatonia in older patients referred to a liaison psychiatry service in a general hospital.

PATIENTS AND METHODS

All patients over 65 years referred to liaison psychiatry were screened for catatonic phenomena with the Bush-Francis Catatonia Screening Instrument (BFCSI) between January and May 2012. Their clinical characteristics and the outcome of treatment were recorded.

RESULTS

One hundred and twelve patients over 65 years were referred. Ten (8.9%) met research diagnostic criteria for catatonia and 7 (6.3%) Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria for catatonia. All patients presented with the inhibited variant and 5 to 12 catatonic signs. Three patients presented concomitant delirium. The etiology of catatonia was multifactorial, and complications and death were frequent (40% and 20%, respectively). Lorazepam achieved full resolution of catatonia in 50% of patients.

CONCLUSIONS

Catatonia in older adults referred to liaison psychiatry in a general hospital is not infrequent and has a multifactorial etiology. The BFCSI is a simple and reliable instrument to detect catatonia in this population. Lorazepam seems to be an effective treatment.

摘要

目的

确定在综合医院联络精神病学服务中转诊的老年患者出现紧张症的频率和临床相关性。

方法

2012 年 1 月至 5 月期间,使用 Bush-Francis 紧张症筛查工具(BFCSI)对所有 65 岁以上转诊至联络精神病学的患者进行紧张症的筛查。记录他们的临床特征和治疗结果。

结果

共转诊了 112 名 65 岁以上的患者。10 名(8.9%)符合紧张症的研究诊断标准,7 名(6.3%)符合精神障碍诊断与统计手册第 4 版(DSM-4)的紧张症标准。所有患者均表现为抑制型紧张症,有 5-12 个紧张症特征。3 名患者同时出现谵妄。紧张症的病因是多因素的,并发症和死亡率高(分别为 40%和 20%)。劳拉西泮使 50%的患者的紧张症完全缓解。

结论

综合医院联络精神病学转诊的老年紧张症并不少见,病因是多因素的。BFCSI 是一种在该人群中检测紧张症的简单而可靠的工具。劳拉西泮似乎是一种有效的治疗方法。

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