Nahar Abhinav, Kondapuram Nithin, Desai Geetha, Chandra Prabha S
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Gen Hosp Psychiatry. 2017 Mar-Apr;45:40-43. doi: 10.1016/j.genhosppsych.2016.12.010. Epub 2016 Dec 24.
The aims of the present study were to determine the prevalence of catatonia in women with postpartum psychosis, describe its socio demographic, clinical and obstetric correlates and identify predictors of treatment response.
Data was extracted from clinical charts of 200 women with postpartum psychosis admitted to an inpatient mother baby unit (MBU) in India over a 3year period.
Of the 200 patients, 20% (n=40) had symptoms of catatonia. Mean catatonia score on the Bush Francis Catatonia Rating Scale (BFCRS) was 14.97±3.2. The most frequent catatonic feature was mutism (n=40, 100%). Adequate response to lorazepam trial in catatonia was seen in half the women (n=18/36), with longer duration of untreated catatonia being associated with poorer response. An adequate response to Electroconvulsive therapy (ECT) was seen in 19 women who did not respond to the lorazepam trial. Women with catatonia had significantly higher rates of onset within the first four weeks of postpartum period (50% vs 31.5%, P=0.022) and a longer duration of untreated psychosis at presentation (79.46±159.88 vs 56.12±47.26, P=0.002) compared to mothers without catatonia.
Catatonic symptoms were identified in one-fifth (20%) of women with postpartum psychosis. Early identification and treatment of catatonia are essential for rapid control of symptoms in this vulnerable population.
本研究旨在确定产后精神病女性中紧张症的患病率，描述其社会人口统计学、临床和产科相关因素，并确定治疗反应的预测因素。
从印度一家母婴住院单元（MBU）在3年期间收治的200例产后精神病女性的临床病历中提取数据。
200例患者中，20%（n = 40）有紧张症症状。布什-弗朗西斯紧张症评定量表（BFCRS）的平均紧张症评分为14.97±3.2。最常见的紧张症特征是缄默（n = 40，100%）。一半的女性（n = 18/36）对氯硝西泮试验治疗紧张症有充分反应，未治疗的紧张症持续时间越长，反应越差。19例对氯硝西泮试验无反应的女性对电休克治疗（ECT）有充分反应。与无紧张症的母亲相比，有紧张症的女性在产后头四周内发病的比例显著更高（50%对31.5%，P = 0.022），就诊时未治疗的精神病持续时间更长（79.46±159.88对56.12±47.26，P = 0.002）。
在五分之一（20%）的产后精神病女性中发现了紧张症症状。早期识别和治疗紧张症对于快速控制这一脆弱人群的症状至关重要。
