Cuevas-Esteban Jorge, Iglesias-González Maria, Rubio-Valera Maria, Serra-Mestres Jordi, Serrano-Blanco Antoni, Baladon Luisa
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
Prog Neuropsychopharmacol Biol Psychiatry. 2017 Aug 1;78:27-33. doi: 10.1016/j.pnpbp.2017.05.013. Epub 2017 May 19.
This study aims to describe the prevalence of catatonia in a population of older acute psychiatric inpatients according to different diagnostic criteria. Secondary objectives are: to compare the catatonic symptom profile, prevalence, and severity, in respect to the underlying aetiology, and to evaluate the association between catatonic and somatic comorbidity.
The study included 106 patients admitted to an acute geriatric psychiatry ward. Catatonia was assessed using the Bush Francis Catatonia Rating Scale (BFCRS).
Catatonia was highly prevalent (n=42; 39.6%), even when using restrictive diagnostic criteria: Fink and Taylor (n=19; 17.9%) and DSM 5 (n=22; 20.8%). Depression was the most frequent psychiatric syndrome among catatonic patients (n=18; 42.8%). Catatonia was more frequent in depression (48.6%) and delirium (66.7%). Affective disorders showed a higher risk than psychotic disorders to develop catatonia (OR=2.68; 95% CI 1.09-6.61). This association was not statistically significant when controlling for dementia and geriatric syndromes. The most prevalent catatonic signs were excitement (64.3%), verbigeration (61.9%), negativism (59.5%), immobility/stupor (57.1%), and staring (52.4%).
Catatonia in older psychiatric inpatients was highly prevalent. Depression was the most common psychiatric syndrome among catatonic patients, and catatonia was more frequent in depression and mania, as well as in delirium. Affective disorders were associated with a higher risk of developing catatonia compared to psychotic disorders. Somatic and cognitive comorbidity played a crucial aetiological role in catatonia in this series.
本研究旨在根据不同诊断标准描述老年急性精神科住院患者中紧张症的患病率。次要目标是：比较紧张症症状谱、患病率及严重程度与潜在病因的关系，并评估紧张症与躯体共病之间的关联。
该研究纳入了106名入住急性老年精神科病房的患者。使用布什-弗朗西斯紧张症评定量表（BFCRS）评估紧张症。
即使采用严格的诊断标准，紧张症的患病率也很高（n = 42；39.6%）：芬克和泰勒标准（n = 19；17.9%）以及DSM-5标准（n = 22；20.8%）。抑郁症是紧张症患者中最常见的精神综合征（n = 18；42.8%）。紧张症在抑郁症（48.6%）和谵妄（66.7%）中更为常见。情感障碍患者发生紧张症的风险高于精神障碍患者（OR = 2.68；95%CI 1.09 - 6.61）。在控制痴呆和老年综合征后，这种关联无统计学意义。最常见的紧张症体征为兴奋（64.3%）、言语重复（61.9%）、违拗（59.5%）、不动/木僵（57.1%）和凝视（52.4%）。
老年精神科住院患者中紧张症的患病率很高。抑郁症是紧张症患者中最常见的精神综合征，紧张症在抑郁症、躁狂症以及谵妄中更为常见。与精神障碍相比，情感障碍发生紧张症的风险更高。在本系列研究中，躯体和认知共病在紧张症的病因中起关键作用。
