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紧张症的现象学与治疗反应:一项基于医院的描述性研究。

The Phenomenology and Treatment Response in Catatonia: A Hospital Based Descriptive Study.

作者信息

Swain Sarada Prasanna, Behura Sushree Sangita, Dash Manoj Kumar

机构信息

Department of Psychiatry, Mental Health Institute, Centre of Excellence, Cuttack, Odisha, India.

Clinical Psychologist, Neuropsychiatric Consultation Centre, Cuttack, Odisha, India.

出版信息

Indian J Psychol Med. 2017 May-Jun;39(3):323-329. doi: 10.4103/0253-7176.207338.

Abstract

BACKGROUND

Literatures regarding clinical symptomatology and treatment response of catatonia are very few.

OBJECTIVE

To assess onset, clinical profile, diagnostic break up, treatment response and outcome in patients diagnosed as Catatonia, reported to a tertiary care hospital.

METHODS

The present study was a cross-sectional descriptive study conducted in indoor of Mental Health Institute (Centre of Excellence), S.C.B. Medical College, between March 2015 to March 2016. A total of 34 patients were included in the study who reported at outdoor department of Mental Health Institute with catatonic symptoms. All patients admitted in inpatient department were routinely assessed through a detailed semi-structured interview. The diagnosis of catatonia was made if the patients present with three or more symptoms out of twelve symptoms fulfilling the criteria of DSM-5. All the patients were assessed through Bush-Francis Catatonia Rating Scale. They were initially given parental lorazepam at the doses ranging from 4-12 mg per day as per requirement. Patients who did not respond to lorazepam trial were given ECT.

RESULTS

The patients were predominantly presented with retarded symptoms of catatonia such as staring, mutism, withdrawal, posturing and negativism. Schizophrenia and other psychotic spectrum disorders were more commonly presented as catatonia as compared to mood disorders. Younger age group patients were mainly responded to lorazepam only, whereas older age group patients responded to both ECT and lorazepam.

CONCLUSION

This study has came out with very important insights in the age of incidence, phenomenology, clinical profile, source of referral, diagnostic break up and treatment response with lorazepam and ECT in catatonic patients following mental disorder.

摘要

背景

关于紧张症临床症状学和治疗反应的文献非常少。

目的

评估在一家三级医院报告的被诊断为紧张症患者的发病情况、临床特征、诊断分类、治疗反应及结局。

方法

本研究是一项横断面描述性研究,于2015年3月至2016年3月在S.C.B.医学院精神卫生研究所(卓越中心)的室内进行。共有34名有紧张症症状的患者在精神卫生研究所门诊就诊并纳入研究。所有住院患者均通过详细的半结构化访谈进行常规评估。如果患者出现符合DSM-5标准的12种症状中的3种或更多症状,则诊断为紧张症。所有患者均通过布什-弗朗西斯紧张症评定量表进行评估。最初根据需要给予患者每天4 - 12毫克的静脉注射劳拉西泮。对劳拉西泮试验无反应的患者给予ECT治疗。

结果

患者主要表现为紧张症的迟缓症状,如凝视、缄默、退缩、姿势异常和违拗。与心境障碍相比,精神分裂症和其他精神病性谱系障碍更常表现为紧张症。较年轻年龄组的患者主要仅对劳拉西泮有反应,而较年长年龄组的患者对ECT和劳拉西泮均有反应。

结论

本研究在精神障碍后紧张症患者的发病率、现象学、临床特征、转诊来源、诊断分类以及劳拉西泮和ECT的治疗反应方面得出了非常重要的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3231/5461844/713c28cca895/IJPsyM-39-323-g001.jpg

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