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劳拉西泮与电休克疗法在紧张症治疗中的应用:60例患者的治疗特征与结局

The Use of Lorazepam and Electroconvulsive Therapy in the Treatment of Catatonia: Treatment Characteristics and Outcomes in 60 Patients.

作者信息

Unal Ahmet, Altindag Abdurrahman, Demir Bahadir, Aksoy Ihsan

出版信息

J ECT. 2017 Dec;33(4):290-293. doi: 10.1097/YCT.0000000000000433.

Abstract

OBJECTIVES

Lorazepam and electroconvulsive therapy (ECT) are effective treatments for catatonia. However, systematic data on these treatments in catatonia are limited. In the present study, we aimed to investigate the clinical and treatment-related characteristics of patients with catatonia who underwent lorazepam and/or ECT.

METHODS

Between January 2012 and December 2016, we received 60 patients with catatonia hospitalized in the Gaziantep University Faculty of Medicine Clinic of Psychiatry. Lorazepam and/or ECT were used in the patients' treatment schedule. Treatment results were evaluated using the Bush-Francis Catatonia Rating Scale and Clinical Global Impression-Improvement.

RESULTS

Thirty-five patients (58.3%) in the sample were in their first catatonic episode. The most common comorbidity was mood disorder (n = 34, 56.7%), whereas the most frequent catatonic sign was mutism (n = 43, 71.7%). Moreover, 31 patients (51.7%) had some form of medical comorbidity. Cerebral abnormalities were detected in computed tomography/magnetic resonance imaging in 22 patients (36.7%). Furthermore, 95% of the patients (n = 57) fully recovered after administration of the treatment.

CONCLUSIONS

Lorazepam is a reasonable initial choice in the treatment of catatonia, with rapid consideration for ECT if there is no rapid response to lorazepam.

摘要

目的

劳拉西泮和电休克治疗(ECT)是治疗紧张症的有效方法。然而,关于这些治疗方法用于紧张症的系统性数据有限。在本研究中,我们旨在调查接受劳拉西泮和/或ECT治疗的紧张症患者的临床及治疗相关特征。

方法

2012年1月至2016年12月期间,我们接收了60例在加济安泰普大学医学院精神病科住院的紧张症患者。在患者的治疗方案中使用了劳拉西泮和/或ECT。使用布什-弗朗西斯紧张症评定量表和临床总体印象改善量表评估治疗结果。

结果

样本中的35例患者(58.3%)处于首次紧张症发作。最常见的合并症是情绪障碍(n = 34,56.7%),而最常见的紧张症体征是缄默(n = 43,71.7%)。此外,31例患者(51.7%)有某种形式的内科合并症。22例患者(36.7%)在计算机断层扫描/磁共振成像中检测到脑部异常。此外,95%的患者(n = 57)在接受治疗后完全康复。

结论

劳拉西泮是治疗紧张症的合理初始选择,如果对劳拉西泮没有快速反应,则应迅速考虑ECT。

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