Psychiatry and Neurology Emeritus, State University of New York at Stony Brook, St. James, NY, USA.
History of Medicine, University of Toronto Faculty of Medicine, Toronto, ON, Canada.
Acta Psychiatr Scand. 2017 Nov;136(5):441-444. doi: 10.1111/acps.12796. Epub 2017 Aug 31.
To examine the psychological substrate of catatonia.
Reviewing the historical descriptions and explanations of catatonic behaviours by clinicians from its delineation in the 19th century to the present.
Patients with catatonia are often haunted by fears and terrors; this has not been widely appreciated, and certainly was lost from view in the days when catatonia was considered a subtype of schizophrenia. The report contributes to resolving a major question in catatonia: is the mind in stupor inactive, as the blank state that we picture in anesthetized patients, or is the mind active, so preoccupied as to exclude all other influences.
Persistent fear occupies the mind of catatonic patients.
The signs of catatonia are adaptations to persistent fear, akin to tonic immobilization. The relief afforded by sedation supports this interpretation.
探讨紧张症的心理基础。
回顾 19 世纪以来临床医生对紧张症行为的描述和解释。
紧张症患者常常被恐惧和恐惧所困扰；这一点尚未得到广泛认可，而且在紧张症被认为是精神分裂症的一种亚型的时代，这种观点肯定已经消失了。该报告有助于解决紧张症的一个主要问题：昏迷中的思维是否像我们在麻醉患者中想象的那样不活跃，或者思维是否活跃，以至于排除了所有其他影响。
持续的恐惧占据着紧张症患者的思维。
紧张症的症状是对持续恐惧的适应，类似于强直不动。镇静所带来的缓解支持了这一解释。
