Pelzer Anne Cm, van der Heijden Frank Mma, den Boer Erik
Department of Psychiatry, Reinier van Arkel, 's-Hertogenbosch.
Department of Psychiatry, Vincent van Gogh Institute for Psychiatry, Venlo.
Neuropsychiatr Dis Treat. 2018 Jan 17;14:317-326. doi: 10.2147/NDT.S147897. eCollection 2018.
To investigate the evidence-based treatment of catatonia in adults. The secondary aim is to develop a treatment protocol.
A systematic review of published treatment articles (case series, cohort or randomized controlled studies) which examined the effects of particular interventions for catatonia and/or catatonic symptoms in adult populations and used valid outcome measures was performed. The articles for this review were selected by searching the electronic databases of the Cochrane Library, MEDLINE, EMBASE and PSYCHINFO.
Thirty-one articles met the inclusion criteria. Lorazepam and electroconvulsive therapy (ECT) proved to be the most investigated treatment interventions. The response percentages in Western studies varied between 66% and 100% for studies with lorazepam, while in Asian and Indian studies, they were 0% and 100%. For ECT, the response percentages are 59%-100%. There does not seem to be evidence for the use of antipsychotics in catatonic patients without any underlying psychotic disorder.
Lorazepam and ECT are effective treatments for which clinical evidence is found in the literature. It is not possible to develop a treatment protocol because the evidence for catatonia management on the basis of the articles reviewed is limited. Stringent treatment studies on catatonia are warranted.
探讨成人紧张症的循证治疗。次要目的是制定治疗方案。
对已发表的治疗文章（病例系列、队列研究或随机对照研究）进行系统综述，这些文章考察了针对成人紧张症和/或紧张症状的特定干预措施的效果，并使用了有效的结局指标。通过检索Cochrane图书馆、MEDLINE、EMBASE和PSYCHINFO的电子数据库来选择本次综述的文章。
31篇文章符合纳入标准。氯硝西泮和电休克治疗（ECT）被证明是研究最多的治疗干预措施。在西方研究中，使用氯硝西泮的研究的缓解率在66%至100%之间，而在亚洲和印度的研究中，缓解率分别为0%和100%。对于ECT，缓解率为59% - 100%。对于没有任何潜在精神障碍的紧张症患者，似乎没有证据支持使用抗精神病药物。
氯硝西泮和ECT是文献中有临床证据支持的有效治疗方法。由于基于所综述文章的紧张症管理证据有限，因此无法制定治疗方案。有必要开展关于紧张症的严格治疗研究。
