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内科病房中的急性紧张症:病例系列

Acute catatonia on medical wards: a case series.

作者信息

Doran Elisabeth, Sheehan John D

机构信息

Mater Misericordiae University Hospital, Dublin, Ireland.

出版信息

J Med Case Rep. 2018 Jul 6;12(1):206. doi: 10.1186/s13256-018-1714-z.

Abstract

BACKGROUND

Catatonia is a behavioral syndrome which presents with an inability to move normally. It is associated with mood disorders and schizophrenia, as well as with medical and neurological conditions. It is an expression of the severity of the underlying condition. The awareness of catatonia among general medical doctors and even psychiatrists is poor. It is often seen as an historical diagnosis. Because of this, catatonia is often not recognized. If patients in catatonic states are not diagnosed, their condition is likely to progress with a risk of increased morbidity and potentially fatal outcomes.

CASE PRESENTATION

We present a case series of three acutely unwell, frail, elderly medical patients (a 65-year-old Irish woman, a 75-year-old Irish woman, and a 68-year-old Irish woman) with a background of longstanding well-controlled psychiatric illnesses, who developed acute catatonia while being treated for medical conditions in a general medical in-patient setting.

CONCLUSIONS

Catatonia is common in acute medical settings but is underdiagnosed due to the low awareness of the condition among both general medical doctors and psychiatrists. Within a short time period, we diagnosed and successfully treated three acutely unwell patients in acute medical settings. We would like to increase the awareness of catatonia among medical doctors.

摘要

背景

紧张症是一种行为综合征,表现为无法正常活动。它与情绪障碍、精神分裂症以及医学和神经疾病有关。它是潜在病情严重程度的一种表现。普通医生甚至精神科医生对紧张症的认识都很差。它常被视为一种过时的诊断。因此,紧张症常常未被识别。如果处于紧张症状态的患者未被诊断出来,他们的病情可能会进展,有发病率增加和潜在致命后果的风险。

病例报告

我们呈现了一个包含三名病情严重、身体虚弱的老年内科患者的病例系列(一名65岁的爱尔兰女性、一名75岁的爱尔兰女性和一名68岁的爱尔兰女性),她们都有长期病情得到良好控制的精神疾病史,在综合内科住院环境中接受内科治疗时出现了急性紧张症。

结论

紧张症在急性医疗环境中很常见,但由于普通医生和精神科医生对该病症的认识不足,导致其诊断率较低。在短时间内,我们在急性医疗环境中诊断并成功治疗了三名病情严重的患者。我们希望提高医生对紧张症的认识。

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