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埃塞俄比亚吉马大学医学中心精神科住院部收治的紧张症患者的临床表现及治疗反应

The Presentation and Treatment Response of Catatonia in Patients Admitted to the Psychiatric Inpatient Unit at Jimma University Medical Center, Ethiopia.

作者信息

Yitayih Yimenu, Tesfaye Elias, Adorjan Kristina

机构信息

Department of Psychiatry, College of Health Sciences, Jimma University, Jimma, Ethiopia.

Institute of Psychiatric Phenomics and Genomics (IPPG), Medical Center of the University of Munich, Germany.

出版信息

Psychiatry J. 2020 Jun 30;2020:8739546. doi: 10.1155/2020/8739546. eCollection 2020.

Abstract

BACKGROUND

Catatonia is among the most mysterious and poorly understood neuropsychiatric syndrome. It is underresearched and virtually forgotten but still a frequent neuropsychiatric phenotype in both developed and low-income countries. Catatonia is associated with a number of medical complications like pulmonary embolism, dehydration, or pneumonia if it is not treated and managed adequately. In Ethiopia, however, almost no studies are available to describe the symptoms and the response to treatment in patients with catatonia. The aim of this retrospective study was therefore to describe the symptom profile of catatonia and to evaluate the treatment and outcome of catatonia in patients admitted to the psychiatric inpatient unit at Jimma University, Ethiopia.

METHOD

Detailed treatment records of all inpatients were reviewed for the period from May 2018 to April 2019. All patients with catatonia at the inpatient unit of Jimma University Medical Center were assessed with the Bush-Francis Catatonia Rating Scale (BFCRS), and all comorbid psychiatric diagnoses were made according to the criteria of the Diagnostic Statistical Manual V. The presence and severity of catatonia were assessed by using the BFCRS at baseline and at discharge from the hospital.

RESULT

In the course of one year, a total of 18 patients with the diagnosis of catatonia were admitted. The mean age of the participants was 22.8 years (SD 5.0; range: 15 to 34 years). The most common diagnosis associated with catatonia was schizophrenia ( = 12; 66.7%), followed by severe depressive disorders ( = 4; 22.2%). Mutism, posture, and withdrawal were registered in all patients ( = 18, 100%). All patients received an injection of diazepam and had improved at discharge.

CONCLUSION

Our study provides further evidence that catatonia is most commonly associated with schizophrenia, followed by major depressive disorder, and that mutism, posturing, and withdrawal are the most common signs and symptoms of catatonia.

摘要

背景

紧张症是最神秘且了解甚少的神经精神综合征之一。它研究不足且几乎被遗忘,但在发达国家和低收入国家仍是常见的神经精神表型。如果紧张症未得到充分治疗和管理,会引发一系列医学并发症,如肺栓塞、脱水或肺炎。然而,在埃塞俄比亚,几乎没有研究描述紧张症患者的症状及治疗反应。因此,这项回顾性研究的目的是描述紧张症的症状特征,并评估埃塞俄比亚吉姆马大学精神科住院部收治的紧张症患者的治疗情况及结局。

方法

回顾了2018年5月至2019年4月期间所有住院患者的详细治疗记录。吉姆马大学医学中心住院部的所有紧张症患者均使用布什-弗朗西斯紧张症评定量表(BFCRS)进行评估,所有共病精神诊断均根据《精神疾病诊断与统计手册》第五版标准做出。在基线和出院时使用BFCRS评估紧张症的存在及严重程度。

结果

在一年时间里,共有18例诊断为紧张症的患者入院。参与者的平均年龄为22.8岁(标准差5.0;范围:15至34岁)。与紧张症相关的最常见诊断是精神分裂症(n = 12;66.7%),其次是重度抑郁症(n = 4;22.2%)。所有患者(n = 18,100%)均出现缄默、姿势异常和退缩症状。所有患者均接受了地西泮注射,出院时症状有所改善。

结论

我们的研究进一步证明,紧张症最常与精神分裂症相关,其次是重度抑郁症,缄默、姿势异常和退缩是紧张症最常见的体征和症状。

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Catatonia in an inpatient gerontopsychiatric population.老年精神科住院患者的紧张症。
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本文引用的文献

1
Catatonia and the immune system: a review.紧张症与免疫系统:综述
Lancet Psychiatry. 2019 Jul;6(7):620-630. doi: 10.1016/S2215-0366(19)30190-7. Epub 2019 Jun 10.
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Catatonia Under-Diagnosis in the General Hospital.综合医院中紧张症的诊断不足。
J Neuropsychiatry Clin Neurosci. 2018 Spring;30(2):145-151. doi: 10.1176/appi.neuropsych.17060123. Epub 2018 Jan 12.
8
Catatonic syndrome: From detection to therapy.紧张症综合征:从检测到治疗
Encephale. 2016 Aug;42(4):340-5. doi: 10.1016/j.encep.2015.09.008. Epub 2016 May 20.

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