Bolgov M I, Barkhatova A N
Mental Health Research Center, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(6. Vyp. 2):78-83. doi: 10.17116/jnevro202212206278.
To determine the psychopathological structure of catatonia and its major components in depression and depressive-delusional conditions in affective and schizophrenia spectrum disorders.
Ninety-six patients (67 women and 29 men), aged 16 to 65 years, with depression and depressive-delusional conditions with catatonic features were examined (ICD-10 - F20, F25, F31, F33). Exploratory factor analysis with MLE data extraction and varimax rotation was used to determine the structure of catatonia. Thirty-one catatonic features were selected for the analysis.
Heterogeneity of catatonic syndrome in depression and depressive-delusional conditions has been revealed. Four factors of catatonia have been extracted (KMO test=0.782, Bartlett test: χ=2098, df=465, <.001): Agitated (eigenvalue 5.64, 18.2% of variance), Hypokinetic (4.88, 15.7% of variance), Parakinetic (3.84, 12.4% of variance), Proskinetic (3.75, 12.1% of variance). The extracted factors can be considered as the subsyndromes of catatonia in depressive conditions. The agitated factor (31 patients, 32.3%) is manifested by an increase in psychomotor activity. The hypokinetic factor (75 patients, 78.1%) reflects a decrease in reactivity combined with negativism. The parakinetic factor (30 patients, 31.3%) is associated with negative symptoms of schizophrenia. The proskinetic factor (20 patients, 20.8%) doesn't occur separately from other catatonic features in depression and depressive-delusional conditions.
The results are partially consistent with earlier investigations in other groups of patients with catatonic features. Schizophrenia is characterized by the presence of parakinetic manifestations of catatonia, the greater severity of hypokinetic manifestations and a higher degree of catatonia polymorphism, in contrast to affective disorders. The results indicate the heterogeneity of catatonia associated with the manifestations of depression and with concomitant symptoms. Catatonic subsyndromes may differ not only phenomenologically, but also neurobiologically.
确定紧张症的精神病理结构及其在情感障碍和精神分裂症谱系障碍中的抑郁及抑郁妄想状态下的主要组成部分。
对96例年龄在16至65岁之间、患有伴有紧张症特征的抑郁及抑郁妄想状态的患者（国际疾病分类第十版 - F20、F25、F31、F33）进行检查。采用最大似然估计数据提取和方差最大化旋转的探索性因素分析来确定紧张症的结构。分析选取了31项紧张症特征。
揭示了抑郁及抑郁妄想状态下紧张症综合征的异质性。提取出紧张症的四个因素（KMO检验 = 0.782，巴特利特检验：χ = 2098，自由度 = 465，<.001）：激越性（特征值5.64，占方差的18.2%）、运动减退性（4.88，占方差的15.7%）、运动障碍性（3.84，占方差的12.4%）、运动增多性（3.75，占方差的12.1%）。提取出的因素可被视为抑郁状态下紧张症的亚综合征。激越性因素（31例患者，32.3%）表现为精神运动性活动增加。运动减退性因素（75例患者，78.1%）反映反应性降低并伴有违拗症。运动障碍性因素（30例患者，31.3%）与精神分裂症的阴性症状相关。运动增多性因素（20例患者，20.8%）在抑郁及抑郁妄想状态下不会独立于其他紧张症特征出现。
研究结果部分与早期对其他伴有紧张症特征患者群体的调查一致。与情感障碍相比，精神分裂症的特征是存在紧张症的运动障碍性表现、运动减退性表现更为严重以及紧张症多态性程度更高。研究结果表明与抑郁表现及伴随症状相关的紧张症具有异质性。紧张症亚综合征不仅在现象学上可能不同，在神经生物学上也可能不同。
