Borisova P O, Lobanova V M
Mental Health Research Center, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(7):81-87. doi: 10.17116/jnevro202212207181.
To determinate the premorbid personality dimensions in patients with hysterocatatonia; to study the psychopathological characteristics, making it possible to distinguish the manifestations of hysterical catatonia among other hysterical and catatonic phenomena; to establish the prognostic value of the hysterocatatonia, occurring in the structure of schizophrenia and schizophrenic spectrum disorders (SSD).
25 patients with a verified diagnosis of schizophrenia and SSD (according to ICD-10) with a predominance of «mild» catatonic phenomena in the clinical picture of the disease (manifestations of hyperkinesia, pseudoepileptic paroxysms, isolated parakinesis, psychomotor agitation, accompanied by local muscle spasm and/or an increase in general muscle tone, etc.).
The overall severity of catatonic disorders corresponded to 22.7±8.3 BFCRS scale points. The phenomenon of abulic deficiency prevailed in the structure of negative disorders (SANS avolition-apathy - 3.7±0.6; SANS anhedonia-asociality - 2.8±0.7). The increase in the subscales of delusional (2.1±0.2) and hallucinatory phenomena (mild signs of somatic passivity according to K. Schneider), accompanied by a feeling of uncontrollability and «alienation» of motor symptoms, was observed according to the SAPS scale. The correlation between the BFCRS scores and the hallucinations (0.765) and delusions (0.653) subscales of the SAPS scale has been found. The hysterocatatonia phenomenon is an independent psychopathological construct, forming in the space of schizophrenia and SSD and revealing a tropism to the pathocharacterological structure of conversion hysteria. The key characteristic, that distinguishes the manifestations of hysterocatonia - is the formation mechanism of movement disorders, based on the phenomenon of mental automatism by G.G. Clérambault.
The inclusion of hysterocatatonical symptoms into the clinical picture of schizophrenia and SSD serves as the predictor of adverse course of the disease as long as the condition is accompanied by the "layering" of catatonic-hypochondrical and catatonic-delusional symptoms, and the previously low-progressive course of the disease starts being aggravated by the development of repeated attacks with exacerbation of psychomotor symptoms.
确定癔症性紧张症患者病前的人格维度；研究精神病理学特征，以便能够在其他癔症性和紧张症性现象中区分癔症性紧张症的表现；确定在精神分裂症和精神分裂症谱系障碍（SSD）结构中出现的癔症性紧张症的预后价值。
25例经确诊为精神分裂症和SSD（根据ICD - 10）的患者，其疾病临床表现中以“轻度”紧张症现象为主（表现为运动增多、假性癫痫发作、孤立性异动症、精神运动性激越，伴有局部肌肉痉挛和/或全身肌张力增加等）。
紧张症障碍的总体严重程度相当于22.7±8.3个BFCRS量表得分点。意志缺乏缺陷现象在阴性障碍结构中占主导（SANS意志减退 - 情感淡漠为3.7±0.6；SANS快感缺失 - 社交障碍为2.8±0.7）。根据SAPS量表，妄想（2.1±0.2）和幻觉现象（根据K. 施奈德的轻度躯体被动症状）的分量表得分增加，同时伴有运动症状的失控感和“异化”感。已发现BFCRS得分与SAPS量表的幻觉（0.765）和妄想（0.653）分量表之间存在相关性。癔症性紧张症现象是一种独立的精神病理学结构，在精神分裂症和SSD的范围内形成，并显示出对转换性癔症的病理性格结构的趋向性。区分癔症性紧张症表现的关键特征是基于G.G. 克莱朗博的精神自动症现象的运动障碍形成机制。
只要癔症性紧张症症状伴有紧张症 - 疑病性和紧张症 - 妄想性症状的“叠加”，并且疾病先前进展缓慢的病程因反复发作且精神运动症状加重而开始恶化，那么将其纳入精神分裂症和SSD的临床表现中就是疾病不良病程的预测指标。
