Division of Psychiatry, University College London, London, UK.
South London and Maudsley NHS Foundation Trust, London, UK.
J Psychopharmacol. 2023 Apr;37(4):327-369. doi: 10.1177/02698811231158232. Epub 2023 Apr 11.
The British Association for Psychopharmacology developed an evidence-based consensus guideline on the management of catatonia. A group of international experts from a wide range of disciplines was assembled. Evidence was gathered from existing systematic reviews and the primary literature. Recommendations were made on the basis of this evidence and were graded in terms of their strength. The guideline initially covers the diagnosis, aetiology, clinical features and descriptive epidemiology of catatonia. Clinical assessments, including history, physical examination and investigations are then considered. Treatment with benzodiazepines, electroconvulsive therapy and other pharmacological and neuromodulatory therapies is covered. Special regard is given to periodic catatonia, malignant catatonia, neuroleptic malignant syndrome and antipsychotic-induced catatonia. There is attention to the needs of particular groups, namely children and adolescents, older adults, women in the perinatal period, people with autism spectrum disorder and those with certain medical conditions. Clinical trials were uncommon, and the recommendations in this guideline are mainly informed by small observational studies, case series and case reports, which highlights the need for randomised controlled trials and prospective cohort studies in this area.
英国精神药理学协会制定了一项基于证据的共识指南，用于治疗紧张症。该指南汇集了来自广泛学科的一组国际专家。从现有系统评价和原始文献中收集证据。根据这些证据提出建议，并根据其强度进行分级。该指南最初涵盖紧张症的诊断、病因、临床特征和描述性流行病学。然后考虑临床评估，包括病史、体格检查和检查。涵盖苯二氮䓬类药物、电惊厥疗法和其他药物及神经调节疗法的治疗。特别关注周期性紧张症、恶性紧张症、神经阻滞剂恶性综合征和抗精神病药引起的紧张症。特别关注特定群体的需求，即儿童和青少年、老年人、围产期妇女、自闭症谱系障碍患者以及某些患有特定疾病的人群。临床试验很少，本指南中的建议主要来自小型观察性研究、病例系列和病例报告，这突出表明该领域需要随机对照试验和前瞻性队列研究。
