Piskarev M V, Lobanova V M, Ilyina N A
Mental Health Research Center, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(8):98-106. doi: 10.17116/jnevro202312308198.
Typological differentiation of periodic catatonia in schizophrenia and schizophrenia spectrum disorders (SSD), in particular, schizoaffective disorder.
Seventy-four patients with the verified diagnosis of schizophrenia and SSD (ICD-10 items F20, F21) were studied. The clinical, psychometric (BFCRS, SANS) and statistical methods were used. Clinical and psychometric study of seizures of periodic catatonia was carried out at the following stages: 1) manifestation of a seizure; 2) the maximum severity of psychopathological disorders. Also, at the end of the seizure, an additional assessment of the severity of negative symptoms was carried out using the SANS.
Three forms of periodic catatonia have been identified: hypokinetic, parakinetic, multikinetic. Clinical distinguishing indicators of periodic catatonia seizurs have been established (protracted - two-stage - form of seizures; the phenomenon of «secondary catatonia»). The psychometric study revealed significant differences between the variants of periodic catatonia seizures in terms of the severity of motor phenomena (at both stages of the seizure) and negative disorders. BFCRS scores at the first stage of seizures were as follows: hypokinetic - 9.7±0.4; parakinetic - 12.8±0.9; multikinetic - 32.3±1.6 (the differences were found between 1 and 2 (<0.05); between 1 and 3, as well as 2 and 3 (<0.01)). BFCRS scores at the second stage of seizures were 12.1±0.8; 19.9±1.2 and 47.7±1.9, respectively,with the differences between 1 and 2 (<0.05); between 1 and 3, and also 2 and 3 (<0.01). The scores on the SANS anhedonia-asociality subscale were 1.9±0.2 for hypokinetic; 2.3±0.3 for parakinetic and 3.2±0.2 for multikinetic with the differences between 1 and 2, 1 and 3, 2 and 3 (<0.01).
Periodic catatonia is the clinical entity that includes a complex of progressively worsening seizures, the psychopathological systematics of which takes into account the clinical structure of motor disorders, their affiliations with positive and negative dimensions, and functional activity.
对精神分裂症及精神分裂症谱系障碍（SSD），特别是精神分裂症性情感障碍中的周期性紧张症进行类型学区分。
对74例确诊为精神分裂症和SSD（国际疾病分类第十版F20、F21项）的患者进行研究。采用临床、心理测量（简明躁狂抑郁评定量表、阴性症状评定量表）和统计学方法。对周期性紧张症发作进行临床和心理测量研究分以下阶段：1）发作表现；2）精神病理障碍的最大严重程度。此外，在发作结束时，使用阴性症状评定量表对阴性症状的严重程度进行额外评估。
已确定三种周期性紧张症形式：运动不能型、运动增多型、多动型。已确立周期性紧张症发作的临床鉴别指标（发作持续时间长——两阶段——发作形式；“继发性紧张症”现象）。心理测量研究显示，周期性紧张症发作的不同类型在运动现象严重程度（发作的两个阶段均如此）和阴性障碍方面存在显著差异。发作第一阶段简明躁狂抑郁评定量表得分如下：运动不能型——9.7±0.4；运动增多型——12.8±0.9；多动型——32.3±1.6（1与2之间差异有统计学意义（<0.05）；1与3之间以及2与3之间差异有统计学意义（<0.01））。发作第二阶段简明躁狂抑郁评定量表得分分别为12.1±0.8；19.9±1.2和47.7±1.9，1与2之间差异有统计学意义（<0.05）；1与3之间以及2与3之间差异有统计学意义（<0.01）。阴性症状评定量表快感缺乏-社交退缩分量表得分：运动不能型为1.9±0.2；运动增多型为2.3±0.3；多动型为3.2±0.2，1与2之间、1与3之间、2与3之间差异有统计学意义（<0.01）。
周期性紧张症是一种临床实体，包括一系列逐渐加重的发作，其精神病理分类考虑了运动障碍的临床结构、它们与阳性和阴性维度的关联以及功能活动。
