Altshuler L L, Cummings J L, Mills M J
Am J Psychiatry. 1986 Nov;143(11):1409-14. doi: 10.1176/ajp.143.11.1409.
Mutism is a common manifestation of both psychiatric and neurologic illness. Psychiatric disturbances associated with mutism include schizophrenia, affective disorders, conversion reactions, dissociative states, and dementias. Neurologic disorders producing mutism involve the basal ganglia, frontal lobes, or limbic system structures. In psychiatric and neurologic conditions, mutism is often associated with other signs of catatonia. The authors review the literature on mutism, including psychiatric, neurologic, toxic-metabolic, and drug-induced causes. Methods to discriminate among the many causes of mutism in the clinical setting are discussed, and 22 new cases of mutism are reported to emphasize the wide differential diagnosis.
缄默症是精神疾病和神经疾病的常见表现。与缄默症相关的精神障碍包括精神分裂症、情感障碍、转换反应、分离状态和痴呆症。导致缄默症的神经疾病涉及基底神经节、额叶或边缘系统结构。在精神和神经疾病中，缄默症常与其他紧张症体征相关。作者回顾了关于缄默症的文献，包括精神、神经、毒性代谢和药物引起的病因。讨论了在临床环境中区分多种缄默症病因的方法，并报告了22例新的缄默症病例以强调广泛的鉴别诊断。
