Department of Psychiatry and Behavioral Health, Penn State Hershey Medical Center, Hershey, Pennsylvania.
Department of Psychiatry, Mansoura General Hospital, Ministry of Health and Population, Mansoura, Egypt.
J Nerv Ment Dis. 2024 Feb 1;212(2):120-121. doi: 10.1097/NMD.0000000000001727.
Catatonia is an underrecognized disorder that has been widely described as a psychomotor syndrome, with little emphasis on its thought and cognitive dimensions. The current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision describes only motor and behavioral presentations, whereas a few catatonia scales describe only one form of thought disorders, which is thought perseveration. Thought blocking, a disorder of the thought process, is characterized by regular interruptions in the thought stream. It was described by several scholars as a sign of schizophrenia, with few reports describing thought blocking in association with catatonia. In this article, we describe the course of a patient with bipolar I disorder who presented with catatonia and demonstrated thought blocking. Her catatonic symptoms and thought blocking improved with the addition of lorazepam, recurred upon lorazepam discontinuation, and improved with resumption of lorazepam, demonstrating a clear on/off phenomenon. This report highlights the importance of recognizing thought and cognitive manifestations of catatonia, as it can enhance recognition and improve treatment.
紧张症是一种未被充分认识的障碍，它被广泛描述为一种精神运动综合征，很少强调其思维和认知方面。目前的《精神障碍诊断与统计手册》第五版修订本仅描述了运动和行为表现，而少数紧张症量表仅描述了一种思维障碍，即思维固着。思维中断是一种思维过程障碍，其特征是思维流的定期中断。几位学者将其描述为精神分裂症的一个标志，很少有报道描述与紧张症相关的思维中断。在本文中，我们描述了一位患有双相情感障碍的患者的病程，该患者表现出紧张症，并表现出思维中断。她的紧张症症状和思维中断在加用劳拉西泮后得到改善，在停用劳拉西泮后复发，并在重新开始使用劳拉西泮后得到改善，表现出明显的开关现象。该报告强调了认识紧张症的思维和认知表现的重要性，因为这可以提高认识并改善治疗。
