Smith Joshua R, York Tasia, Baldwin Isaac, Fuchs Catherine, Fricchione Gregory, Luccarelli James
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center at Village of Vanderbilt, Tennessee, USA; and Vanderbilt Kennedy Center, Vanderbilt University, Tennessee, USA.
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center at Village of Vanderbilt, Tennessee, USA.
BJPsych Open. 2024 Apr 30;10(3):e96. doi: 10.1192/bjo.2024.61.
Catatonia is a neuropsychiatric disorder characterised by psychomotor changes that can affect individuals across the lifespan. Although features of catatonia have been described in adults, the most common clinical symptoms among paediatric patients with catatonia are not well characterised.
The goal of this study was to characterise the symptoms of catatonia demonstrated by paediatric patients, and to explore demographic and diagnostic factors associated with greater catatonia severity.
We conducted a multicentre retrospective cohort study, from 1 January 2018 to 6 January 2023, of patients aged 18 and younger with a clinical diagnosis of catatonia and symptom assessment using the Bush Francis Catatonia Rating Scale (BFCRS).
A total of 143 patients met inclusion criteria. The median age was 15 (interquartile range: 13-16) years and 66 (46.2%) patients were female. Neurodevelopmental disabilities were present in 55 (38.5%) patients. Patients demonstrated a mean of 6.0 ± 2.1 signs of catatonia on the Bush Francis Catatonia Screening Item, with a mean BFCRS score of 15.0 ± 5.9. Among the 23 items of the BFCRS, six were present in >50% of patients (staring, mutism, immobility/stupor, withdrawal, posturing/catalepsy, rigidity), and four were present in <20% of cases (waxy flexibility, mitgehen, gegenhalten, grasp reflex). In an adjusted model, patients with neurodevelopmental disorders demonstrated greater BFCRS severity than those with other diagnoses.
Catatonia was diagnosed in a range of mental health conditions. Further research is needed to define optimal diagnostic criteria for catatonia in paediatric patients, and clarify the clinical course of the disorder.
紧张症是一种神经精神障碍，其特征为精神运动改变，可影响各年龄段的个体。尽管成人紧张症的特征已有描述，但儿童紧张症患者中最常见的临床症状尚未得到充分描述。
本研究的目的是描述儿童紧张症患者的症状，并探讨与紧张症严重程度较高相关的人口统计学和诊断因素。
我们进行了一项多中心回顾性队列研究，研究对象为2018年1月1日至2023年1月6日期间临床诊断为紧张症且使用布什-弗朗西斯紧张症评定量表（BFCRS）进行症状评估的18岁及以下患者。
共有143名患者符合纳入标准。中位年龄为15岁（四分位间距：13 - 16岁），66名（46.2%）患者为女性。55名（38.5%）患者存在神经发育障碍。患者在布什-弗朗西斯紧张症筛查项目上平均表现出6.0±2.1项紧张症体征，BFCRS平均得分为15.0±5.9。在BFCRS的23项中，6项出现在超过50%的患者中（凝视、缄默、不动/木僵、退缩、姿势/蜡样屈曲、僵硬），4项出现在不到20%的病例中（蜡样屈曲、主动服从、被动抵抗、抓握反射）。在调整模型中，神经发育障碍患者的BFCRS严重程度高于其他诊断患者。
在一系列心理健康状况中诊断出紧张症。需要进一步研究来确定儿童紧张症的最佳诊断标准，并阐明该疾病的临床病程。
