Carpita Barbara, Amatori Giulia, Cremone Ivan Mirko, Bonelli Chiara, Nardi Benedetta, Massimetti Gabriele, Pini Stefano, Dell'Osso Liliana
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 67 Via Roma, 56126 Pisa, Italy.
J Clin Med. 2024 Aug 14;13(16):4796. doi: 10.3390/jcm13164796.
: Major Depressive Disorder (MDD) represents a significant global health concern, often complicated by comorbidities such as catatonia and autism spectrum disorder (ASD). Recognizing the interplay among these conditions and their impact on suicidal tendencies is crucial for effective clinical management. : A total sample of 147 subjects with MDD was divided into Significant Catatonia (SC) and Non-Significant Catatonia (NSC) groups based on Catatonia Spectrum (CS) scores. Participants were evaluated through the Structured Clinical Interview for DSM-5, Research Version (SCID-5-RV), the Adult Autism Subtreshold Spectrum (AdAS Spectrum), and the Mood Spectrum-Self Report questionnaires. Statistical analyses included Mann-Whitney U test, Chi-square test, logistic regression analyses, and a decision tree model. : The SC group exhibited higher CS, AdAS Spectrum, and MOODS-SR total and domain scores compared to the NSC group. Individuals with significant autistic traits were over-represented in the SC group, as well as participants with higher suicidality, suicidal ideation, and a history of suicide attempts. The total AdAS Spectrum and MOOD-SR score, the AdAS domain "Hyper-hypo reactivity to sensory input", and the "Cognitive depressive" MOOD-SR domain were predictive of belonging to the SC group. Suicidality levels appeared to be higher in clinically significant ASD, intermediate in subjects with autistic traits (AT), and low in the absence of AT. : the study suggests the existence of a specific phenotype of MDD associated with catatonia, characterized by elevated autistic traits and suicide risk.
重度抑郁症（MDD）是一个重大的全球健康问题，常伴有诸如紧张症和自闭症谱系障碍（ASD）等共病。认识到这些病症之间的相互作用及其对自杀倾向的影响对于有效的临床管理至关重要。
147名患有MDD的受试者的总样本根据紧张症谱系（CS）评分分为显著紧张症（SC）组和非显著紧张症（NSC）组。通过《精神疾病诊断与统计手册》第5版研究版结构化临床访谈（SCID-5-RV）、成人自闭症阈下谱系（AdAS Spectrum）和情绪谱系自我报告问卷对参与者进行评估。统计分析包括曼-惠特尼U检验、卡方检验、逻辑回归分析和决策树模型。
与NSC组相比，SC组的CS、AdAS Spectrum以及MOODS-SR总分和各领域得分更高。具有显著自闭症特征的个体在SC组中占比过高，自杀倾向较高、有自杀意念和自杀未遂史的参与者也是如此。AdAS Spectrum总分和MOOD-SR得分、AdAS领域“对感觉输入的过度-低反应性”以及MOOD-SR领域“认知性抑郁”可预测属于SC组。在临床上显著的ASD中自杀倾向水平似乎更高，在具有自闭症特征（AT）的受试者中处于中等水平，在没有AT的情况下则较低。
该研究表明存在一种与紧张症相关的MDD特定表型，其特征是自闭症特征和自杀风险升高。
