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精神科和神经科中不同评估量表对紧张症的评估。

Evaluation of Catatonia with Different Assessment Scales in Psychiatry and Neurology.

出版信息

Turk Psikiyatri Derg. 2024 Fall;35(3):198-206. doi: 10.5080/u27363.

Abstract

OBJECTIVE

Catatonia is a syndrome that can be missed in clinical settings. Diagnosis of catatonia is important because the condition can be reversible and is associated with severe complications. This study aims to screen patients with catatonia admitted to a university hospital's psychiatry and neurology services, examine their characteristics, and compare the coverage of different catatonia scales.

METHOD

During a consecutive 20 months study period, the Turkish adaptations of the Bush-Francis Catatonia Rating and the KANNER scales were administered in psychiatry and neurology inpatient units and patients on the waiting list for psychiatric hospitalization. The participants were also evaluated with DSM-5 criteria. In addition, the sociodemographic and clinical characteristics of the patients in the psychiatric group were compared.

RESULTS

A total of 214 patients were evaluated. Twenty-eight (13.1%) screened positive for catatonia, and 23 (82.1%) were diagnosed with catatonia according to DSM-5 criteria. KANNER and Bush- Francis identified the same patients as having catatonia. In addition to schizophrenia and mood disorders; neurodevelopmental disorder, encephalitis, postpartum psychosis, obsessive-compulsive disorder, delirium, cerebrovascular disease, functional neurological symptom disorder have also been found to be associated with catatonia. The most common complication was urinary tract infection. Life-threatening complications were also observed.

CONCLUSION

Overlooking catatonia may have dire consequences. Adhering solely to the DSM-5 criteria may miss some patients with catatonia. Widely and efficiently using standardized catatonia scales can improve detection capacity and enhance the management of morbidity and mortality.

摘要

目的

紧张症在临床环境中可能被忽视。紧张症的诊断很重要,因为这种病症是可以逆转的,而且与严重的并发症有关。本研究旨在筛选在一所大学医院的精神科和神经科就诊的紧张症患者,检查他们的特征,并比较不同紧张症量表的涵盖范围。

方法

在连续 20 个月的研究期间,在精神科和神经科住院病房以及等待精神科住院的患者中,使用了土耳其语版的 Bush-Francis 紧张症评定量表和 KANNER 量表。还使用 DSM-5 标准对参与者进行了评估。此外,还比较了精神科患者的社会人口统计学和临床特征。

结果

共评估了 214 名患者。28 名(13.1%)患者紧张症筛查阳性,23 名(82.1%)患者根据 DSM-5 标准诊断为紧张症。KANNER 和 Bush-Francis 量表都识别出了患有紧张症的相同患者。除了精神分裂症和心境障碍;神经发育障碍、脑炎、产后精神病、强迫症、谵妄、脑血管病、功能性神经症状障碍也与紧张症有关。最常见的并发症是尿路感染。还观察到危及生命的并发症。

结论

忽视紧张症可能会产生严重后果。仅仅依靠 DSM-5 标准可能会遗漏一些患有紧张症的患者。广泛、有效地使用标准化的紧张症量表可以提高检测能力,并加强对发病率和死亡率的管理。

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