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紧张症快速筛查量表(CQS):成人及儿童群体紧张症的快速筛查工具

The Catatonia Quick Screen (CQS): A Rapid Screening Tool for Catatonia in Adult and Pediatric Populations.

作者信息

Luccarelli James, Kalinich Mark, Wilson Jo Ellen, Liu Jinyuan, Fuchs D Catherine, Francis Andrew, Heckers Stephan, Fricchione Gregory, Smith Joshua Ryan

机构信息

Harvard Medical School, Boston, MA, USA.

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

出版信息

medRxiv. 2024 Nov 30:2024.11.26.24317940. doi: 10.1101/2024.11.26.24317940.

Abstract

INTRODUCTION

Catatonia is a neuropsychiatric disorder marked by significant disturbances in motor, cognitive, and affective functioning and that is frequently under-diagnosed. To enhance clinical detection of catatonia, this study aimed to develop a rapid, sensitive Catatonia Quick Screen (CQS) using a reduced set of catatonic signs to facilitate screening in adult and pediatric patients.

METHODS

Data were derived from two retrospective cohorts totaling 446 patients (254 adults, 192 children) who screened positive for catatonia using the Bush Francis Catatonia Screening Instrument (BFCSI). Sensitivity analyses were performed for all combinations of BFCSI signs, with sensitivity defined as the proportion of patients identified by each subset relative to the full BFCSI. The CQS was developed by selecting signs from the BFCSI based on sensitivity, ease of assessment, and relevance to diverse catatonia presentations.

RESULTS

Screening for the presence of any one of four signs-excitement, mutism, staring, or posturing-using the CQS yielded a theoretical sensitivity of 97% (95% CI: 95 to 98%) relative to the full BFCSI (which requires two signs out of 14). The CQS demonstrated 97% sensitivity across both pediatric and adult subsets.

CONCLUSION

The Catatonia Quick Screen provides a rapid screening alternative to the BFCSI with high sensitivity, potentially improving early detection of catatonia in clinical settings. Future prospective studies are necessary to validate the CQS's sensitivity and to determine its specificity in clinical populations.

摘要

引言

紧张症是一种神经精神障碍,其特征在于运动、认知和情感功能出现显著紊乱,且常常未得到充分诊断。为提高紧张症的临床检测率,本研究旨在开发一种快速、灵敏的紧张症快速筛查量表(CQS),该量表使用一组简化的紧张症体征,以方便对成人和儿童患者进行筛查。

方法

数据来源于两个回顾性队列,共有446例患者(254例成人,192例儿童),这些患者使用布什-弗朗西斯紧张症筛查量表(BFCSI)筛查出紧张症呈阳性。对BFCSI体征的所有组合进行敏感性分析,敏感性定义为每个子集识别出的患者比例相对于完整BFCSI的比例。CQS是通过从BFCSI中选择基于敏感性、易于评估以及与各种紧张症表现的相关性的体征而开发的。

结果

使用CQS筛查兴奋、缄默、凝视或姿势这四种体征中的任何一种,相对于完整的BFCSI(需要从14种体征中找出2种),理论敏感性为97%(95%CI:95%至98%)。CQS在儿童和成人亚组中的敏感性均为97%。

结论

紧张症快速筛查量表为BFCSI提供了一种快速筛查的替代方法,具有高敏感性,有可能改善临床环境中紧张症的早期检测。未来有必要进行前瞻性研究,以验证CQS的敏感性,并确定其在临床人群中的特异性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d66b/11623750/ab5cf50782e9/nihpp-2024.11.26.24317940v1-f0001.jpg

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