Cuevas-Esteban Jorge, Serrat Francesc, Iglesias-González Maria, Motta Nicole, Jimenez-Fernandez Beltran, Vila-Badia Regina, Colomer-Salvans Alicia, Serra-Arumí Clara, Cacho Núria Del, Corbella-Sotil Ariadna, Butjosa Anna, Pardo Marta, Usall Judith
Departamento Psiquiatría, Autonomous University of Barcelona, Barcelona, Spain.
Servicio Psiquiatría, Germans Trias i Pujol University Hospital, Badalona, Spain.
BJPsych Open. 2025 Sep 23;11(5):e220. doi: 10.1192/bjo.2025.10834.
First-episode psychosis (FEP) is a critical phase in psychotic disorders where early intervention significantly influences long-term outcomes. Catatonia, characterised by motor, behavioural, and psychological abnormalities, is an under-recognised aspect of FEP.
This study examines catatonia prevalence in affective and non-affective FEP, its role as a severity indicator across psychopathological domains, its correlations with other symptoms and its association with clinical syndromes.
A cross-sectional study was conducted with 58 FEP patients (38 females, 20 males) aged 15-55 years. Of those, 40 were antipsychotic-naive, and 18 had minimal prior antipsychotic exposure. Participants were recruited from acute psychiatric units. Catatonia was assessed using the Bush Francis Catatonia Rating Scale (BFCRS), while psychopathology was evaluated with the Positive and Negative Symptom Scale (PANSS), Calgary Depression Scale (CDS) and Young Mania Rating Scale (YMRS). Data analysis included descriptive statistics, -tests, tests, and multivariable regression using SPSS version 25 for Windows.
Catatonic signs were identified in 22.4% of cases based on the Bush Francis Catatonia Screening Instrument (BFCSI) criteria (BFCSI-positive group, defined as ≥2 signs present for over 24 h), indicating potential catatonia. Prevalence varied by criteria: 13.8% (DSM-IV), 10.3% (Fink and Taylor), 10.38% (ICD-11) and 8.6% (DSM-5). Catatonic patients had more years of education and significantly higher PANSS totals, Emsley negative, disorganised, excited, and anxiety scores. Catatonic signs moderately correlated with Emsley disorganised scores. Regression analysis identified PANSS total and Emsley domain scores as significant predictors of catatonia severity.
Catatonia is notably prevalent in FEP and associated with severe psychopathology, particularly in negative and disorganised domains. These findings underscore the importance of improving recognition of catatonia in early psychosis. Larger longitudinal studies are needed to confirm these findings and explore treatment implications.
首发精神病（FEP）是精神障碍的关键阶段，早期干预对长期预后有显著影响。紧张症以运动、行为和心理异常为特征，是FEP中一个未得到充分认识的方面。
本研究考察情感性和非情感性FEP中紧张症的患病率、其作为跨精神病理学领域严重程度指标的作用、与其他症状的相关性以及与临床综合征的关联。
对58名年龄在15至55岁的FEP患者（38名女性，20名男性）进行了一项横断面研究。其中，40名未使用过抗精神病药物，18名之前使用过极少的抗精神病药物。参与者从急性精神科病房招募。使用布什-弗朗西斯紧张症评定量表（BFCRS）评估紧张症，同时用阳性和阴性症状量表（PANSS）、卡尔加里抑郁量表（CDS）和青年躁狂评定量表（YMRS）评估精神病理学。数据分析包括描述性统计、t检验、检验以及使用适用于Windows的SPSS 25版本进行多变量回归分析。
根据布什-弗朗西斯紧张症筛查工具（BFCSI）标准，22.4%的病例中发现了紧张症体征（BFCSI阳性组，定义为存在≥2种体征超过24小时），表明可能存在紧张症。患病率因标准而异：13.8%（DSM-IV）、10.3%（芬克和泰勒标准）、10.38%（ICD-11）和8.6%（DSM-5）。紧张症患者受教育年限更多，PANSS总分、埃姆斯利阴性、紊乱、兴奋和焦虑得分显著更高。紧张症体征与埃姆斯利紊乱得分中度相关。回归分析确定PANSS总分和埃姆斯利领域得分是紧张症严重程度的重要预测因素。
紧张症在FEP中明显普遍，且与严重的精神病理学相关，尤其是在阴性和紊乱领域。这些发现强调了提高对早期精神病中紧张症认识的重要性。需要更大规模的纵向研究来证实这些发现并探索治疗意义。
