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紧张症患者症状特征、诊断及短期转归的临床研究
作者:武文珺  吴迪  蔡敏  王莹  张瑞国  王化宁 
单位:空军军医大学第一附属医院 心身科, 陕西 西安 710032
关键词:紧张症 木僵 精神分裂症 抑郁症 诊断 
分类号:R749.3;R749.4
出版年·卷·期(页码):2018·46·第十二期(1335-1338)
摘要:

目的:探讨紧张症的症状特征、病因诊断及短期转归,为提高紧张症的诊断及治疗有效率提供依据。方法:纳入符合美国精神障碍诊断与统计手册第五版(DSM-5)中紧张症诊断标准的住院患者,使用Bush-Francis紧张症量表完成症状及严重程度评估;于12个月后进行电话随访。结果:32例紧张症患者中,最终诊断精神分裂症13例(40.63%),分裂样精神病6例(18.75%),抑郁症6例(18.75%),双相情感障碍抑郁发作3例(9.38%),痴呆1例(3.13%),脑梗死1例(3.13%),精神发育迟滞1例(3.13%),恶性综合征1例(3.13%)。最常见的紧张症症状为凝视(29例,90.6%)、木僵(27例,84.4%)及持续姿势/强直(27例,84.4%),18例(56.25%)患者进行了电休克治疗。12个月随访结果提示2例仍有部分症状,1例诊断分裂样精神病的患者纠正诊断为双相情感障碍,1例患者因紧张症再次发作入院。结论:紧张症最常见的诊断为精神分裂症及分裂样精神病,各类诊断预后差异较大。

Objective: To explore the characteristics of symptoms, causes and short-term outcome in catatonia patients, and to analyze the relevant factors. Methods:Hospitalized patients who met the Fifth Edition of the Diagnostic and Statistical Manual for Mental Disorders(DSM-5)criteria for the diagnosis of catatonia were included. Symptom and severity assessments were performed using the Bush-Francis Catatonia Rating Scale (BFCRS). Telephone follow-up was performed in the 12th month after discharge. Results:32 patients were included in the study, 13 (46.3%) patients were diagnosed as schizophrenia, 6(18.75%) patients of schizophrenic psychosis, 6(18.75%) patients of depression, 3(8.38%) patients of bipolar disorder. 2 patients had organic dyslexia, 1(3.13%) patient had malignant syndrome and 1(3.13%) patient had mental retardation. The most common symptoms of catatonia were immobility/stupor(27 patients, 84.4%), staring(29 patients, 90.6%) and posturing/catalepsy(27 patients, 84.4%). 18(56.25%) patients were treated with ECT. 12 months follow-up results suggested that 2 patients with organic disease still had some symptoms, 1 patient who had diagnosed with schizophrenic psychosis was diagnosed with bipolar disorder, 1 patient was hospitalized again. Conclusion:The most common diagnosis in patients with catatonia are schizophrenia and schizophrenic psychosis, the prognosis of various types of diagnosis is quite different.

参考文献:

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