紧张症患者症状特征、诊断及短期转归的临床研究-现代医学

紧张症患者症状特征、诊断及短期转归的临床研究

单位：空军军医大学第一附属医院心身科, 陕西西安 710032

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.

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