Catatonia Due to General Medical Conditions in Psychiatric Patients: Implications for Clinical Practice

被引:4
|
作者
Peritogiannis, Vaios [1 ]
Rizos, Dimitrios V. [2 ]
机构
[1] Soc Promot Mental Hlth Epirus, Mobile Mental Hlth Unit Prefectures Ioannina & Th, 54 Pashidi Str, Ioannina 44445, Greece
[2] G Hatzikosta Gen Hosp, Intens Care Unit, Ioannina, Greece
来源
PSYCHIATRY INTERNATIONAL | 2023年 / 4卷 / 01期
关键词
antipsychotics; benzodiazepines; catatonia; critical illness; general medical condition; hyponatremia; psychiatric patients; PERIODIC CATATONIA; MENTAL-ILLNESS; SCHIZOPHRENIA; DIAGNOSIS; HYPONATREMIA; METAANALYSIS; PREVALENCE; DISORDERS; MORTALITY; DELIRIUM;
D O I
10.3390/psychiatryint4010003
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Catatonic syndrome is frequently observed over the course of severe mental disorders and general medical conditions, but when catatonia occurs in psychiatric patients with co-morbid medical or neurologic conditions, diagnosis and management may be challenging. Several medical conditions may cause catatonia in psychiatric patients, but some, such as brain injury, infections, hyponatremia and critical illness, may be most relevant in this population. Alongside appropriate etiologic treatment, benzodiazepines and electroconvulsive therapy in refractory cases are effective and safe, and may resolve catatonic syndrome rapidly. When newly-onset psychotic symptoms in catatonic patients with established psychotic disorders occur, delirium should be suspected and appropriately managed. An extensive clinical and laboratory diagnostic workup to determine the underlying etiology of catatonic syndrome should be carried out. In cases of acute multi-morbidity, the exact cause of catatonic syndrome in psychiatric patients may be unclear. It is recommended to avoid antipsychotic drugs in acutely catatonic patients, because they may exacerbate the catatonic symptoms. The akinetic type of catatonia should be differentiated from hypoactive delirium, as treatments for these syndromes differ substantially. When a psychiatric patient presents with symptomatology of both catatonia and delirium, treatment is particularly challenging.
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页码:18 / 27
页数:10
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