Abstract：
The term \"catatonia\" was introduced by German psychiatrist Karl Kahlbaum in 1874. Although historically tied to schizophrenia, catatonia exhibits a diverse range of phenotypes and has been observed in various medical and neuropsychiatric conditions. Its intrinsic movement characteristics and association with hypokinetic and hyperkinetic phenomenologies place catatonia within the purview of movement disorders. Despite the presence of catatonia in psychiatry literature for over 150 years, many gaps and controversies persist regarding its etiopathogenesis, phenomenology, diagnostic criteria, and treatment. The current versions of the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) require clinicians to identify any three signs of 15 (ICD-11) or 12 (DSM-5) for the diagnosis of catatonia. Catalepsy and waxy flexibility are the only motor features with high specificity for the diagnosis. We highlight the gaps and controversies in catatonia as a movement disorder, emphasize the lack of a clear definition, and discuss the inconsistencies in the description of various catatonic signs. We propose the exploration of a bi-axial classification framework similar to that used for dystonia and tremor to encourage the evaluation of underlying etiologies and to guide therapeutic decisions to improve the outcome of these patients. © 2024 International Parkinson and Movement Disorder Society.
摘要：
“catatonia”一词是由德国精神病学家KarlKahlbaum于1874年提出的。尽管历史上与精神分裂症有关，紧张症表现出多种表型，并已在各种医学和神经精神疾病中观察到。其固有的运动特征以及与运动机能减退和运动亢进现象的关联将卡顿强症置于运动障碍的范围内。尽管150多年来在精神病学文献中出现了卡通症，关于其病因的许多空白和争议仍然存在，现象学,诊断标准,和治疗。国际疾病分类（ICD-11）和精神疾病诊断和统计手册（DSM-5）的当前版本要求临床医生识别15（ICD-11）或12（DSM-5）的任何三个体征用于诊断紧张症。僵症和蜡状柔韧性是唯一对诊断具有高特异性的运动特征。我们强调了紧张症作为一种运动障碍的差距和争议，强调缺乏明确的定义，并讨论各种紧张性体征描述中的不一致之处。我们建议探索类似于肌张力障碍和震颤的双轴分类框架，以鼓励对潜在病因的评估并指导治疗决策以改善这些患者的预后。©2024国际帕金森和运动障碍协会。
