■Catatonia已越来越多地与情绪障碍相关,并被认为是DSM-5和DSM-5-TR的说明符。DSM-5-TR将忧郁症识别为重度抑郁症和双相情感障碍中抑郁发作的指定者。它的特点是严重的快感缺失,缺乏反应性,过度或妄想的内疚,和显著的植物症状。随着忧郁症的概念化扩展到其情绪成分之外,包括精神运动性障碍,其与精神运动症状或紧张症的重叠变得明显。Kahlbaum的原始文献中也描述了这种重叠,他描述了忧郁症状态之间的过渡,躁狂症,和紧张症.
■6例因重度抑郁而入院的重度抑郁障碍或双相情感障碍抑郁期患者的病例总结,快感缺失,强烈的焦虑,精神运动性激动或迟钝,优柔寡断,坚持,以及睡眠不佳等植物性症状,食欲,和显著的体重减轻。
■所有患者的情绪和精神运动症状都能迅速、完全缓解,优柔寡断,坚持,以及服用劳拉西泮后不久的精神病,劳拉西泮停药后上述症状复发,恢复后消退,以断断续续的方式。
■根据我们的案例系列,本研究认为忧郁症和卡顿多尼亚之间存在更紧密的关系,历史回顾,现象学的重叠,以及对治疗的反应。我们为重度抑郁症和忧郁症患者提出临时[Mahgoub]标准。GABA激动剂的作用,如劳拉西泮,对于符合这些忧郁症标准的难治性抑郁症患者,可以作为一种选择。
■缺乏标准化,系统的评估工具和小样本量。
UNASSIGNED: Catatonia has been increasingly associated with mood disorders and is recognized as a specifier in the DSM-5 and DSM-5-TR. The DSM-5-TR recognizes melancholia as a specifier for depressive episodes in major depressive disorder and bipolar disorder. It is characterized by severe anhedonia, lack of reactivity, excessive or delusional guilt, and significant vegetative symptoms. As the conceptualization of melancholia expanded beyond its mood components to include psychomotor disturbances, its overlap with psychomotor symptoms or catatonia becomes evident. This overlap was also described in Kahlbaum\'s original literature, where he describes the transition between states of melancholia, mania, and catatonia.
UNASSIGNED: Case summary of six patients with major depressive disorder or depressed phase of bipolar disorder who were admitted for severe depression, anhedonia, intense anxiety, psychomotor agitation or retardation, indecisiveness, perseveration, and vegetative symptoms such as poor sleep, appetite, and significant weight loss.
UNASSIGNED: All patients demonstrated rapid and complete resolution of their mood and psychomotor symptoms, indecisiveness, perseveration, as well as psychosis shortly after administration of
lorazepam, with recurrence of the above symptoms upon
lorazepam discontinuation and resolution upon resumption, in an on-and-off manner.
UNASSIGNED: The present study argues for a closer relationship between melancholia and catatonia based on our
case series, historical review, overlap in phenomenology, and response to treatment. We propose provisional [Mahgoub] criteria for patients with severe depression and melancholia. The role of GABA agonists, such as
lorazepam, can be explored as an option for patients with treatment-resistant depression who meet these criteria for melancholia.
UNASSIGNED: Absence of a standardized, systematic assessment tool and a small sample size.