Dergi Ara >>
Yıl:2016; Cilt: 23; Sayı: 2>> Özet
TAM METİN
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2016;23(2):141-145
Ergenlik Döneminde Katatoni İle Giden Psikotik Bulgulu Depresyon Olgusu
B Atar, Ö Kardaş, NB Özbaran, S Köse, T Bildik
Ege Üniversitesi, İzmir
Katatoni ilk defa Kahlbaum tarafından tanımlanmıştır. Önceleri sadece şizofreninin alt tipi olarak görülse de daha sonra başta duygudurum bozuklukları olmak üzere diğer psikiyatrik bozukluklarda da görüldüğü saptanmıştır. Bunun dışında genel tıbbi durumlara bağlı olarak (endokrin bozukluklar, elektrolit dengesizlikleri, nörolojik hastalıklar, renal ve hepatik disfonksiyon, enfeksiyonlar vb.) katatoni görüldüğü belirtilmiştir. DSM-5 tanı ölçütlerinde şizofreni ile ilişkili bozukluklar içinde yer almaktadır. Katatoninin etiyolojisi tam olarak açıklanabilmiş değildir. Primer inhibitör nörotransmitter olarak görev yapan kortikal gama-aminobütirik asitin (GABA) yetersizliğine bağlı olarak meydana gelen bazal gangliyon modülasyon bozukluğunun, katatoninin motor belirtilerini açıklayabileceği düşünülmektedir. Bu olguda depresif bulgular sonrasında, akut başlayan katatoni tablosu anlatılmaya çalışılmıştır. Bizim olgumuzda önce genel tıbbı durumlara ve diğer psikiyatrik rahatsızlıklara yönelik ayırıcı tanı yapılmış sonra tedavisi düzenlenmiştir. Benzodiazepin tedavisi sonrası katatoni bulguları gerileyen hastanın yapılan değerlendirme sonucunda depresyon zemininde gelişen bir katatoni olduğu görülmüş, hastanın katatonisine ve depresyonuna yönelik tedavisi yapılmıştır. Katatonik bozukluğa yönelik lorazepam, depresyona yönelik önce fluoksetin tedavisi başlanmış olup daha sonra aripiprazol eklenmiştir. Sonuç olarak adölesan çağında da katatoni görülebileceği unutulmamalıdır ve özellikle ayırıcı tanı açısından göz önünde bulundurulmalıdır.
Catatonia in Adolescence Depression with Psychotic Features Outgoing Case
Catatonia was first described by Kahlbaum. Previously catatonia was associated with psychiatric conditions such as schizophrenia (catatonic type), later on it was recognized in mood disorder and other mental disorders. Catatonia can also occur due to general medication conditions (endocrine disorders, electrolyte imbalances, neurological disorders, renal and hepatic dysfunction, and infections). Catatonia is categorized in schizophrenia and related disorders in DSM-5. Etiology of catatonia is not well explained. It is suggested that catatonic symptoms are based on insufficiency of GABA (primary inhibitory neurotransmitter) in basal ganglia area. In this case report we will discuss acute onset of catatonia secondary to depressive symptoms. After differential diagnosis of catatonic symptoms with general medication conditions and other psychiatric diseases that can cause catatonia, we emerged out treatment on this case. The catatonic symptoms diminished with benzodiazepine treatment and we find out that catatonia was seconder to depression, and we added fluoxetine treatment for his depression, aripiprazole was also added in follow up period. In catatonia can be seen in adolescent period and we should keep in mind further by differential diagnosis of adolescents.

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