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Yıl:2024; Cilt: 35; Sayı: 3>> Özet
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Türk Psikiyatri Dergisi; 2024;35(3):198-206
Psikiyatri ve Nörolojide Katatoninin Farklı Ölçeklerle Değerlendirilmesi
İM Erdoğan, A Aytulun, KB Avanoğlu, Ö Türkoğlu, N Erdoğan,ŞC Gürel, S Karahan, B Carroll, MK Yazıcı, E Yağcıoğlu
Silopi Devlet Hastanesi, Şırnak
Amaç: Katatoni klinik ortamlarda gözden kaçabilen bir klinik sendromdur.Katatoni tanısı tablonun çoğunlukla geri dönüşlü olabilmesi ve müdahale edilmediğinde ciddi komplikasyonlarla sonuçlanması nedeniyle önemlidir. Bu çalışmada, bir üniversite hastanesi psikiyatri ve nöroloji servislerinde yatan hastaların katatoni açısından taranması, özelliklerinin incelenmesi ve ölçeklerin karşılaştırılması amaçlanmıştır. Yöntem: Ardışık 20 aylık bir süre boyunca psikiyatri, nöroloji yatan hasta klinikleri ve psikiyatri servisine yatış için bekleme listesindeki hastalara Bush-Francis Katatoni Değerlendirme ve KANNER ölçeklerinin Türkçe uyarlamalarıyla eş zamanlı olarak DSM-5 Katatoni Tanı Ölçütleri uygulandı. Psikiyatri grubundaki hastaların sosyodemografik ve klinik özellikleri karşılaştırıldı. 28’i (%13,1) ölçek değerlendirmesinde katatoni taramasını geçti ve taramayı geçen hastaların 23’üne (%82,1) DSM-5’e göre katatoni tanısı konuldu. Daha önce sıklıkla katatoniyle ilişkilendirilen şizofreni ve duygudurum bozukluklarının yanında nörogelişimsel bozukluk, ensefalit, postpartum psikoz, obsesif kompulsif bozukluk, deliryum, serebrovasküler hastalık, fonksiyonel nörolojik belirti bozukluğu gibi tanıların da katatoniyle ilişkili olabildiği saptandı. Değerlendirmede kullanılan her iki ölçek de aynı hastaları katatoni olarak tanımladı. En yaygın komplikasyonun idrar yolu enfeksiyonu olduğu görülmekle birlikte hayatı tehdit eden daha ciddi komplikasyonlar da mevcuttu. Sonuç: Gözden kaçtığında ciddi sonuçlara neden olabilen katatoninin tanısında sadece DSM-5 kriterlerine bağlı kalmak, bazı hastalara katatoni tanısının konulamamasına neden olabilmektedir. Standardize katatoni ölçeklerinin dünya genelinde yaygın ve etkili bir şekilde kullanılmasıyla klinisyenlerin teşhis kapasitesi artabilir ve katatoniyle ilişkili morbidite ve mortalite iyileştirilebilir.
Evaluation of Catatonia with Different Assessment Scales in Psychiatry and Neurology
Objective: Catatonia is a syndrome that can be missed in clinical settings. Diagnosis of catatonia is important because the condition can be reversible and is associated with severe complications. This study aims to screen patients with catatonia admitted to a university hospital’s psychiatry and neurology services, examine their characteristics, and compare the coverage of different catatonia scales.Method: During a consecutive 20 months study period, the Turkish adaptations of the Bush-Francis Catatonia Rating and the KANNER scales were administered in psychiatry and neurology inpatient units and patients on the waiting list for psychiatric hospitalization. The participants were also evaluated with DSM-5 criteria. In addition, the sociodemographic and clinical characteristics of the patients in the psychiatric group were compared. Results: A total of 214 patients were evaluated. Twenty-eight (13.1%) screened positive for catatonia, and 23 (82.1%) were diagnosed with catatonia according to DSM-5 criteria. KANNER and BushFrancis identified the same patients as having catatonia. In addition to schizophrenia and mood disorders; neurodevelopmental disorder, encephalitis, postpartum psychosis, obsessive-compulsive disorder, delirium, cerebrovascular disease, functional neurological symptom disorder have also been found to be associated with catatonia. The most common complication was urinary tract infection. Life-threatening complications were also observed. Conclusion: Overlooking catatonia may have dire consequences. Adhering solely to the DSM-5 criteria may miss some patients with catatonia. Widely and efficiently using standardized catatonia scales can improve detection capacity and enhance the management of morbidity and mortality.

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