The Catatonia Quick Screen (CQS): A Rapid Screening Tool for Catatonia in Adult and Pediatric Populations

IF 5 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2025-05-06 DOI:10.1111/acps.13820

James Luccarelli, Mark Kalinich, Jo Ellen Wilson, Jonathan P. Rogers, Jinyuan Liu, D. Catherine Fuchs, Andrew Francis, Stephan Heckers, Gregory Fricchione, Joshua Ryan Smith

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引用次数: 0

Abstract

Introduction

Catatonia is a potentially lethal and frequently underdiagnosed neuropsychiatric disorder marked by significant disturbances in motor, cognitive, and affective functioning. To enhance clinical detection of catatonia, this study aimed to develop and independently validate a rapid, sensitive Catatonia Quick Screen (CQS) using a reduced set of catatonic signs to facilitate screening in both adult and pediatric patients.

Methods

Training data were derived from two retrospective cohorts totaling 446 patients (254 adults, 192 children) who screened positive for catatonia using the Bush Francis Catatonia Screening Instrument (BFCSI). The sensitivity of every potential combination of BFCSI signs was calculated from these data, with sensitivity defined as the proportion of patients identified by each combination of signs relative to the full BFCSI. The CQS was developed by selecting the combination of signs from the BFCSI that offered high sensitivity, ease of assessment by non-expert providers, and relevance to diverse catatonia presentations. The CQS was then validated in an independent 1456 patient cohort.

Results

Using only four of the full BFCSI's 14 signs—excitement, mutism, staring, and posturing—yielded a sensitivity of 97% (95% CI: 95%–98%) relative to the BFCSI across both pediatric and adult patients within the training data. The CQS showed only a modest decrease in sensitivity (91%; 95% CI: 90%–93%) relative to the BFCSI when tested on the independent 1456 patient validation cohort.

Conclusion

The CQS provides an independently validated, high sensitivity, rapid, and easy to use screening alternative to the BFCSI, potentially improving early detection of catatonia in clinical settings. A positive CQS should lead to a more detailed and definitive assessment for catatonia. Future prospective studies are necessary to determine the specificity of the CQS in diverse clinical populations.

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紧张症快速筛查（CQS）：成人和儿童紧张症的快速筛查工具

紧张症是一种潜在的致命的、经常被误诊的神经精神疾病，其特征是运动、认知和情感功能的显著障碍。为了加强临床对紧张症的检测，本研究旨在开发并独立验证一种快速、敏感的紧张症快速筛查（CQS），使用一组减少的紧张症体征来促进成人和儿童患者的筛查。方法训练数据来自两个回顾性队列，共446例患者（成人254例，儿童192例），均使用Bush Francis紧张症筛查仪（BFCSI）筛查出紧张症阳性。根据这些数据计算每一种潜在BFCSI体征组合的敏感性，敏感性定义为每一种体征组合所识别的患者相对于完整BFCSI的比例。CQS是通过选择BFCSI的体征组合而开发的，这些体征具有高灵敏度，易于非专业提供者评估，并且与各种紧张症表现相关。然后在一个独立的1456例患者队列中验证CQS。结果：在训练数据中，仅使用BFCSI全部14个体征中的4个——兴奋、缄默、凝视和姿势——相对于BFCSI的灵敏度为97% (95% CI: 95% - 98%)，适用于儿科和成人患者。当在独立的1456例患者验证队列中进行测试时，CQS显示相对于BFCSI的敏感性仅略有下降（91%;95% CI: 90%-93%）。结论CQS是一种独立验证、灵敏度高、快速、简便的筛查方法，可替代BFCSI，有望提高临床对紧张症的早期发现。CQS阳性应导致对紧张症更详细和明确的评估。未来的前瞻性研究有必要确定CQS在不同临床人群中的特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.