舍曲林治疗青少年肌张力障碍合并有精神病性特征的重度抑郁症。

IF 2 Q3 NEUROSCIENCES
Neuropsychopharmacology Reports Pub Date : 2024-03-01 Epub Date: 2023-11-20 DOI:10.1002/npr2.12401
Chia-Chien Liu, Chen-Chia Lan, Ying-Sheue Chen
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引用次数: 0

摘要

肌张力障碍的特征是持续或间歇的不随意肌收缩。精神症状是肌张力障碍的基本非运动特征,并且据报道,抑郁和焦虑障碍的风险更高。一些患者的精神症状优先于运动症状,以及多巴胺能和血清素能系统在运动和精神方面的参与表明,这些精神障碍可能是肌张力障碍的神经生物学内在的。然而,精神合并症通常被解释为运动障碍和肌张力障碍的负面生物-心理-社会影响的继发反应,导致诊断和治疗不足。关于抗抑郁药在肌张力障碍中的应用的研究很少,特别是在儿童和青少年中。本报告报告了一位17岁女性肌张力障碍合并抑郁症的精神病性特征,其运动症状得到改善,但精神症状在多巴胺能药物治疗后仍然存在。舍曲林最终在发病5年后加入,并成功地控制了她的精神病性抑郁症,没有加重运动症状。早期发现,及时诊断,及时使用多巴胺能药物,抗抑郁药和社会心理干预进行整体治疗对肌张力障碍患者的心理健康至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The use of sertraline to treat an adolescent of dystonia comorbid with major depressive disorder with psychotic features.

Dystonia is characterized by sustained or intermittent involuntary muscle contractions. Psychiatric symptoms are essential non-motor features of dystonia, and higher risks of depressive and anxiety disorders have been reported. The precedence of psychiatric to motor symptoms in some patients and the dopaminergic and serotonergic system involvement in both the motor and psychiatric aspects suggest these psychiatric disorders may be intrinsic to the neurobiology of dystonia. Nevertheless, psychiatric comorbidities are often construed as secondary reactions to motor disabilities and the negative bio-psycho-social impacts of dystonia, leading to underdiagnosis and undertreatment. Research on antidepressant use in dystonia is scarce, especially in children and adolescents. This report presents a 17-year-old female with dystonia comorbid with depression with psychotic features, whose motor symptoms improved but psychiatric symptoms persisted with dopaminergic pharmacotherapy. Sertraline was finally added 5 years after the onset and successfully managed her psychotic depression without worsening motor symptoms. Early detection, prompt diagnosis, and timely holistic treatment with dopaminergic agents, antidepressants, and psychosocial interventions are critical for the mental health of dystonia patients.

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来源期刊
Neuropsychopharmacology Reports
Neuropsychopharmacology Reports Psychology-Clinical Psychology
CiteScore
3.60
自引率
4.00%
发文量
75
审稿时长
14 weeks
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