Jorge Cuevas-Esteban, Francesc Serrat, Maria Iglesias-González, Nicole Motta, Beltran Jimenez-Fernandez, Regina Vila-Badia, Alicia Colomer-Salvans, Clara Serra-Arumí, Núria Del Cacho, Ariadna Corbella-Sotil, Anna Butjosa, Marta Pardo, Judith Usall
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Catatonia, characterised by motor, behavioural, and psychological abnormalities, is an under-recognised aspect of FEP.</p><p><strong>Aims: </strong>This study examines catatonia prevalence in affective and non-affective FEP, its role as a severity indicator across psychopathological domains, its correlations with other symptoms and its association with clinical syndromes.</p><p><strong>Method: </strong>A cross-sectional study was conducted with 58 FEP patients (38 females, 20 males) aged 15-55 years. Of those, 40 were antipsychotic-naive, and 18 had minimal prior antipsychotic exposure. Participants were recruited from acute psychiatric units. Catatonia was assessed using the Bush Francis Catatonia Rating Scale (BFCRS), while psychopathology was evaluated with the Positive and Negative Symptom Scale (PANSS), Calgary Depression Scale (CDS) and Young Mania Rating Scale (YMRS). Data analysis included descriptive statistics, <i>t</i>-tests, <i>X</i><sup>2</sup> tests, and multivariable regression using SPSS version 25 for Windows.</p><p><strong>Results: </strong>Catatonic signs were identified in 22.4% of cases based on the Bush Francis Catatonia Screening Instrument (BFCSI) criteria (BFCSI-positive group, defined as ≥2 signs present for over 24 h), indicating potential catatonia. Prevalence varied by criteria: 13.8% (DSM-IV), 10.3% (Fink and Taylor), 10.38% (ICD-11) and 8.6% (DSM-5). Catatonic patients had more years of education and significantly higher PANSS totals, Emsley negative, disorganised, excited, and anxiety scores. Catatonic signs moderately correlated with Emsley disorganised scores. Regression analysis identified PANSS total and Emsley domain scores as significant predictors of catatonia severity.</p><p><strong>Conclusions: </strong>Catatonia is notably prevalent in FEP and associated with severe psychopathology, particularly in negative and disorganised domains. These findings underscore the importance of improving recognition of catatonia in early psychosis. 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引用次数: 0
摘要
背景：首发精神病（FEP）是精神障碍的关键阶段，早期干预对其长期预后有显著影响。以运动、行为和心理异常为特征的紧张症是FEP的一个未被充分认识的方面。目的：本研究探讨了情感性和非情感性FEP中紧张症的患病率，其作为精神病理领域严重程度指标的作用，其与其他症状的相关性以及与临床综合征的关联。方法：对58例FEP患者进行横断面研究，其中女性38例，男性20例，年龄15 ~ 55岁。其中，40人没有服用过抗精神病药物，18人之前服用过最低限度的抗精神病药物。参与者是从急性精神科招募的。采用Bush Francis紧张症评定量表（BFCRS）评定紧张症，采用阳性和阴性症状评定量表（PANSS）、卡尔加里抑郁量表（CDS）和青年躁狂症评定量表（YMRS）评定精神病理。数据分析包括描述性统计、t检验、X2检验和多变量回归，使用SPSS version 25 for Windows。结果：根据Bush Francis紧张症筛查仪（BFCSI）标准（BFCSI阳性组，定义为≥2个症状持续24小时以上），22.4%的病例发现紧张症体征，提示潜在的紧张症。不同标准的患病率不同：13.8% (DSM-IV), 10.3% (Fink和Taylor), 10.38% （ICD-11）和8.6% （DSM-5）。紧张性精神分裂症患者受教育年限更长，PANSS总分、Emsley阴性、混乱、兴奋和焦虑得分明显更高。紧张性症状与埃姆斯利紊乱得分有中度相关。回归分析发现PANSS总分和Emsley域评分是紧张症严重程度的显著预测因子。结论：紧张症在FEP中非常普遍，并与严重的精神病理有关，特别是在消极和混乱的领域。这些发现强调了在早期精神病中提高对紧张症的认识的重要性。需要更大规模的纵向研究来证实这些发现并探索治疗意义。
Catatonia in first-episode psychosis: prevalence and psychopathological association.
Background: First-episode psychosis (FEP) is a critical phase in psychotic disorders where early intervention significantly influences long-term outcomes. Catatonia, characterised by motor, behavioural, and psychological abnormalities, is an under-recognised aspect of FEP.
Aims: This study examines catatonia prevalence in affective and non-affective FEP, its role as a severity indicator across psychopathological domains, its correlations with other symptoms and its association with clinical syndromes.
Method: A cross-sectional study was conducted with 58 FEP patients (38 females, 20 males) aged 15-55 years. Of those, 40 were antipsychotic-naive, and 18 had minimal prior antipsychotic exposure. Participants were recruited from acute psychiatric units. Catatonia was assessed using the Bush Francis Catatonia Rating Scale (BFCRS), while psychopathology was evaluated with the Positive and Negative Symptom Scale (PANSS), Calgary Depression Scale (CDS) and Young Mania Rating Scale (YMRS). Data analysis included descriptive statistics, t-tests, X2 tests, and multivariable regression using SPSS version 25 for Windows.
Results: Catatonic signs were identified in 22.4% of cases based on the Bush Francis Catatonia Screening Instrument (BFCSI) criteria (BFCSI-positive group, defined as ≥2 signs present for over 24 h), indicating potential catatonia. Prevalence varied by criteria: 13.8% (DSM-IV), 10.3% (Fink and Taylor), 10.38% (ICD-11) and 8.6% (DSM-5). Catatonic patients had more years of education and significantly higher PANSS totals, Emsley negative, disorganised, excited, and anxiety scores. Catatonic signs moderately correlated with Emsley disorganised scores. Regression analysis identified PANSS total and Emsley domain scores as significant predictors of catatonia severity.
Conclusions: Catatonia is notably prevalent in FEP and associated with severe psychopathology, particularly in negative and disorganised domains. These findings underscore the importance of improving recognition of catatonia in early psychosis. Larger longitudinal studies are needed to confirm these findings and explore treatment implications.
期刊介绍：
Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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