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Katatonie in der klinischen Realität: unterdiagnostiziert und vergessen

Catatonia in clinical reality: underdiagnosed and forgotten

  • Published:
MMW - Fortschritte der Medizin Aims and scope

Zusammenfassung

Hintergrund

Die Katatonie ist ein noch wenig verstandenes, durchaus häufiges, aber doch oft übersehendes Krankheitsbild. Folgen für die Patienten sind eine unzureichende Behandlung, verlängerte Krankenhausaufenthalte und schwerwiegendere Komplikationen.

Methode

In dieser übersichtsarbeit werden die Ursachen für eine Unterdiagnose dargestellt und Maßnahmen zu deren Vermeidung genannt, Hilfen zur differenzialdiagnostischen Einordnung der Katatonie gegeben und die Therapie kurz erläutert.

Ergebnisse und Schlussfolgerungen

Katatonien werden in erster Linie mit Schizophrenie in Verbindung gebracht. Sie werden aber auch bei anderen Erkrankungen wie z. B. dem malignen neuroleptischen Syndrom (MNS), bei Enzephalitiden und auch bei Allgemeinerkrankungen beobachtet. Durch einfache Maßnahmen wie eine gründliche körperliche Untersuchung, das Beachten verbaler und non-verbaler Zeichen der Katatonie sowie durch psychiatrische Konsultationen in Allgemeinkrankenhäusern lässt sich vermeiden, dass eine Katatonie übersehen wird. Zur Behandlung der akuten Katatonie sind in erster Linie die hochdosierte Gabe von Benzodiazepinen sowie eine Elektrokonvulsionstherapie empfohlen.

Abstract

Background

Catatonia is still a poorly understood, quite common, but often overlooked clinical picture. Consequences for patients are inadequate treatment, prolonged hospital stays and more serious complications.

Method

In this overview, the causes for an underdiagnosis are presented and measures for their prevention named, help for the differential diagnostic classification of catatonia is offered and the treatment is briefly explained.

Results and conclusions

Catatonia is primarily associated with schizophrenia, but is also observed in other diseases such as neuroleptic malignant syndrome (MNS), in encephalitis and also in systemic diseases. Underdiagnosis can be avoided by simple measures such as a thorough physical examination, observance of verbal and non-verbal signs of catatonia, and psychiatric consultations in general hospitals. For the treatment of acute catatonia, the high-dose administration of benzodiazepines and electroconvulsive therapy are recommended.

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Authors and Affiliations

  1. Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Nußbaumstraße 7, 80336, München, Deutschland

    Kristina Adorjan,  Peter Falkai &  Oliver Pogarell

  2. Institut für Psychiatrische Phänomik und Genomik (IPPG), Klinikum der Universität München (LMU), München, Deutschland

    Kristina Adorjan

Authors
  1. Kristina Adorjan
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  2. Peter Falkai
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  3. Oliver Pogarell
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Corresponding author

Correspondence to Kristina Adorjan.

Additional information

This article is part of a supplement not sponsored by the industry.

Interessenkonflikt

Dr. Kristina Adorjan, Prof. Dr. Peter Falkai und Prof. Dr. Oliver Pogarell erklären, dass keine finanziellen Interessenkonflikte im Zusammenhang mit dieser Arbeit vorliegen.

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Adorjan, K., Falkai, P. & Pogarell, O. Katatonie in der klinischen Realität: unterdiagnostiziert und vergessen. MMW - Fortschritte der Medizin 161 (Suppl 7), 7–11 (2019). https://doi.org/10.1007/s15006-019-1173-5

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  • DOI: https://doi.org/10.1007/s15006-019-1173-5

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