Clinical cases, pathogenesis and diagnosis of catatonia in affective disorders (depression and mania) in adolescents
Catatonia is an important syndrome found in both psychiatry and general medicine. However, identification and treatment of this phenomenon is difficult without modern diagnostic scales for catatonia. Purpose - to describe the cases of inhibited and excitable catatonia in adolescents with affective disorders. Methods - clinical observation in accordance with the ICD-10 diagnostic criteria for affective disorders in depression and mania, the use of Beck depression scale, Beck anxiety scale, Young scale of mania, Bush-Francis catatonia rating scale. Differential diagnosis with the participation of a team of specialists: neurologist, psychiatrist, clinical psychologist, cardiologist, infectious disease specialist, pediatrician. Results and discussion. Catatonia in children occurs in various conditions that are not always associated with schizophrenia: with general developmental disorders, epilepsy, affective disorders, sports injuries of the cervical spine. Difficulties in recognizing and appropriately treating catatonia can lead to poor patient outcomes due to inappropriate treatment that aggravates the course of catatonia. The most effective treatment for catatonia is benzodiazepine tranquilizers and / or electroconvulsive therapy; the latter is the method of last choice if the early administration of benzodiazepine derivatives has been missed, or they are ineffective even at high doses. The use of a standardized, highly valid Bush-Francis catatonia rating scale will facilitate the diagnosis of this disorder and taking a fast decision-making.