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2008, vol. 30, br. 3-4, str. 93-102
Katatoni sindrom - savremena razmatranja
aKlinički centar Srbije, Klinika za psihijatriju, Beograd
bDom zdravlja, Despotovac

e-adresanadjamaric@yahoo.com
Ključne reči: katatonija; shizofrenija; neurološki poremećaji; konverzivni poremećaji; benzodijazepini
Sažetak
Iako katatonija predstavlja poznat entitet kako u psihijatriji, tako i u opštoj medicini, ova klinička slika svojom upadljivošću uvek intrigira. Manifestacije katatonije su mnoge, povremeno kontradiktorne i delikatne za dijagnostiku. Katatoni sindrom sreće se kod: a) psihijatrijskih poremećaja (poremećaji raspoloženja, shizofrenija i konverzivni poremećaj); b) neuroloških; c) metaboličkih; d) infektivnih (toksičnih infekcija CNS-a, virusnih infekcija) ili e) autoimunih bolesti. Ovaj pregledni članak ima za cilj sumiranje podataka savremenih istraživanja o katatoniji. Iako je tradicionalno vezana za shizofreniju ili ponekad konverzivnu neurozu, prema literaturi objavljenoj tokom poslednjih decenija katatonija se češće vezuje za poremećaje raspoloženja i nepsihijatrijske poremećaje. Neprepoznavanje ovog sindroma izvan dijagnoze shizofrenije i zanemarivanje potrebnih dijagnostičkih i terapijskih procedura, uz odloženo terapijsko reagovanje, može voditi u nepovoljan ishod. Benzodijazepini predstavljaju lek izbora za katatoniju. Pacijentima koji nedovoljno ili uopšte ne reaguju na benzodijazepine potrebna je elektrokonvulzivna terapija (EKT), a ima indikacija da i atipični antipsihotici mogu biti korisni u tretmanu nemaligne katatonije. Iako je katatoni sindrom nesumnjivo priznat njegovo shvatanje veoma se razlikuje što može dovesti do podcenjivanja i neadekvatne terapije. Dilema koju treba dalje razmotriti je da li katatonija predstavlja jedinstveni sindrom koji zahteva nezavisnu terapiju u odnosu na bilo koji poremećaj koji leži u njenoj osnovi ili je samo deo različitih poremećaja.
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O članku

jezik rada: srpski
vrsta rada: pregledni članak
objavljen u SCIndeksu: 30.06.2009.

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