hrvatski

Istraživanje katatonog i paranoidnog tipa shizofrenije na temelju dugotrajnog praćenja

Objective: The aim of this study was to analyze characteristics of the catatonic type of schizophrenia and the occurrence in the population of Croatia, as well as differences in comparison to paranoid type of schizophrenia. Methods: In 1972, from the base population of 10569 schizophrenic patients recorded in Croatian Psychotics Case Register (CPCR), the representative sample of 402 patients (207 males and 195 females) was formed for further long-term field-clinical- epidemiological follow-up. In this sample there were 59 (14.7%) patients, who were diagnosed at least once in their life as catatonic schizophrenics (ICD). Every catatonic schizophrenic was matched with paranoid schizophrenic from the sample, according to residential area, sex and age. The patients were followed up until 1995. Results: The great majority of ever-catatonic schizophrenic patients showed unstable clinical picture and positive family history of psychosis, while paranoid schizophrenics showed more stabile clinical picture and also positive heredity. Catatonic schizophrenia was not evenly distributed among Croatia, i. e. it was more often found in areas with higher prevalence of schizophrenia and with a higher rate of family history of schizophrenia. Also, various differences in socio- demographic, clinical and hospital characteristics were observed between those two groups. Patients with schizophrenia, catatonic type were younger at the age of onset, and at the initial hospitalization, had shorter pre-hospitalization interval. Although during the course of the catatonic schizophrenics had better compliance they spent greater percentage of time in hospital then paranoid patients. Catatonic episodes usually occurred early in the course, but frequently changed over the course of illness. This study presents data about the catatonic subtype instability during the long- term follow up. Namely, during the course of illness the majority of schizophrenic patients changed their types of clinical picture and at the end of this follow-up in only 11 (18.6%) cases the diagnosis of catatonic schizophrenia was made. The positive family history of psychosis was found in 47.5% of both groups of schizophrenics. Conclusion: In conclusion, it is stressed that for the present real causes of catatonic schizophrenia are not known, and as differences among the groups were also found in this study, it is considered that it is useful and necessary to record and examine schizophrenia on the basis of the types of clinical picture and the course of the illness. This study is supporting the thesis that catatonic schizophrenia is a valid and separate diagnostic entity and is in part familial disorder.

katatoni ; paranoidni ; shizofrenija ; dugotrajno praćenje

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