긴장형 정신분열병 환자에게 생긴 비우성 수부의 근위지관 관절 굴곡 구축 1예 (A Case of Catatonic Schizophrenia Associated With Proximal Interphalangeal Joint Flexion Contracture in Non-Dominant Hand)

서지정보

· 발행기관 : 대한신경정신의학회
· 수록지 정보 : 신경정신의학 / 47권 / 2호 / 200 ~ 204페이지
· 저자명 : 이상수, 문석우, 남범우, 서정석

초록

Objectives：Psychogenic contractures in the hand are a rare topic in the medical literature and psychoflexed hand is rarely
mentioned even in orthopedic textbooks. By reporting a case with classic catatonic features of the catatonic type of schizophrenia
associated with proximal interphalangeal joint flexion contracture in non-dominant hand, the existence of this rare and
almost unknown entity is emphasized and the diagnostic and therapeutic importance facing the clinicians dealing with psychological
related symptomatology is suggested.
Case：A 54-year-old, single, right-handed woman who lived alone presented to emergency department in catatonic stupor
state, severe dehydration due to refusal of oral intake for about 15 days. She had received a diagnosis of schizophrenia, catatonic
type at age 33 and had been hospitalized with catatonic motor and behavioral symptoms for a long time. She was hospitalized
in medical intensive care unit and abnormal results of laboratory studies at admission including hypernatremia due to
severe dehydration, prerenal azotemia, and hemoconcentration was corrected. Catatonia was confirmed by CRS Catatonia
Rating Scale (CRS). Her catatonic and other psychotic symptoms began to resolve with treatment, but the patient was found to
have had the psychogenic hand deformity characteristics of proximal interphalangeal joint flexion contractures of left 2nd, 3rd,
4th, 5th finger which started about 20 years ago. She allowed us to try to have a appropriate diagnostic evaluation but as she had
experienced a full resolution of catatonic and other psychotic symptoms, she began to resist all the orthopedic treatments. She
was discharged by caregiver’s request because of economic problems.
Conclusion：This case highlights the importance of having specific and systemized medical workups for catatonia of schizophrenia
in order to prevent the sequelae of severe psychopatholgy such as flextion contractures and other potential complications.
(J Korean Neuropsychiatr Assoc 2008;47(2):200-204)

영어초록

Objectives：Psychogenic contractures in the hand are a rare topic in the medical literature and psychoflexed hand is rarely
mentioned even in orthopedic textbooks. By reporting a case with classic catatonic features of the catatonic type of schizophrenia
associated with proximal interphalangeal joint flexion contracture in non-dominant hand, the existence of this rare and
almost unknown entity is emphasized and the diagnostic and therapeutic importance facing the clinicians dealing with psychological
related symptomatology is suggested.
Case：A 54-year-old, single, right-handed woman who lived alone presented to emergency department in catatonic stupor
state, severe dehydration due to refusal of oral intake for about 15 days. She had received a diagnosis of schizophrenia, catatonic
type at age 33 and had been hospitalized with catatonic motor and behavioral symptoms for a long time. She was hospitalized
in medical intensive care unit and abnormal results of laboratory studies at admission including hypernatremia due to
severe dehydration, prerenal azotemia, and hemoconcentration was corrected. Catatonia was confirmed by CRS Catatonia
Rating Scale (CRS). Her catatonic and other psychotic symptoms began to resolve with treatment, but the patient was found to
have had the psychogenic hand deformity characteristics of proximal interphalangeal joint flexion contractures of left 2nd, 3rd,
4th, 5th finger which started about 20 years ago. She allowed us to try to have a appropriate diagnostic evaluation but as she had
experienced a full resolution of catatonic and other psychotic symptoms, she began to resist all the orthopedic treatments. She
was discharged by caregiver’s request because of economic problems.
Conclusion：This case highlights the importance of having specific and systemized medical workups for catatonia of schizophrenia
in order to prevent the sequelae of severe psychopatholgy such as flextion contractures and other potential complications.
(J Korean Neuropsychiatr Assoc 2008;47(2):200-204)

참고자료

· 없음