Bush Francis Katatoni Değerlendirme ve KANNER Katatoni Ölçeklerinin Türkçeye Uyarlanarak Karşılaştırılması ve Katatoninin Yatan Hastalarda Değerlendirilmesi

Abstract

ERDOGAN, I.M., Adaptation and Comparison of Bush Francis Catatonia Rating and the KANNER Scales to Turkish and Evaluation of Catatonia in Inpatients, Hacettepe University Faculty of Medicine, Department of Psychiatry, Dissertation Thesis, Ankara 2021. Catatonia is a common syndrome that is easily diagnosed when related symptoms are recognized, and it can be life-threatening due to its complications. The aims of this study are to translate the Bush Francis Catatonia Rating Scale (BFCRS) and the KANNER Scale to Turkish, to conduct the validity and reliability analyses of the Turkish versions, and to compare the features of the BFCRS, KANNER Scale and DSM-5 Catatonia Diagnostic Criteria. Further, evaluating and determining the frequency of catatonia in patients hospitalized at a university hospital inpatient psychiatry and neurology clinics and internal medicine intensive care unit utilizing these scales and evaluating of the relationship between catatonia and sociodemographic and clinical features, test results and its complications have been aimed. During a 20 months long study period, the Turkish versions of the scales were administered to a total of 223 patients. Clinical and sociodemographic characteristics of all patients admitted to the inpatient psychiatry unit were evaluated. The clinical information of the patients who passed the catatonia screening through both scales were collected through a detailed form. The frequency of the patients who passed the catatonia screening through scales in the psychiatry service was 16.7%, and the frequency of diagnosis of catatonia according to DSM-5 was 14.2%. It has been found that a history of catatonia is a clinical feature that has a significant relationship with catatonia. The most common complication related with catatonia was urinary tract infections, and life-threatening complications such as malignant catatonia could be seen. Among the patients evaluated in the neurology inpatient unit and the emergency department, although there were patients who passed catatonia screening, the condition was not considered in their differential diagnosis. Consistent with the literature, it was concluded that the most common symptoms of catatonia were mutism, staring, negativism, posturing/catalepsy, withdrawal and immobility/stupor. The internal consistency reliability of the Turkish versions of both scales were found to be high (Cronbach’s alpha 0,902 for the BFCRS and 0,9, 0,891, 0,806 for the KANNER Scale subsections). Inter-rater reliability was also found to be high for most of the scale items (mean Kappa coefficient: 0,885 for the BFCRS and 0.904 for the KANNER Scale). There was a high correlation between the screening instruments of both scales, and a positive correlation between the BFCRS total score and the part 2 and part 3 total scores of the KANNER Scale was detected. It was found that a total score of 6 in the BFCRS and KANNER Scale 2nd part score of 15 or 3rd part score of 1 point can be use with high accuracy in diagnosing catatonia according to DSM-5. DSM-5 Catatonia Diagnostic Criteria were found to be more restrictive in the diagnosis of catatonia compared to these two scales. In conclusion, the Turkish adaptations of both the BFCRS and KANNER Scale were found to be valid and reliable, showing strong psychometric properties.