Catatonia
| Catatonia | |
|---|---|
| Other names | Catatonic syndrome |
| A patient in catatonic stupor, 1914 | |
| Specialty | Psychiatry, neurology |
| Symptoms | Immobility, mutism, staring, posturing, rigidity, low consciousness, etc. |
| Complications | Physical trauma, malignant catatonia (autonomic instability, life-threatening), dehydration, pneumonia, pressure ulcers due to immobility, muscle contractions, deep vein thrombosis (DVT)[1] and pulmonary embolism (PE)[1] |
| Causes | Underlying illness (psychiatric, neurologic, or medical), brain injury/damage, certain drugs/medications |
| Diagnostic method | Clinical, lorazepam challenge |
| Treatment | Benzodiazepines (lorazepam challenge), electroconvulsive therapy (ECT)[1] |
Catatonia is a neuropsychiatric syndrome characterized by a range of psychomotor disturbances. It is most commonly observed in individuals with underlying mood disorders, such as major depressive disorder, and psychotic disorders, including schizophrenia.[2][3]
The condition involves abnormal motor behavior that can range from immobility (stupor) to excessive, purposeless activity. These symptoms may vary significantly among individuals and can fluctuate during the same episode.[4] Affected individuals often appear withdrawn, exhibiting minimal response to external stimuli and showing reduced interaction with their environment.[5] Some may remain motionless for extended periods, while others exhibit repetitive or stereotyped movements. Despite the diversity in clinical presentation, these features are part of a defined diagnostic syndrome.
Effective treatment options include benzodiazepines and electroconvulsive therapy (ECT), both of which have shown high rates of symptom remission.[3]
Several subtypes of catatonia are recognized, each defined by characteristic symptom patterns. These include:
- Stuporous/akinetic catatonia: marked by immobility, mutism, and withdrawal;
- Excited catatonia: characterized by excessive motor activity and agitation;
- Malignant catatonia: a severe form involving autonomic instability and fever;
- Periodic catatonia: involving episodic or cyclical symptom presentation.[6]
Although catatonia was historically classified as a subtype of schizophrenia (catatonic schizophrenia), it is now more frequently associated with mood disorders.[3] Catatonic features are considered nonspecific and may also occur in a variety of other psychiatric, neurological, or general medical conditions.
- ^ a b c Balaguer AP, Rivero IS (22 December 2021). "Electroconvulsive therapy, catatonia, deep vein thrombosis and anticoagulant treatment: a case report". General Psychiatry. 34 (6): e100666. doi:10.1136/gpsych-2021-100666. ISSN 2517-729X. PMC 8705197. PMID 35028525.
- ^ Fink M, Taylor MA (1 November 2009). "The Catatonia Syndrome: Forgotten but Not Gone". Archives of General Psychiatry. 66 (11): 1173–7. doi:10.1001/archgenpsychiatry.2009.141. PMID 19884605.
- ^ a b c Burrow JP, Spurling BC, Marwaha R (2022). "Catatonia". StatPearls. StatPearls Publishing. PMID 28613592.
- ^ Cite error: The named reference
Heckers 2023was invoked but never defined (see the help page). - ^ Edinoff AN, Kaufman SE, Hollier JW, Virgen CG, Karam CA, Malone GW, Cornett EM, Kaye AM, Kaye AD (8 November 2021). "Catatonia: Clinical Overview of the Diagnosis, Treatment, and Clinical Challenges". Neurology International. 13 (4): 570–586. doi:10.3390/neurolint13040057. ISSN 2035-8385. PMC 8628989. PMID 34842777.
- ^ "Catatonia treatment and prognosis". UpToDate. Retrieved 22 November 2024.