Let's be clear about these fundamental concepts about catatonia

This article was first published on May 23, 2023. It was last reviewed/ updated on May 23, 2023.

Catatonia is a clinical condition about which there can be some misconceptions. In this article, we’ll go over Let’s clarify some of them in this article.

1. Catatonia is NOT a diagnosis as such. It is a clinical syndrome that can be found in many different diagnoses.

2. Catatonia is not necessarily a psychiatric condition. It can be found in BOTH psychiatric AND non-psychiatric disorders.

3. Also, among psychiatric disorders in which catatonia can be present, it is a misconception that catatonia is found only in schizophrenia.

Catatonia can also be present in other psychiatric disorders including bipolar disorders, depressive disorders, and autism spectrum disorder (Vaquerizo-Serrano et al., 2021; Ghaziuddin et al., 2021).

4. The clinical syndrome of catatonia does not consist of symptoms that are reported by the patient.

Instead, it consists of signs that are either observed or elicited by us (Rogers et al., 2023).

5. There are many different clinical signs that can be present in catatonia. More than 50 such clinical signs that can be present in catatonia have been described (Sienaert et al., 2011).

6. Different patients may present with different sets of clinical signs even if all of them have catatonia.

Catatonia: General

Let’s be clear about these fundamental concepts about catatonia

Catatonia: Evaluation and Diagnosis

How to carry out the Lorazepam Challenge Test in catatonia

Is brain imaging useful in catatonia?

Catatonia: Management

Lorazepam for catatonia: How much? How long?

Which antipsychotics should be preferred for catatonia?

How to use ECT for catatonia

Getting authorization from a court for a patient’s medical guardian to be able to consent for ECT

References

Ghaziuddin N, Andersen L, Ghaziuddin M. Catatonia in Patients with Autism Spectrum Disorder. Psychiatr Clin North Am. 2021 Mar;44(1):11-22. doi: 10.1016/j.psc.2020.11.002. PMID: 33526232.

Rogers JP, Oldham MA, Fricchione G, Northoff G, Ellen Wilson J, Mann SC, Francis A, Wieck A, Elizabeth Wachtel L, Lewis G, Grover S, Hirjak D, Ahuja N, Zandi MS, Young AH, Fone K, Andrews S, Kessler D, Saifee T, Gee S, Baldwin DS, David AS. Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2023 Apr;37(4):327-369. doi: 10.1177/02698811231158232. Epub 2023 Apr 11. PMID: 37039129; PMCID: PMC10101189.

Sienaert P, Rooseleer J, De Fruyt J. Measuring catatonia: a systematic review of rating scales. J Affect Disord. 2011 Dec;135(1-3):1-9. doi: 10.1016/j.jad.2011.02.012. Epub 2011 Mar 21. PMID: 21420736.

Vaquerizo-Serrano J, Salazar De Pablo G, Singh J, Santosh P. Catatonia in autism spectrum disorders: A systematic review and meta-analysis. Eur Psychiatry. 2021 Dec 15;65(1):e4. doi: 10.1192/j.eurpsy.2021.2259. PMID: 34906264; PMCID: PMC8792870.

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