Catatonia as an internal medicine disease: infrequent or still underdiagnosed?

Proença, Margarida; Marquês, Filipa; Cardoso, Débora Morais; Fonseca, Cândida

doi:10.1136/bcr-2015-214233

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…Associated endocrine disorders are hyperparathyroidism[ 102 , 103 ], hypothyroidism[ 93 , 95 ], subclinical Cushing’s syndrome[ 104 ], and hyperthyroidism due to Grave's disease[ 105 ]. Finally, pertaining to nutritional and neoplastic etiologies, only one case of cyanocobalamin deficiency[ 106 ] and another of a colon tumor have been described[ 15 ]. Most of these patients had a psychiatric history and developed catatonia secondary to a GMC or in association with drug withdrawal.…”

Section: Resultsmentioning

confidence: 99%

“…Most of these patients had a psychiatric history and developed catatonia secondary to a GMC or in association with drug withdrawal. None of these cases presented with acute psychopathology, with the exception of 4 cases that showed affective and/or psychotic symptoms secondary to the primary metabolic[ 93 ] and endocrine disorders[ 103 , 105 , 106 ].…”

Section: Resultsmentioning

confidence: 99%

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Catatonia in older adults: A systematic review

Jaimes-Albornoz¹,

Pellon-Santamaria²,

Nizama-Vía³

et al. 2022

WJP

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BACKGROUND Catatonia is a complex psychomotor syndrome that often goes unrecognized and untreated, even though its classification has evolved in recent years. Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications. The underrecognition of catatonia in older patients is also frequent, and research in this population is scarce. AIM To conduct a systematic review of the literature on catatonia in older people to ascertain its clinical characteristics across settings. METHODS Following the PRISMA guidelines, MEDLINE, EMBASE, and PsycINFO databases were searched from inception to December 2021, with a strategy aimed at identifying all articles published on catatonia in older adults. Titles and abstracts were scanned and selected independently by two authors. Papers investigating issues related to catatonia and/or catatonic symptoms in older people, with English abstracts available, were included. References of selected articles were revised to identify other relevant studies. RESULTS In total, 1355 articles were retrieved. After removing duplicates, 879 remained. Of the 879 identified abstracts, 669 were excluded because they did not meet the inclusion criteria. A total of 210 articles underwent full text review, and 51 were eliminated for various reasons. Fourteen more articles were selected from the references. Overall, 173 articles were reviewed: 108 case reports, 35 case series, 11 prospective cohort studies, 6 case-control studies, 3 retrospective cohort studies and 10 reviews. We found several particular aspects of catatonia in this population. Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology. Older patients, compared to younger patients, have a higher risk of developing catatonia with benzodiazepine (BZD) withdrawal, in bipolar disorder, and in the general hospital. Age, together with other risk factors, was significantly associated with the incidence of deep venous thrombosis, neuroleptic malignant syndrome poor outcome, other complications and mortality. Treatment with BZDs and electroconvulsive therapy is safe and effective. Prompt treatment of its cause is essential to ensure a good prognosis. CONCLUSION Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology. The risk of developing catatonia in some settings and conditions, as well as of developing complications, is high in this population. Symptomatic treatment is safe and effective, and timely etiologic treatment is fundamental.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Catatonia in older adults: A systematic review

Jaimes-Albornoz¹,

Pellon-Santamaria²,

Nizama-Vía³

et al. 2022

WJP

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show abstract

“…However, catatonia tends to be under diagnosed, 1 especially when presenting in the setting of medical disease or acuity. [2][3][4] Both underlying psychiatric and medical conditions can cause catatonia. In 1874, Kahlbaum described catatonia as a syndrome that follows affective derangements.…”

Section: Introductionmentioning

confidence: 99%

Catatonia in the medically ill: Differences and parallels in etiology, phenomenology and management

Forcén

Respino

Eloge

et al. 2021

Int J Psychiatry Med

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Objective Catatonia is a disorder characterized by psychomotor symptoms. The etiology, symptomatology, response and outcome of catatonia in the medically ill has not been vigorously studied. Those who have catatonia associated with another mental disorder versus. catatonic disorder due to another medical condition may differ. The aim of this study is to study the causes, phenomenology and outcomes of medically ill patients with catatonia and explore differences among those who have catatonia associated with psychiatric illness vs. systemic medical illness. Method We studied the incidence of catatonic symptoms in medically hospitalized patients to identify any apparent differences in clinical manifestations due to distinctive etiologies. Specifically, we assessed if there are differences between those who had catatonia associated with another mental disorder versus those with catatonic disorder due to another medical condition in their phenomenology, management and likelihood of response to treatment. Results Of our 40 patients, 18 patients (45%) had catatonia associated with another mental disorder, 17 (42.5%) had catatonic disorder due to another medical condition, and in 5 patients (12.5%) the cause of catatonia was not identified. The most common catatonic symptoms regardless of etiology in our medically ill were mutism, followed by rigidity, and immobility. Bipolar disorder, schizophrenia, major depressive disorder, metabolic abnormalities, anti NMDAR encephalitis were the most frequent causes of catatonia in our medically ill patients. Compared to subjects with catatonic disorder due to another medical condition, those with catatonia associated with another mental disorder had more frequent mannerisms (Chi-square = 4.27; p = 0.039), waxy flexibility (Chi-square = 11.0; p < 0.01), and impulsivity (Chi-square = 4.12, p = 0.042). Nonsignificant trends were noted for posturing (Chi-square = 3.74, p = 0.053), perseveration (Chi-square = 3.37, p = 0.067), and stereotypy (Chi-square = 2.91, p = 0.088) also being more frequent in catatonia associated with a psychiatric cause. Discussion Our data supports phenomenological differences between medical and psychiatric causes of catatonia in the medically ill.

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“…In view of infectious cause for catatonia, the pathogenesis is thought to be due to either a direct toxic effect of pathogen or an immune response [1,4]. Despite that Coronavirus disease 2019 (COVID-19) known to cause severe acute respiratory symptoms, surprisingly, there have been reports of neurologic symptoms [5]. By the way, the presence of catatonia denotes the severity of the underlying illness [6].…”

Section: Introductionmentioning

confidence: 99%

“…The syndrome is grouped under three forms of presentation: retarded (characterised by mutism, rigidity,immobility, negativism, catalepsy, posturing and echophenomena), excited (with restlessness, impulsivity and aggressively presenting as the main symptoms) and malignant catatonia, a life-threatening form of which fever and autonomic instability are the warning signs [5,9].…”

Section: Introductionmentioning

confidence: 99%