Catatonia in inpatients with psychiatric disorders: A comparison of schizophrenia and mood disorders

Grover, Sandeep; Chakrabarti, Subho; Ghormode, Deepak; Agarwal, Mayank Mohan; Sharma, Akhilesh; Avasthi, Ajit

doi:10.1016/j.psychres.2015.07.020

Cited by 46 publications

(35 citation statements)

References 17 publications

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“…Inhibition and Excitement have been the most replicated factors. 16 However, as mentioned by previous authors, a two-factor analysis may only cover motor symptoms of catatonia and this may be insufficient to characterize the full complexity of the catatonia syndrome including its psychic ones. 11 As in previous studies, 37,39 this study also found a parakinetic factor although it did not comprise the same items.…”

Section: Discussionmentioning

confidence: 99%

“…12 Differences in the symptom profile of catatonia in patients with psychotic disorders and affective disorders has been a subject of debate with controversial results throughout history. 15,16 As catatonia presents with a wide range of signs, several studies have used factor analysis in order to identify its different clinical dimensions and to distinguish clinical presentations in affective and psychotic disorders. 17 Up to seven dimensions of catatonia have been described so far, being inhibition and excitement the most replicated findings, and 4.1 the mean number of reported factors.…”

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confidence: 99%

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Catatonia in elderly psychiatric inpatients is not always associated with intense anxiety: Factor analysis and correlation with psychopathology

Cuevas‐Esteban

Iglesias-González

Serra-Mestres

et al. 2020

Int J Geriat Psychiatry

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Objective: Catatonic stupor has been linked to extreme fear. Whether the underlying phenomenology of every catatonic dimension is intense anxiety or fear remains unknown. Methods: One hundred and six patients aged ≥64 years were assessed for catatonia and clinical variables during the first 24 hours of admission. Two-sample t test were used to test for group differences. A principal component analysis was developed. Analysis of variance was performed to assess for differences in the diagnostic groups. Correlation coefficients were used to examine the association between catatonic dimensions and psychopathological variables. Results: There were statistically significant differences between catatonic and noncatatonic patients in the Hamilton and NPI scores. The three factor-model accounted for 52.23% of the variance. Factor 1 loaded on items concerned with "excitement," factor 2 on "inhibition" items, and factor 3 on "parakinetic" items. There was a significant effect for factor 1 (F [5.36] = 2.83, P = .02), and not significant for factor 2 and factor 3. Compared with patients with depression, patients with mania scored significantly higher on factor "excitement" (P < .05). Factor 2 showed a moderate correlation with Hamilton total score (r = .346, P = .031) and Hamilton psychic score (r = .380, P = .017). Conclusions: Catatonic patients experienced more anxiety and hyperactivity. A three-factor solution provided best fit for catatonic symptoms. Patients with mania scored highest on Excitement, patients with depression on Inhibition, and patients with schizophrenia on Parakinetic. The main finding in this study was a positive moderate correlation between the Hamilton psychic score and the Inhibition factor score, meaning that not every catatonic dimension is associated to intense anxiety.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Catatonia in elderly psychiatric inpatients is not always associated with intense anxiety: Factor analysis and correlation with psychopathology

Cuevas‐Esteban

Iglesias-González

Serra-Mestres

et al. 2020

Int J Geriat Psychiatry

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“…This finding reinforces the importance of establishing whether people are smokers and considering whether some agitation might be due to nicotine withdrawal. Catatonia is a rare condition that can occur in both schizophrenia and mood disorders (Grover et al, 2015). While retarded catatonia is more common, excited catatonia may occasionally present as an acute behavioural disturbance.…”

Section: The Management Of Acute Behavioural Disturbance In Schizophrmentioning

confidence: 99%

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Galletly

Castle

Dark

et al. 2016

Aust N Z J Psychiatry

641

672

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Objectives: This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function. Methods:The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international clinical practice guidelines. Evidence-based recommendations were formulated when the writing group judged that there was sufficient evidence on a topic. Where evidence was weak or lacking, consensus-based recommendations were formulated. Consensus-based recommendations are based on the consensus of a group of experts in the field and are informed by their agreement as a group, according to their collective clinical and research knowledge and experience. Key considerations were selected and reviewed by the writing group. To encourage wide community participation, the Royal Australian and New Zealand College of Psychiatrists invited review by its committees and members, an expert advisory committee and key stakeholders including professional bodies and special interest groups. RANZCP GuidelinesGalletly et al. 411 Australian & New Zealand Journal of Psychiatry, 50(5)Results: The clinical practice guideline for the management of schizophrenia and related disorders reflects an increasing emphasis on early intervention, physical health, psychosocial treatments, cultural considerations and improving vocational outcomes. The guideline uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care. This guideline also refers its readers to selected published guidelines or statements directly relevant to Australian and New Zealand practice. Conclusions:This clinical practice guideline for the management of schizophrenia and related disorders aims to improve care for people with these disorders living in Australia and New Zealand. It advocates a respectful, collaborative approach; optimal evidence-based treatment; and consideration of the specific needs of those in adverse circumstances or facing additional challenges.

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“…Bezüglich der Pharmakokinetik zeigt Aripiprazol ein rasches Erreichen des Spitzenplasmaspiegels innerhalb von 2 bis 3 Stunden bei intramuskulärer Gabe und Introduction About 10 % of patients with schizophrenia or mood disorders present with at least three symptoms on the Bush Francis Catatonia Rating Scale (BFCRS) which is sufficient for a diagnosis of catatonia. The prevalence of catatonic symptoms does not appear to differ between subjects with schizophrenia and mood disorders [1].…”

Section: Zusammenfassungmentioning

confidence: 85%

Rapid efficacy of aripiprazole in the treatment of catatonic depression/catatonia with consideration of the drug’s unique receptor profile: a case report

Sichert

Volz

2020

Fortschr Neurol Psychiatr

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Catatonia is a widespread problem in psychiatric hospitals as approximately 10% of patients present with catatonic symptoms upon admission. Catatonia carries the risk of severe, even fatal complications. The first line treatment is usually electroconvulsive therapy (ECT) or benzodiazepines, but ECT may not be readily available and benzodiazepines may not always be effective. We describe the case of a patient presenting with severe symptoms of catatonic depression who completed a 3-day course of 25 mg aripiprazole that rapidly resolved his catatonic symptoms. Several cases have already been reported where administration of aripiprazole successfully resolved catatonic symptoms after other treatment options had failed. Aripiprazole’s efficacy and advantages may lie in its unique receptor profile. It acts as a dopamine D2 receptor (D2 R) antagonist and partial D2 R agonist depending on the precise cellular milieu, which may explain its efficacy and favourable side effect profile compared to other antipsychotics used to treat catatonia. Aripiprazole also partially agonises D3 receptors and serotonin 2 C receptors (5-HT2 C), which may contribute to its antidepressant properties. Aripiprazole enhances gamma-aminobutyric acid (GABA) transmission in certain brain areas, and it is widely agreed that low GABA activity may contribute to catatonic symptoms. Pharmacokinetics studies show that peak plasma levels are reached rapidly, within 2–3 hours of intramuscular administration and 4–6 hours of oral administration. Administration of high-dose aripiprazole (>25 mg/day) should be considered as a viable alternative to ECT and benzodiazepines in patients presenting with catatonic symptoms. Aripiprazole also carries a much lower risk of complications compared to other antipsychotics.

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Catatonia in inpatients with psychiatric disorders: A comparison of schizophrenia and mood disorders

Cited by 46 publications

References 17 publications

Catatonia in elderly psychiatric inpatients is not always associated with intense anxiety: Factor analysis and correlation with psychopathology

Catatonia in elderly psychiatric inpatients is not always associated with intense anxiety: Factor analysis and correlation with psychopathology

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Rapid efficacy of aripiprazole in the treatment of catatonic depression/catatonia with consideration of the drug’s unique receptor profile: a case report

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