Electroconvulsive therapy use in the adult U.S. correctional setting: A case report and literature review

Abstract

A higher prevalence of mental illness in inmates is also shown when looking at specific psychiatric disorders. For example, major depressive disorder ranged between 9 and 31% compared to 7% of the general population; bipolar disorder ranged between 6 and 25% among inmates compared to 2.8% in the general population; and schizophrenia spectrum and other psychotic disorders ranged between 2 and 12% versus an estimated prevalence between 0.25 and 0.64% in the general population (1,3,4,5,6).Catatonia is a severe motor disturbance associated with these primary psychotic disorders and mood disorders, which is also associated with other medical or neurological etiologies. According to the DSM-V, at least three of the following symptoms must be present for a diagnosis of catatonia: stupor (no psychomotor activity, no reactivity to the environment), cataplexy (passive induction of postures held against gravity), waxy flexibility (slight and even resistance to repositioning by the examiner), mutism (no verbal response), negativism (not responding to external stimuli), posturing (spontaneous and active maintenance of posture against gravity), mannerism (odd caricatures of ordinary actions), stereotypy (repetitive, frequent, non-goal directed movement), agitation (not influenced by external stimuli), grimacing, echolalia (repeating the words spoken by the examiner), and echopraxia (mimicking of movements made by the examiner) (7,8) There are three subtypes of catatonia: stuporous, excited, and malignant catatonia (9). Symptoms of stuporous catatonia include rigidity and "freezing" in place, mutism, inability to eat or drink, posturing, grimacing, and waxy flexibility. Excited catatonia is associated with purposeless and repetitive motor activity. Malignant