Measuring catatonia motor behavior with objective instrumentation

Abstract

ObjectiveCatatonia is a neuropsychiatric syndrome, with important psychomotor features, associated with schizophrenia and other psychiatric disorders. The syndrome comprises multiple symptoms including abnormal motor control, behaviors, volition, and autonomic regulation. Catatonia assessment relies on clinical rating scales and clinicians familiar with the catatonia exam. However, objective instrumentation may aid the detection of catatonia. We aimed to investigate the relationship between movement parameters derived from actigraphy and expert ratings of catatonia symptoms measured by the Bush Francis Catatonia Rating Scale (BFCRS) and the Northoff Catatonia scale (NCS).MethodsEighty-six acutely ill inpatients with schizophrenia spectrum disorders were assessed with the BFCRS, the NCS, and 24 h continuous actigraphy. Non-wear and sleep periods were removed from the actigraphy data prior to analysis. Associations between total catatonia scores, derived from both BFCRS and NCS, and actigraphy parameters as well as between single BFCRS items and actigraphy parameters were calculated using Spearman's rank correlation and non-parametric ANCOVAs (Quade's ANCOVAs), respectively.ResultsBoth higher BFCRS total scores (r = 0.369, p = 0.006) and NCS total scores (r = 0.384, p = 0.004) were associated with lower activity levels (AL). Higher scores on single BFCRS items such as immobility/stupor or staring were linked to lower AL (immobility/stupor: F = 17.388, p < 0.001, η2 = 0.175; staring: F = 7.849, p = 0.001, η2 = 0.162) and lower metabolic equivalents of task (MET).ConclusionSpecific catatonia symptoms such as immobility/stupor and staring can be measured with actigraphy. This may aid the detection, staging, and monitoring of catatonia in clinical settings.

The Behavioral Mapping of Psychomotor Slowing in Psychosis Demonstrates Heterogeneity Among Patients Suggesting Distinct Pathobiology

“…Likewise, previous studies reported an association between activity levels and PS, 27 or catatonia and parkinsonism. 23,33,58 Furthermore, all motor measures assessing PS (except IPAQ) correlated with severity of catatonia and parkinsonism, which is in contrast to a prior report in which neither catatonia nor parkinsonism correlated with a single item measure of PS. 67 However, in line with other reports, PS was strongly associated with negative symptom severity.…”

“…These findings corroborate prior studies linking lower activity levels to slower processing speed, catatonia, parkinsonism, negative symptoms, and to deteriorating courses in schizophrenia spectrum disord ers. 23,25,27,[30][31][32][33][56][57][58] However, no prior study compared activity levels between psychosis patients with PS and patients without PS. The current report suggests that activity levels measured by actigraphy might be a good marker to identify PS.…”

Early-onset catatonia associated with SHANK3 mutations: looking at the autism spectrum through the prism of psychomotor phenomena

“…Then, from adolescence onwards, psychomotor signs may be neglected during phases of subacute manifestations and overshadowed by affective symptoms, prompting diagnoses of mood disorders. Finally, such manifestations may be difficult to perceive due to our fragmented knowledge of catatonia in terms of its definition and clinical description, which varies according to age, severity, and underlying mental disorder (77)(78)(79).…”

A case report of a patient with Turner syndrome who develops catatonia secondary to psychotic symptoms

“…We also enrolled patients with a score of 22 points on the Bush Francis Catatonia Rating Scale. [ 5 ] The patient was diagnosed as having the following conditions: unspecified catatonia; TS. In accordance with the 2021 UK Guidelines for Catatonia, [ 6 ] we prescribed esazolam injections (2 mg twice daily) to relieve the symptoms of catatonia.…”