Nosological Dilemma and Clinical Polymorphism of the Catatonia Phenomenon

Abstract

Objective: to provide the description of researchers’ views evolution and provide the review of modern scientific literature on nosological affiliation and clinical features of catatonia. Material and methods: Scopus, PubMed, Cochrane Library, eLIBRARY databases were searched for literature (44 000 papers) using the keyword ‘catatonia‘. Based on the selection criteria, the search has been found the clinical cases, cohort and random studies, dedicated to psychopathologic description of catatonia, accompanied by affective disorders, autism and hysteria. 50 papers issued between 2000 and 2020 were selected for the analysis. Conclusions: catatonia, traditionally treated as a symptom of schizophrenia, currently is predominantly interpreted as a “transnosological syndrome”, which accompanies various (both mental and somatic) diseases. The clinical manifestations of catatonia in affective disorders, autism and hysteria have their own distinctive features, also the presence of catatonic symptoms is associated with a greater severity of the underlying disease, low quality of remissions, which explains why the experts are wary of the endogenic factors.

Clinical Effectiveness of Lurasidone Monotherapy in Patients with Acute Episodes of Schizophrenia and Associated Symptoms of Depression

“…Figure 3 shows the results of a Kaplan-Meier survival analysis among patients treated with lurasidone at daily doses of 40–80 mg, 80–120 mg, and 120–160 mg, respectively. A dose range of 80–120 mg was associated with a statistically longer use of lurasidone compared to the dose ranges (i.e., 40–80 mg) (Restricted Mean Survival Time (RMST) Difference [95% CI]: 20 [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ] days, z=1.488, p =0.01) and 120–160 mg (mean [95% CI] difference: 8 [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ,…”

“…Difficulties in the differential diagnosis between affective disorders or negative symptoms are common in the presence of symptoms such as anhedonia, mental anesthesia, emotional indifference, loss of motivation, anergy, flat affect, social withdrawal, ideational retardation, and impoverished thinking [ 1 , 6 , 11 , 13 ]. Sometimes it is difficult to immediately distinguish between depression and catatonia [ 14 , 15 ]. Notably, severe depression might be associated with psychotic features, such as delusions, hallucinations, and conceptual disorganization [ 1 ].…”

“…Sometimes it is difficult to immediately distinguish between depression and catatonia [14,15]. Notably, an antipsychotic effect [27,28].…”

Treatment of Depression with Vortioxetine and Second Generation Antipsychotics During the Period of Remission Formation in Schizophrenia (Interim Data Analysis)

“…In particular, it is difficult to determine whether such symptoms as anhedonia, mental anesthesia, and emotional indifference, loss of motivation, anergy, flattened affect, social isolation, ideational retardation, and impoverishment of thinking denote depression or are negative manifestations of schizophrenia [1,15,16]. It is often difficult to distinguish between signs of depression and catatonia [17,18].…”