The Syndrome of Catatonia

Abstract

Catatonia is a psychomotor syndrome which has historically been associated with schizophrenia. Many clinicians have thought that the prevalence of this condition has been decreasing over the past few decades. This review reminds clinicians that catatonia is not exclusively associated with schizophrenia, and is still common in clinical practice. Many cases are related to affective disorders or are of an idiopathic nature. The illusion of reduced prevalence has been due to evolving diagnostic systems that failed to capture catatonic syndromes. This systemic error has remained unchallenged, and potentiated by the failure to perform adequate neurological evaluations and catatonia screening exams on psychiatric patients. We find that current data supports catatonic syndromes are still common, often severe and of modern clinical importance. Effective treatment is relatively easy and can greatly reduce organ failure associated with prolonged psychomotor symptoms. Prompt identification and treatment can produce a robust improvement in most cases. The ongoing prevalence of this syndrome requires that psychiatrists recognize catatonia and its presentations, the range of associated etiologies, and the import of timely treatment.

Lorazepam-Resistant Catatonia in an Antipsychotic-Naïve 24-Year-Old with Psychotic Symptoms

“…Catatonia is an identifiable, complex clinical syndrome characterized mainly by psychomotor symptoms and, in the majority of cases, demanding inpatient treatment to avoid life-threatening complications. It was first described by Karl Kahlbaum in 1874, with many other researchers and clinicians coming to the same observation since then [1][2][3]. Although for the better part of the 20 th century catatonia was thought to be a subtype of schizophrenia and subsequently classified as such (from DSM I to DSM IV and ICD10) [4,5], since a few decades ago, certain authors consider that catatonia is recognized to occur within a broad spectrum of psychiatric as well as medical illnesses.…”

“…Although for the better part of the 20 th century catatonia was thought to be a subtype of schizophrenia and subsequently classified as such (from DSM I to DSM IV and ICD10) [4,5], since a few decades ago, certain authors consider that catatonia is recognized to occur within a broad spectrum of psychiatric as well as medical illnesses. The most common psychiatric diagnoses that can be presented with a catatonic syndrome are bipolar disorder, unipolar depression, schizophrenia, and other psychotic disorders and autistic spectrum disorders [1][2][3][6][7][8].…”

“…In fact, two conceptions of catatonia arise in these last decades: one where a clinical characterization seems to play a determinant role (a categorical point of view, where the catatonic syndrome appears as an expression of a specific psychiatric or medical condition) and another one where a dimensional perspective takes an important place, advocating the existence of catatonia as a clinical entity of its own, completely detached from the underlying pathology. While the exact prevalence of the syndrome is unknown, some authors believe catatonia occurs in more than 10% of acute psychiatric inpatients [3,6]. Fink [1] estimates that catatonia can have a broad range of diverse features, thus adopting a dimensional perspective, and considers that catatonia presentation is often subtle, and that is probably the reason why it is likely underdiagnosed by psychiatrists and other physicians [13].…”

En mann i 30-årene med psykotiske symptomer blir komatøs

“…Fenomenet katatoni ble først beskrevet av den tyske psykiateren Kahlbaum i 1874 (4) og av Kraepelin og Bleuler senere knyttet til schizofreni (5). Katatoni omfatter et spekter av forstyrrede bevegelsesmønstre som rigiditet, manierte (tilgjorte, affekterte) bevegelser, stirring, negativisme og voksaktig motstand i muskulaturen ved passiv bevegelse (flexibilitas cerea) (6)(7)(8). I ICD-10 er katatoni fortsatt knyttet til en form for schizofreni, nemlig kataton schizofreni, mens det amerikanske diagnoseverket DSM-IV (Diagnostic and statistical manual, 4th edition) klassifiserer katatoni som en tilstand som kan opptre i forbindelse med schizofreni, alvorlig depressiv episode eller somatisk sykdom (9).…”

Sperm Quality in Rats Predisposed to the Manifestation of Catatonic Reactions

“…Линия крыс ГК может являться перспективной моделью для исследова ния взаимосвязи между наследственной предрасположенностью к кататонии и сперматогенезом. (Wilcox, Duffy, 2015). На сегодняшний день считается, что кататонические реакции характерны для аффективных расстройств, шизофрен-ных психозов и посттравматических состояний (Daniels, 2009).…”