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Catatonia in Psychiatric Illnesses

  • Chapter
The Medical Basis of Psychiatry

Abstract

Increased interest in the demarcation of catatonia from other conditions such as schizophrenia and autism is shown in the new DSM-5 category Catatonia Not Elsewhere Classified (NEC) encompassing catatonia of uncertain origin or associated with developmental conditions. Catatonia NEC is an imminently relevant diagnosis in patients who meet criteria for catatonia but without clearly defined associated psychotic, affective, or medical disorders. Catatonia NEC should be considered when catatonic symptoms present in patients with autism spectrum disorders, developmental disorders such as Prader-Willi Syndrome and Down Syndrome, tic disorders and Tourette Syndrome, Kleine-Levin Syndrome, aseptic encephalitis such as Anti-N-methyl-D-aspartate Receptor encephalitis, Pervasive Refusal Syndrome, or complex posttraumatic conditions.

Current experiences continue to support the use of benzodiazepines and ECT in catatonia as safe and effective treatments without the risk of worsening catatonia or precipitating Neuroleptic Malignant Syndrome as opposed to when antipsychotic medications are used as first-line or sole treatment

Historical and contemporary clinical and experimental catatonia models are available for future research, focusing on motor circuitry dysfunction, abnormal neurotransmitters, epileptic discharges, genetics, neuroendocrine and immune abnormalities, fear reactions akin to the animal defense strategy of tonic immobility, and developmental risk factors.

There have been advances in demarcating catatonia in a wide variety of patients as a treatable condition that requires prompt identification. Catatonia NEC in DSM-5 is likely to improve proper diagnosis and treatment of catatonia and to intensify research of this condition.

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Acknowledgement

The authors thank Edward Shorter, Professor in the History of Medicine and Professor of Psychiatry, University of Toronto, for lending a copy of Oswald Bumke’s 1924 textbook (155).

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Authors and Affiliations

  1. Department of Psychiatry, University of Mississippi Medical Center, Jackson, MS, USA

    Dirk M. Dhossche M.D., Ph.D. (Professor)

  2. Department of Psychiatry, Johns Hopkins University, School of Medicine, Baltimore, MD, USA

    Lee Elizabeth Wachtel M.D. (Associate Professor Medical Director)

  3. Neurobehavioral Unit, Kennedy Krieger Institute, Baltimore, MD, USA

    Lee Elizabeth Wachtel M.D. (Associate Professor Medical Director)

  4. Department of Child Psychiatry, University Hospital Motol, Charles University, Prague, Czech Republic

    Michal Goetz M.D., Ph.D. (Assistant Professor)

  5. Department of Psychiatry, University Psychiatric Center – Catholic University of Leuven, campus Kortenberg, Kortenberg, Belgium

    Pascal Sienaert M.D., Ph.D. (Assistant Professor)

Authors
  1. Dirk M. Dhossche M.D., Ph.D.
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  2. Lee Elizabeth Wachtel M.D.
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  3. Michal Goetz M.D., Ph.D.
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  4. Pascal Sienaert M.D., Ph.D.
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Corresponding author

Correspondence to Dirk M. Dhossche M.D., Ph.D. .

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Editors and Affiliations

  1. University of Minnesota School of Medicine, Minneapolis, Minnesota, USA

    S. Hossein Fatemi

  2. University of New Mexico School of Medicine Pasadena, University of Minnesota School of Medicine, California, California, USA

    Paula J. Clayton

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Dhossche, D.M., Wachtel, L.E., Goetz, M., Sienaert, P. (2016). Catatonia in Psychiatric Illnesses. In: Fatemi, S., Clayton, P. (eds) The Medical Basis of Psychiatry. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2528-5_27

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