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Catatonia: Diagnosis, Classification, and Treatment

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Abstract

Catatonia is a distinct neuropsychiatric syndrome that is becoming more recognized clinically and in ongoing research. It occurs with psychiatric, metabolic, or neurologic conditions. It may occur in many forms, including neuroleptic malignant syndrome. Treatment with benzodiazepines or electroconvulsive therapy leads to a dramatic and rapid response, although systematic, randomized trials are lacking. An important unresolved question is the role of antipsychotic agents in treatment and their potential adverse effects.

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References

Papers of particular interest, published recently, have been highlighted as: ••Of major importance

  1. Kahlbaum KL: Catatonia. Translated by Levi Y, Pridon T. Baltimore, MD: Johns Hopkins University Press; 1973.

  2. Rosebush PL, Hildebrand AM, Furlong BG, Mazurek MF: Catatonic syndrome in a general psychiatric inpatient population: frequency, clinical presentation, and response to lorazepam. J Clin Psychiatry 1990, 51:357–362.

    CAS  PubMed  Google Scholar 

  3. Francis A: Update on catatonia. Psychiatr Times 2006, 23:23–24.

    Google Scholar 

  4. Benegal V, Hingorani S, Khanna S: Idiopathic catatonia: validity of the concept. Psychopathology 1993, 26:41–46.

    Article  CAS  PubMed  Google Scholar 

  5. Taylor MA, Fink M: Catatonia in psychiatric classification: a home of its own. Am J Psychiatry 2003, 160:1233–1241.

    Article  PubMed  Google Scholar 

  6. Koch M, Chandragiri S, Rizvi S, et al.: Catatonic signs in neuroleptic malignant syndrome. Compr Psychiatry 2000, 41:73–75.

    Article  CAS  PubMed  Google Scholar 

  7. Francis A, Chandragiri S, Rizvi S, et al.: Is lorazepam a treatment for neuroleptic malignant syndrome? CNS Spectr 2000, 5:54–57.

    CAS  PubMed  Google Scholar 

  8. Khaldarov V: Benzodiazepines as a treatment for neuroleptic malignant syndrome. Hosp Physician 2000, 6:51–55.

    Google Scholar 

  9. Petrides G, Malur C, Fink M: Convulsive therapy. In Catatonia: From Psychopathology to Neurobiology. Edited by Caroff SN, Mann SC, Francis A, Fricchione GL. Washington, DC: American Psychiatric Press; 2004:151–160.

  10. Sachdev PS: A rating scale for neuroleptic malignant syndrome. Psychiatry Res 2005, 135:249–256.

    Article  PubMed  Google Scholar 

  11. Yacoub A, Francis A: Neuroleptic malignant syndrome induced by atypical neuroleptics and responsive to lorazepam. Neuropsychiatr Dis Treat 2006, 2:235–240.

    Article  CAS  PubMed  Google Scholar 

  12. Bush G, Petrides G, Francis A: Catatonia and other motor syndromes in a chronically hospitalized psychiatric population. Schizophr Res 1997, 27:83–92.

    Article  CAS  PubMed  Google Scholar 

  13. Starkstein SE, Petracca G, Teson A, et al.: Catatonia in depression: prevalence, clinical correlates, and validation of a scale. J Neurol Neurosurg Psychiatry 1996, 60:326–332.

    Article  CAS  PubMed  Google Scholar 

  14. Bush G, Fink M, Petrides G, et al.: Catatonia I: rating scale and standardized examination. Acta Psychiatr Scand 1996, 93:129–136.

    Article  CAS  PubMed  Google Scholar 

  15. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 4. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  16. Bush G, Fink M, Petrides G, et al.: Catatonia II: treatment with lorazepam and electroconvulsive therapy. Acta Psychiatr Scand 1996, 93:137–143.

    Article  CAS  PubMed  Google Scholar 

  17. Lee JWY, Schwartz DI, Hallmayer J: Catatonia in a psychiatric intensive care facility: incidence and response to benzodiazepines. Ann Clin Psychiatry 2000, 12:89–96.

    CAS  PubMed  Google Scholar 

  18. Northoff G, Koch A, Wenke A, et al.: Catatonia as a psychmotor syndrome: a rating scale and extrapyramidal motor symptoms. Mov Disord 1999, 14:404–416.

    Article  CAS  PubMed  Google Scholar 

  19. Bräunig P, Kruger S, Shugar G, et al.: The catatonia rating scale—development, reliability, and use. Compr Psychiatry 2000, 41:147–158.

    Article  PubMed  Google Scholar 

  20. Cohen D: Towards a valid nosography and psychopathology of catatonia in children and adolescents. Int Rev Neurobiol 2006, 72:131–147.

    Article  PubMed  Google Scholar 

  21. Cohen D, Flament M, Dubos PF, Basquin M: Case series: catatonic syndrome in young people. J Am Acad Child Adolesc Psychiatry 1999, 38:1040–1046.

    Article  CAS  PubMed  Google Scholar 

  22. Dhossche D, Wing, L, Ohta M, Jurge-Neumarker K: Catatonia in Autism Spectrum Disorders. San Diego, CA: Academic Press; 2006.

    Google Scholar 

  23. Kakooza-Mwesige A, Wachtel LE, Dhossche DM: Catatonia in autism: implications across the life span. Eur Child Adolesc Psychiatry 2008, 17:327–335.

    Article  PubMed  Google Scholar 

  24. Esmaili T, Malek A: Electroconvulsive therapy (ECT) in a six-year-old girl suffering from major depressive disorder with catatonic features. Eur Child Adolesc Psychiatry 2007, 16:58–60.

    Article  PubMed  Google Scholar 

  25. Zarr ML, Nowak T: Catatonia and burns. Burns 1990, 16:133–134.

    Article  CAS  PubMed  Google Scholar 

  26. Carroll BT, Kennedy JC, Goforth HW: Catatonic signs in medical and psychiatric catatonias. CNS Spectr 2000, 5:66–69.

    CAS  PubMed  Google Scholar 

  27. Cottencin O, Warembourg F, de Chouly de Lenclave M, et al.: Catatonia and consultation-liaison psychiatry study of 12 cases. Prog Neuropsychopharmacol Biol Psychiatry 2007, 31:1170–1176.

    Google Scholar 

  28. Francis A, Lopez-Canino A: Delirium with catatonic features—a new subtype? Psychiatr Times 2009, 26:15–18.

    Google Scholar 

  29. Taylor MA: Catatonia: a review of a behavioral neurologic syndrome. Neuropsychiatry Neuropsychol Behav Neurol 1990, 3:48–72.

    Google Scholar 

  30. Barnes MP, Saunders M, Walls TJ, et al.: The syndrome of Karl Ludwig Kahlbaum. J Neurol Neurosurg Psychiatry 1986, 49:991–996.

    Article  CAS  PubMed  Google Scholar 

  31. Stöber G: Genetics. In Catatonia: From Psychopathology to Neurobiology. Edited by Caroff SN, Mann SC, Francis A, Fricchione GL. Washington, DC: American Psychiatric Press; 2004:173–188.

  32. Northoff G: Neuroimaging and neurophysiology. In Catatonia: From Psychopathology to Neurobiology. Edited by Caroff SN, Mann SC, Francis A, Fricchione GL. Washington, DC: American Psychiatric Press; 2004:77–92.

  33. Carroll BT: The universal field hypothesis of catatonia and neuroleptic malignant syndrome. CNS Spectr 2000, 5:26–33.

    CAS  PubMed  Google Scholar 

  34. McCall WV, Shelp FE, McDonald WM: Controlled investigation of the amobarbital interview for catatonic mutism. Am J Psychiatry 1992, 149:202–206. (Published erratum appears in Am J Psychiatry 1992, 149:720.)

    Google Scholar 

  35. Rosebush P, Mazurek M. Pharmacotherapy. In Catatonia: From Psychopathology to Neurobiology. Edited by Caroff SN, Mann SC, Francis A, Fricchione GL. Washington, DC: American Psychiatric Press; 2004:141–150.

  36. Wetzel H, Heuser I, Benkert O: Stupor and affective state: alleviation of psychomotor disturbances by lorazepam and recurrence of symptoms after Ro 15-1788. J Nerv Ment Dis 1987, 175:240–242.

    Article  CAS  PubMed  Google Scholar 

  37. Ungvari GS, Chiu HF, Chow LY, et al.: Lorazepam for chronic catatonia: a randomized double-blind, placebo-controlled cross-over study. Psychopharmacology (Berl) 1999, 142:393–398.

    Article  CAS  Google Scholar 

  38. •• Thomas P, Cottencin O, Rascle C, et al.: Catatonia in French psychiatry: implications of the zolpidem challenge test. Psychiatr Ann 2007, 37:45–54. This was an update on an important new treatment for catatonia, zolpidem.

  39. Carroll, BT, Goforth HW, Thomas C, et al.: Review of adjunctive glutamate antagonist therapy in the treatment of catatonia syndromes. J Neuropsychiatry Clin Neurosci 2007, 19:406–412.

    Google Scholar 

  40. Petrides G, Divadeenam K, Bush G, Francis A: Synergism of lorazepam and ECT in the treatment of catatonia. Biol Psychiatry 1997, 42:375–381.

    Article  CAS  PubMed  Google Scholar 

  41. Hawkins JM, Archer KJ, Strakowski SM, Keck PE: Somatic treatment of catatonia. Int J Psychiatry Med 1995, 25:354–369.

    Google Scholar 

  42. White DA, Robins AH: An analysis of 17 catatonic patients diagnosed with neuroleptic malignant syndrome. CNS Spectr 2000, 5:58–65.

    CAS  PubMed  Google Scholar 

  43. Van Den Eede F, Van Hecke J, Van Dalfsen A, et al.: The use of atypical antipsychotics in the treatment of catatonia. Eur Psychiatry 2005, 20:422–429.

    Article  Google Scholar 

  44. Martenyi F, Metcalfe S, Schausberer B, Dossenbach MR: An efficacy analysis of olanzapine treatment data in schizophrenia patients with catatonic signs and symptoms. J Clin Psychiatry 2001, 62(Suppl 2):25–27.

    CAS  PubMed  Google Scholar 

  45. Girish K, Gill NS: Electro convulsive therapy in lorazepam non-responsive catatonia. Indian J Psychiatry 2003, 45:21–25.

    Google Scholar 

  46. Mann SC, Caroff SN, Fricchione GL, et al.: Malignant catatonia. In Catatonia: From Psychopathology to Neurobiology. Edited by Caroff SN, Mann SC, Francis A, Fricchione GL. Washington, DC: American Psychiatric Press; 2004:105–120.

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  1. Department of Psychiatry, Health Sciences Center T-10, SUNY Stony Brook, Stony Brook, NY, 11794-8101, USA

    Andrew Francis

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Correspondence to Andrew Francis.

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Francis, A. Catatonia: Diagnosis, Classification, and Treatment. Curr Psychiatry Rep 12, 180–185 (2010). https://doi.org/10.1007/s11920-010-0113-y

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