An overview of Catatonia
Catatonia is a severe motor syndrome with an estimated prevalence among psychiatric inpatients of about 10%. Catatonia can accompany many psychiatric illnesses and somatic diseases. A minority of catatonic patients suffer from schizophrenia, while a majority has a bipolar disorder. They have also linked catatonia to other psychiatric disorders, such as obsessive-compulsive disorder, post-traumatic stress disorder, or withdrawal from alcohol or benzodiazepines. In up to 25% of cases, they relate catatonia with general medical or neurologic conditions. Recent studies show repeatedly that catatonic symptoms are observable in most patients diagnosed with anti-N-methyl-d-aspartate receptor encephalitis. In adolescents and young adults with autism, we find catatonia in 12–17%. Pediatric catatonia also emerges in patients with tic disorders, and a variety of other (developmental) disorders. The same principles of evaluation and treatment seem to apply to pediatric patients as in adult patients.
A life-threatening situation occurs when catatonia manifests with fever and autonomic abnormalities. Malignant catatonia, as Stauder in 1934 coined “lethal catatonia”, presents as a constellation of catatonia, stuporous exhaustion, autonomic instability, respiratory failure, collapse, coma, and often death if left untreated. This clinical picture is remarkably close to what we observe in neuroleptic malignant syndrome, which several experts consider a drug-induced form of catatonia.
- Sienaert P, Dhossche DM, Vancampfort D, De Hert M, Gazdag G. A clinical review of the treatment of catatonia. Front Psychiatry. 2014 Dec 9;5:181. doi: 10.3389/fpsyt.2014.00181. PMID: 25538636; PMCID: PMC4260674