A broad range of complications of catatonia can occur, such as aspiration pneumonia, dehydration, muscle contractures, pressure ulcers, nutritional deficiencies, severe weight loss, thiamine deficiency, electrolyte disturbances, urinary tract infections, and venous thromboembolism, some of which can lead to life-threatening situations. Some patients will require a high level of nursing care, and IV fluids and/or nasogastric tube feeds, in order to reduce the risk of morbidity and mortality caused by immobility, poor nutrition, and dehydration. Anticoagulant therapies can prevent deep vein thrombosis/pulmonary embolism in immobile patients. We should treat medical complications lege artist. Given the often dramatic and prompt improvement of motor immobility after treatment, the major measure in preventing complications is a prompt diagnosis and a rapid initiation of an adequate treatment of the catatonic state.

Steps of Clinical Assessment   Step 1: Listen to the patient carefully, establish rapport, and develop a therapeutic alliance. Step 2: Confirm the diagnosis by identifying the full spectrum of signs and symptoms of depression and anxiety, and confirm a lack of a history of mania . Also exclude organicity especially hyper/hypothyroidism, Cushing disease, brain tumors, and any other physical conditions that can induce or mimic the symptoms of depression. A detailed medical history, physical examination, and relevant laboratory investigations (TFTs,   Cortisol, DST, brain imaging, ECG, etc.) Should be obtained for this purpose. Exclude (depression/anxiety as) the impact of medications (e.g. propranolol), substances of abuse, and alcohol.   Step 3: Assess the severity clinically and to monitor, with a standard scale, (HAMD/HAM-A, BDI/BAI, etc). Severity also influences the choice of treatment. Step 4: Assess the impact of the condition on the patient and family, including personal distre

Classification of Depression According to the International Classification Diseases, Tenth Revision (ICD-10) Waleed Ahmad The ICD-10 has comprehensively sub-classified into various categories based on the clinical profile of symptoms and the course of symptoms.  Based on the course, it may be a depressive episode, recurrent (major) depressive disorder, persistent depressive disorder or dysthymia, recurrent brief depression, etc. Depression may also be either unipolar or bipolar or it may occur in   A first depressive episode, duration of at least15 days, is classified as a  depressive episode (F32).  If the first depressive episode severe and rapid onset, duration less than 15 days still depressive episode (F32).   A depressive episode can be mild (2 core symptoms, 2 other symptoms from the list) (32.0) moderate (2 core symptoms, 3 or preferably 4 other symptoms) (32.1) Severe (3 core symptoms, 4 other symptoms) without psychotic symptoms (32.2) (no delusion, hallucination or stupor)

Impaired alertness is generally a feature of delirium. In one form of dementia, however, 'fluctuating alertness' is a striking feature. Can you name it? Lewy body dementia

The Safest NSAID for a patient on lithium What is the most suitable non-steroidal anti-inflammatory drug (NSAID) you can prescribe to a patient who is on Lithium therapy? >> Aspirin or Sulindac.