Catatonia on the consultation-liaison service.
Catatonia is a syndrome that requires both nonpsychiatric medical and psychiatric evaluation. The authors report on six patients with catatonia that were seen by a psychiatric consultation-liaison service. Five of these patients had medical conditions reported to cause catatonia. Treatment recommendations included the following: 1) subcutaneous heparin for deep venous thrombosis prophylaxis, 2) a trial of lorazepam, and 3) transfer to a medical/psychiatric unit or locked psychiatric unit. Catatonia was most parsimoniously attributed to the primary psychiatric illness in five of the patients and to corticosteroid treatment in the sixth patient. These findings suggest that clinicians should use the proposed criteria, past psychiatric history, physical exam, and laboratory and radiological studies when evaluating patients with symptoms of catatonia.
Carroll
B T
BT
Department of Psychiatry, University of Iowa Hospitals and Clinics, Columbus.
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D002389:Catatonia / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007279:Injections, Subcutaneous; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis; D010288:Parenteral Nutrition; D011567:Psychiatric Department, Hospital; D011569:Psychiatric Status Rating Scales; D012017:Referral and Consultation; D013924:Thrombophlebitis / Q000517:prevention & control; D014057:Tomography, X-Ray Computed; D014546:Urinary Catheterization
D000305:Adrenal Cortex Hormones; D006493:Heparin