title: Does catatonia influence the phenomenology of childhood onset schizophrenia beyond motor symptoms?
abstract: Childhood onset schizophrenia (COS) and catatonia (C) are rare and severe psychiatric disorders. The aim of this study was to compare the phenomenology of COS with and without catatonia. We examined 33 cases consecutively referred to two major public university hospitals in Paris. There were 18 cases of COS (age=15.9+/-0.8 years) and 15 of COS+C (age=15.4+/-1.4 years). Patients were referred over the course of 3 and 9 years, respectively. Psychiatric assessment included socio-demographic, clinical and psychometric variables: the Brief Psychiatric Rating Scale (BPRS), the Scales for the Assessment of Positive (SAPS) and Negative Symptoms (SANS), and a catatonia rating scale. Patients with COS+C appeared to be more severely ill at admission and discharge compared with COS in nearly all clinical scores. They also exhibited significantly longer episode duration (50.8 weeks+/-4.8 vs 20.6+/-19.5). On the basis of multivariate logistic regression, the only clinical measure which significantly predicted group membership was the SANS Affective Flattening score (odds ratio=1.24; 95% CI=1.06-1.43). Our findings strongly suggest that catatonic COS differs from COS in ways that extend beyond motor symptoms. The SANS and SAPS scales, commonly used in schizophrenia, are not detailed enough to accurately describe catatonia in COS. The use of a catatonia rating scale is recommended to enhance recognition of and research into COS with catatonia.
authors.affiliation: Department of Child and Adolescent Psychiatry, AP-HP, Hôpital Pitié-Salpétrière, Université Pierre et Marie Curie, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bonnot
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Tanguy
authors.forename: Angèle
authors.initials: A
authors.lastname: Consoli
authors.forename: Françoise
authors.initials: F
authors.lastname: Cornic
authors.forename: Catherine
authors.initials: C
authors.lastname: Graindorge
authors.forename: Claudine
authors.initials: C
authors.lastname: Laurent
authors.forename: Sylvie
authors.initials: S
authors.lastname: Tordjman
authors.forename: David
authors.initials: D
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001321:Autistic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001332:Automatism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D002389:Catatonia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003702:Delusions / Q000175:diagnosis / Q000453:epidemiology; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D011596:Psychomotor Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology; D012560:Schizophrenia, Catatonic / Q000175:diagnosis / Q000523:psychology; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index