Catatonic syndrome: importance of detection and treatment with lorazepam.
BACKGROUND
A resurgence of interest has led to renewed attempts to clarify the concept and treatment of catatonia.


METHODS
A large prospective study was conducted to estimate the incidence of catatonic syndrome in 138 consecutive psychiatric patients admitted to a general hospital in India, to demarcate the common symptom presentations and its response to intravenous benzodiazepines. Patients were screened using the Bush Francis Catatonia Screening Instrument. Patients with two or more signs on the Instrument were subsequently administered intravenous lorazepam and their response was rated on the Bush Francis Catatonia Rating Scale.


RESULTS
Catatonic syndrome was found in 11% of patients with a wide variety of diagnoses, especially schizophrenia. Mutism (87.5% incidence) was the most common symptom. A significant proportion (93%) of these patients showed a marked immediate response to lorazepam, with 75% showing sustained improvement.


CONCLUSIONS
Catatonic syndrome is common, often undiagnosed, and quickly responsive to treatment, irrespective of the diagnosis. It needs to be identified and actively treated with benzodiazepines to minimize distress, and facilitate diagnosis and treatment. Most patients also need additional treatment for the underlying psychiatric condition.
Seethalakshmi
R
R
BYL Nair Charitable Hospital and T.N. Medical College, Mumbai, India.
Dhavale
S
S
Suggu
Kalpana
K
Dewan
Mantosh
M
D000328:Adult; D002389:Catatonia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D018757:GABA Modulators / Q000008:administration & dosage*; D006801:Humans; D007194:India; D007262:Infusions, Intravenous; D008140:Lorazepam / Q000008:administration & dosage*; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D011569:Psychiatric Status Rating Scales; D012560:Schizophrenia, Catatonic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D013577:Syndrome
D018757:GABA Modulators; D008140:Lorazepam