Association of adolescent catatonia with increased mortality and morbidity: evidence from a prospective follow-up study.
This paper examined outcomes among youth with catatonic syndrome and determined whether the characteristics suggesting the relevance of chronic catatonic schizophrenia (CCS) at index episode remained stable at follow-up. From 1993 to 2004, 35 individuals aged 12 to 18 years were prospectively admitted for management of catatonic syndrome and followed up after discharge. Mean duration from discharge to follow-up was 3.9 years (range 1-10). Four patients were lost to follow-up. Among the remaining 31 subjects (mean age=19.5 years, range 15-26), life-time diagnosis using the Diagnostic Interview for Genetic Studies was unchanged in 28 patients, and included schizophrenia (all subtypes; N=20), major depressive episode (N=5), bipolar disorder type I (N=4) and brief psychotic episode (N=2). Mortality (all-cause Standardized Mortality Ratio=6266; 95% CI=1181-18,547) and morbidity were severe, with 3 deaths (including 2 suicides), 6 patients presenting with a causal organic condition and 14 subjects needing continuous psychiatric care. All males in the study (N=8) who had chronic catatonic schizophrenia at the index episode still had chronic catatonic signs at follow-up. Catatonia is one of the most severe psychiatric syndromes in adolescents. It is associated with a 60-fold increased risk of premature death, including suicide, when compared to the general population of same sex and age. This increased risk of premature death remains higher than the one measured in former adolescent psychiatric patients (all-cause SMR=221; 95% CI=156-303; Engqvist and Rydelius, 2006), or in schizophrenia irrespective to age and subtype (all-cause SMR=157; 95% CI=153-160; Harris and Barraclough, 1998).
Cornic
Françoise
F
Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpêtrière, APHP, Université Pierre et Marie Curie, Paris, France.
Consoli
Angèle
A
Tanguy
Marie-Laure
ML
Bonnot
Olivier
O
Périsse
Didier
D
Tordjman
Sylvie
S
Laurent
Claudine
C
Cohen
David
D
D000293:Adolescent; D000328:Adult; D002389:Catatonia / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009017:Morbidity; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult