Catatonia and its treatment.
Psychiatric diagnoses are currently categorized on a syndromic basis. The syndrome of catatonia, however, remains in a diagnostic limbo, acknowledged predominantly as a subtype of schizophrenia. Yet, catatonia is present in about 10% of acutely ill psychiatry patients, only a minority of whom have schizophrenia. Among those with comorbid affective disorders, who comprise the largest subgroup of catatonic patients, the catatonic signs typically resolve dramatically and completely with benzodiazepine therapy. Those with schizophrenia respond less reliably, suggesting that the underlying processes causing the catatonia may be different in this group. The majority of patients with catatonia have concurrent psychosis. Failure to treat the catatonia before institution of antipsychotic medication may increase the risk of inducing neuroleptic malignant syndrome. At this point of time, the pathobiology of catatonia is unknown; the major reason for considering catatonia as a separate diagnostic entity would be to increase recognition of this eminently treatable neuropsychiatric syndrome.
Rosebush
Patricia I
PI
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8P 3B6, Canada. Rosebush@HHSC.CA
Mazurek
Michael F
MF
D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D002389:Catatonia / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy; D006801:Humans; D009459:Neuroleptic Malignant Syndrome / Q000517:prevention & control; D012560:Schizophrenia, Catatonic / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D013577:Syndrome
D014150:Antipsychotic Agents; D001569:Benzodiazepines