Catatonic schizophrenia: a cohort prospective study.
BACKGROUND
In the 20th century, catatonia was usually deemed a subtype of schizophrenia. Recently, the nature and classification of catatonia are being reconsidered. This study is the first to describe catatonia using prospectively collected data and to examine how catatonic schizophrenia differs from, or resembles, other types of schizophrenia.


METHODS
Data were analyzed in a cohort of 90,079 offspring followed from birth till ages 29-41 years. Proportional hazards models were used, calculating time to first psychiatric hospital admission, to compare risk factors for catatonic schizophrenia vs "other schizophrenia."


RESULTS
Of 568 cases of schizophrenia, 43 (7.6%) had catatonic schizophrenia. The sexes were equally at risk for catatonic schizophrenia in contrast to other schizophrenia, for which the incidence was higher in males (1.70, 1.42-2.03, P < .0001). Advancing paternal age had no influence on the risk of catatonic schizophrenia in contrast to other schizophrenia, in which the risk to offspring of fathers age 35+ was 1.27 (1.03-1.57, P = .03) compared with those of younger fathers. Those with catatonic schizophrenia were somewhat more likely to have older mothers (aged 35+) (relative risk = 2.14, 0.85-5.54) while maternal age was not related to other schizophrenia. Both were equally affected by parental history of schizophrenia. Patients with catatonia were significantly more likely to attempt suicide (P = .006).


CONCLUSIONS
Patients with catatonic schizophrenia show a somewhat different profile of risk factors from those with other types of schizophrenia in this cohort and are more likely to attempt suicide. This lends some support to the hypothesis that catatonic schizophrenia may have a distinct etiology.
Kleinhaus
Karine
K
Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA. kleink03@nyumc.org
Harlap
Susan
S
Perrin
Mary C
MC
Manor
Orly
O
Weiser
Mark
M
Harkavy-Friedman
Jill M
JM
Lichtenberg
Pesach
P
Malaspina
Dolores
D
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008423:Maternal Age; D010331:Paternal Age; D011446:Prospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology*; D012560:Schizophrenia, Catatonic / Q000453:epidemiology* / Q000209:etiology*; D012737:Sex Factors; D013406:Suicide, Attempted / Q000706:statistics & numerical data