title: Assessing catatonia using four different instruments: Inter-rater reliability and prevalence in inpatient clinical population.
abstract: OBJECTIVE
  The present study aimed to assess inter-rater reliability and prevalence of catatonia according to four diagnostic methods: Bush Francis Catatonia Rating Scale (BFCRS) both screening and complete scale, Braunig's Catatonia Rating Scale (CRS), ICD 10 and DSM5.
  
  
  METHODS
  For inter-rater reliability, different raters evaluated patients using the definitions provides by the four scales: BFCRS Screen and Total, CRS, ICD10 and DSM5. Kippendorff'α was used to compute the inter-rater reliability. Concordance between different systems was assessed using spearman correlation. Prevalence of catatonia was studied using the four definitions in a clinical sample of consecutive adult admissions in a psychiatry ward of a tertiary care hospital.
  
  
  RESULTS
  The inter-rater reliability was found to be good for BFCRS Total (α=0.779), moderate for DSM5 and BFCRS screen (α=0.575 and α=0.514 respectively) and low for CRS and ICD10 (α=0.111 and α=0.018 respectively). BFCRS Total and DSM5 definitions of catatonia had highest concordance (rs=0.892 p<0.001). In the prevalence sample of consecutive hospital admissions, the prevalence was found to be highest with the definitions of BFCRS Screen and ICD 10 (10.3%, confidence intervals [CI] 3.9% to 16.7%), followed by BFCRS Total and DSM5 definitions 6.9%, CI 1.6% to 12.2%) and while CRS yielded the lowest prevalence rate (3.4%, CI 0% to 7.2%).
  
  
  CONCLUSIONS
  Different methods used to determine catatonia in the clinical sample yield different prevalence of this condition.
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India; Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India. Electronic address: sidsarkar22@gmail.com.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Sarkar
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: Sreekanth
authors.initials: S
authors.lastname: Sakey
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India; Department of Psychiatry, Indira Gandhi Medical College and Research Institute, Puducherry, India.
authors.forename: Kaliaperumal
authors.initials: K
authors.lastname: Mathan
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: Balaji
authors.initials: B
authors.lastname: Bharadwaj
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: Shivanand
authors.initials: S
authors.lastname: Kattimani
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: Ravi P
authors.initials: RP
authors.lastname: Rajkumar
mesh_terms: D000293:Adolescent; D000328:Adult; D002389:Catatonia / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007297:Inpatients; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Catatonia; DSM5; Diagnosis; ICD10