Diagnosing and treating catatonia: An update

G. Gazdag, Pascal Sienaert

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Catatonia is a severe neuropsychiatric syndrome comprising a variety of signs and symptoms ranging from simple motor signs to complex behavioural abnormalities. If recognized and treated early, catatonia usually has an excellent prognosis. Observation and psychiatric interview will not suffice to detect the catatonic syndrome, since the most striking symptoms such as posturing, are present only in a minority of the cases. Therefore, catatonic signs should be elicited during a neuropsychiatric examination. Patients with severe psychiatric conditions, such as bipolar disorder, depression or schizophrenia, should be examined routinely for catatonic signs and symptoms. A number of rating scales, such as the Bush-Francis Catatonia Rating Scale, are available offering the clinician a scheme to aid neuropsychiatric examination. The most robust argument for identifying catatonia as a separate syndrome is that it has a rather specific treatment, either benzodiazepines or electroconvulsive therapy (ECT), irrespective of the underlying etiology. Among the benzodiazepines, lorazepam is the best studied and is currently used as first line treatment for catatonia. ECT in recent clinical practice is usually considered as second line treatment for the syndrome, although in certain conditions, especially in malignant catatonia, its early administration could be lifesaving. A further issue supporting the use of ECT in catatonia is that regardless of the origin of the condition it is effective, while certain antipsychotics or antidepressants can even worsen catatonic phenomena if they go unrecognized.

Original languageEnglish
Pages (from-to)130-135
Number of pages6
JournalCurrent Psychiatry Reviews
Volume9
Issue number2
DOIs
Publication statusPublished - 2013

Fingerprint

Catatonia
Electroconvulsive Therapy
Benzodiazepines
Bipolar Disorder
Signs and Symptoms
Advance Directives
Lorazepam
Antidepressive Agents
Antipsychotic Agents
Psychiatry
Schizophrenia
Therapeutics
Observation
Interviews

Keywords

  • Benzodiazepine
  • Catatonia
  • Electroconvulsive therapy
  • Rating scale

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Diagnosing and treating catatonia : An update. / Gazdag, G.; Sienaert, Pascal.

In: Current Psychiatry Reviews, Vol. 9, No. 2, 2013, p. 130-135.

Research output: Contribution to journalArticle

Gazdag, G. ; Sienaert, Pascal. / Diagnosing and treating catatonia : An update. In: Current Psychiatry Reviews. 2013 ; Vol. 9, No. 2. pp. 130-135.
@article{122a05b816114657a0f4b6e1c02b5303,
title = "Diagnosing and treating catatonia: An update",
abstract = "Catatonia is a severe neuropsychiatric syndrome comprising a variety of signs and symptoms ranging from simple motor signs to complex behavioural abnormalities. If recognized and treated early, catatonia usually has an excellent prognosis. Observation and psychiatric interview will not suffice to detect the catatonic syndrome, since the most striking symptoms such as posturing, are present only in a minority of the cases. Therefore, catatonic signs should be elicited during a neuropsychiatric examination. Patients with severe psychiatric conditions, such as bipolar disorder, depression or schizophrenia, should be examined routinely for catatonic signs and symptoms. A number of rating scales, such as the Bush-Francis Catatonia Rating Scale, are available offering the clinician a scheme to aid neuropsychiatric examination. The most robust argument for identifying catatonia as a separate syndrome is that it has a rather specific treatment, either benzodiazepines or electroconvulsive therapy (ECT), irrespective of the underlying etiology. Among the benzodiazepines, lorazepam is the best studied and is currently used as first line treatment for catatonia. ECT in recent clinical practice is usually considered as second line treatment for the syndrome, although in certain conditions, especially in malignant catatonia, its early administration could be lifesaving. A further issue supporting the use of ECT in catatonia is that regardless of the origin of the condition it is effective, while certain antipsychotics or antidepressants can even worsen catatonic phenomena if they go unrecognized.",
keywords = "Benzodiazepine, Catatonia, Electroconvulsive therapy, Rating scale",
author = "G. Gazdag and Pascal Sienaert",
year = "2013",
doi = "10.2174/1573400511309020007",
language = "English",
volume = "9",
pages = "130--135",
journal = "Current Psychiatry Reviews",
issn = "1573-4005",
publisher = "Bentham Science Publishers B.V.",
number = "2",

}

TY - JOUR

T1 - Diagnosing and treating catatonia

T2 - An update

AU - Gazdag, G.

AU - Sienaert, Pascal

PY - 2013

Y1 - 2013

N2 - Catatonia is a severe neuropsychiatric syndrome comprising a variety of signs and symptoms ranging from simple motor signs to complex behavioural abnormalities. If recognized and treated early, catatonia usually has an excellent prognosis. Observation and psychiatric interview will not suffice to detect the catatonic syndrome, since the most striking symptoms such as posturing, are present only in a minority of the cases. Therefore, catatonic signs should be elicited during a neuropsychiatric examination. Patients with severe psychiatric conditions, such as bipolar disorder, depression or schizophrenia, should be examined routinely for catatonic signs and symptoms. A number of rating scales, such as the Bush-Francis Catatonia Rating Scale, are available offering the clinician a scheme to aid neuropsychiatric examination. The most robust argument for identifying catatonia as a separate syndrome is that it has a rather specific treatment, either benzodiazepines or electroconvulsive therapy (ECT), irrespective of the underlying etiology. Among the benzodiazepines, lorazepam is the best studied and is currently used as first line treatment for catatonia. ECT in recent clinical practice is usually considered as second line treatment for the syndrome, although in certain conditions, especially in malignant catatonia, its early administration could be lifesaving. A further issue supporting the use of ECT in catatonia is that regardless of the origin of the condition it is effective, while certain antipsychotics or antidepressants can even worsen catatonic phenomena if they go unrecognized.

AB - Catatonia is a severe neuropsychiatric syndrome comprising a variety of signs and symptoms ranging from simple motor signs to complex behavioural abnormalities. If recognized and treated early, catatonia usually has an excellent prognosis. Observation and psychiatric interview will not suffice to detect the catatonic syndrome, since the most striking symptoms such as posturing, are present only in a minority of the cases. Therefore, catatonic signs should be elicited during a neuropsychiatric examination. Patients with severe psychiatric conditions, such as bipolar disorder, depression or schizophrenia, should be examined routinely for catatonic signs and symptoms. A number of rating scales, such as the Bush-Francis Catatonia Rating Scale, are available offering the clinician a scheme to aid neuropsychiatric examination. The most robust argument for identifying catatonia as a separate syndrome is that it has a rather specific treatment, either benzodiazepines or electroconvulsive therapy (ECT), irrespective of the underlying etiology. Among the benzodiazepines, lorazepam is the best studied and is currently used as first line treatment for catatonia. ECT in recent clinical practice is usually considered as second line treatment for the syndrome, although in certain conditions, especially in malignant catatonia, its early administration could be lifesaving. A further issue supporting the use of ECT in catatonia is that regardless of the origin of the condition it is effective, while certain antipsychotics or antidepressants can even worsen catatonic phenomena if they go unrecognized.

KW - Benzodiazepine

KW - Catatonia

KW - Electroconvulsive therapy

KW - Rating scale

UR - http://www.scopus.com/inward/record.url?scp=84878638686&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878638686&partnerID=8YFLogxK

U2 - 10.2174/1573400511309020007

DO - 10.2174/1573400511309020007

M3 - Article

AN - SCOPUS:84878638686

VL - 9

SP - 130

EP - 135

JO - Current Psychiatry Reviews

JF - Current Psychiatry Reviews

SN - 1573-4005

IS - 2

ER -