Catatonia in a Liaison Psychiatry Service of a General Hospital: Prevalence and Clinical Features

Abstract

Introduction Catatonia is a neuropsychiatric syndrome described in a variety of medical and psychiatric conditions. The prevalence and clinical features of this syndrome have not been studied sufficiently in patients in this clinical setting. Objectives To determine the prevalence and clinical features of catatonia in patients referred to a liaison psychiatry service at a general hospital. Aim Prospective, descriptive study. Method All patients referred to a liaison psychiatry service were screened for catatonic phenomena using the Bush–Francis Catatonia Screening Instrument (BFCSI), between January and May 2012. The prevalence and clinical features of catatonia were recorded. Results 236 patients were referred. Thirteen (5,5%) met research diagnostic criteria for catatonia and 10 (4,2%) DSM – IV criteria. Three of these patients suffered simultaneously with delirium. All patients presented with the inhibited variant of catatonia and 5 to 12 catatonic signs. 100% presented with immobility/stupor and staring gaze, 84,6% with mutism, 76,9% with rigidity, and 69% with negativism and withdrawal. Sixty-one percent presented with posturing/catalepsy, 53,8% with echophenomena and automatic obedience and 46,1% with stereotypies and grasp reflex, whilst 38,4% presented with grimacing and waxy flexibility. Mitgehen, Gegenhalten and autonomic abnormalities were found in 23% of cases. In 15,3% there were verbigeration, impulsivity, perseveration and combativeness. Excitement, mannerisms and ambitendency were not observed in any case. Conclusion Catatonia is not infrequent in patients referred to a liaison psychiatry service at a general hospital, and it presented with its inhibited variant in all cases. In 23% of patients catatonia occurred simultaneously with delirium.