Complications of Catatonia in Patients in a General Hospital Referred to a Liaison Psychiatry Service.

Abstract

Catatonia is a neuropsychiatric syndrome characterized by a variety of motor, behavioral and autonomic abnormalities that occurs in the context of general medical, neurological and psychiatric conditions. The complications of this syndrome have not been sufficiently studied in patients in this clinical setting. To determine the rate and type of complications of catatonia in patients referred to a liaison psychiatry service. Prospective descriptive study. All patients referred to liaison psychiatry were screened for catatonic phenomena with the Bush–Francis Catatonia Screening Instrument (BFCSI) between January and May 2012. Any complications of catatonia were recorded. 236 patients were referred. Thirteen (5,5%) met research diagnostic criteria for catatonia and 10 (4,2%) DSM – IV criteria. Of these, six patients (46%) suffered from complications secondary to the catatonic syndrome. These patients were also those with the longer duration of catatonia (more than10 days). The complications observed were malnutrition, dehydration, hyponatremia, hypoglycaemia, and problems related to immobility such as pressure ulcers (the more frequent complication, present in all six patients), acute coronary syndrome, aspiration pneumonia, urinary retention and urinary infection. Three patients died as a result of these complications and their underlying conditions. Medical complications of catatonia were frequent (46%) and were more common in those patients with longer duration of catatonia. Death was also frequent (23%).