Abstract
Background Catatonia is among the most mysterious and poorly understood neuropsychiatric syndrome. It is underresearched and virtually forgotten but still a frequent neuropsychiatric phenotype in both developed and low-income countries. Catatonia is associated with a number of medical complications like pulmonary embolism, dehydration, or pneumonia if it is not treated and managed adequately. In Ethiopia, however, almost no studies are available to describe the symptoms and the response to treatment in patients with catatonia. The aim of this retrospective study was therefore to describe the symptom profile of catatonia and to evaluate the treatment and outcome of catatonia in patients admitted to the psychiatric inpatient unit at Jimma University, Ethiopia. Method Detailed treatment records of all inpatients were reviewed for the period from May 2018 to April 2019. All patients with catatonia at the inpatient unit of Jimma University Medical Center were assessed with the Bush-Francis Catatonia Rating Scale (BFCRS), and all comorbid psychiatric diagnoses were made according to the criteria of the Diagnostic Statistical Manual V. The presence and severity of catatonia were assessed by using the BFCRS at baseline and at discharge from the hospital. Result In the course of one year, a total of 18 patients with the diagnosis of catatonia were admitted. The mean age of the participants was 22.8 years (SD 5.0; range: 15 to 34 years). The most common diagnosis associated with catatonia was schizophrenia (n = 12; 66.7%), followed by severe depressive disorders (n = 4; 22.2%). Mutism, posture, and withdrawal were registered in all patients (n = 18, 100%). All patients received an injection of diazepam and had improved at discharge. Conclusion Our study provides further evidence that catatonia is most commonly associated with schizophrenia, followed by major depressive disorder, and that mutism, posturing, and withdrawal are the most common signs and symptoms of catatonia.
Highlights
Catatonia is among the most mysterious and poorly understood neuropsychiatric syndrome
During the one-year period, a total of 18 patients were admitted with a diagnosis of catatonia
The most common diagnosis was catatonia associated with schizophrenia (n = 12; 66.7%), followed by catatonia associated with major depressive disorder (n = 4; 22.2%) and catatonia associated with bipolar disorder (n = 2; 11.1%)
Summary
Catatonia is among the most mysterious and poorly understood neuropsychiatric syndrome. In Ethiopia, almost no studies are available to describe the symptoms and the response to treatment in patients with catatonia. The most common diagnosis associated with catatonia was schizophrenia (n = 12; 66.7%), followed by severe depressive disorders (n = 4; 22.2%). Our study provides further evidence that catatonia is most commonly associated with schizophrenia, followed by major depressive disorder, and that mutism, posturing, and withdrawal are the most common signs and symptoms of catatonia. The mortality rate in patients who are underdiagnosed with malignant catatonia, a severe form, and are not adequately treated is 75-100% in ICU settings [4, 5]. The condition is characterized by a cluster of motor features, including mutism, a rigid posture, fixed staring, stereotypic movements, and stupor [7]
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