The prevalence of catatonic syndrome in acute psychiatric wards.

Rozália Takács,Gabor Ungvari,Anna Antosik-Wójcińska,Gábor Gazdag,Márton Asztalos

doi:10.12740/pp/102657

Abstract

The aim of this prospective study was to determine the prevalence of the catatonic syndrome in a cohort of patients admitted to acute psychiatric units in Hungary. Patients admitted to the acute inpatient unit of the Center of Psychiatry and Addiction Medicine, SzentIstván and SzentLászló Hospitals in a 4-month period were screened for catatonic signs and symptoms. Catatonic signs/symptoms were scored according to both the DSM-5 diagnostic criteria and the Bush-Francis Catatonia Rating Scale (BFCRS). Clinical diagnoses were established using the Structured Clinical Interview for DSM-IV Disorders (SCID), while cognitive performance was estimated with the Clock Drawing Test and the Mini-Mental State Examination (MMSE). During the study period, 342 patients were admitted to the above-mentioned acute inpatient units. The prevalence figures for the catatonic syndrome were 8.55% and 5.02% according to the BFCRS and the DSM-5, respectively. The prevalence of catatonic syndrome in an acute inpatient setting is within the broad range of figures reported in the literature. The difference between the standardized assessment (BFCRS) and routine clinical judgment (DSM-5) is noteworthy and suggests that a significant minority of catatonic patients might not be identified in clinical practice. As acute catatonia can be effectively treated, and early treatment could prevent potentially lifethreatening complications, recognition of catatonic symptoms is vitally important.

Highlights

The concept, clinical features, and nosological status of catatonia, which can be broadly defined as a syndrome characterized by a variety of behavioral, autonomic, and psychomotor abnormalities [1], has undergone a number of changes since it was first described [2]
The prevalence figures for the catatonic syndrome were 8.55% and 5.02% according to the Bush–Francis Catatonia Rating Scale (BFCRS) and the DSM-5, respectively
The prevalence of catatonic syndrome in an acute inpatient setting is within the broad range of figures reported in the literature

Summary

Introduction

The concept, clinical features, and nosological status of catatonia, which can be broadly defined as a syndrome characterized by a variety of behavioral, autonomic, and psychomotor abnormalities [1], has undergone a number of changes since it was first described [2]. Persistent catatonic syndromes with poor prognosis arising in the context of psychoses were included in Kraepelin’s nosological system as a putative subtype of dementia praecox (schizophrenia) [6]. Starting from the 1970s, catatonia as a syndrome was increasingly re-discovered, appearing in conjunction with affective disorders [9], and a host of neurological, medical [10], and drug/substance abuserelated conditions [11]. The association of catatonia with medical and psychiatric conditions other than schizophrenia was reflected in ICD-10 (1992) [12] and DSMIV [13] For the sake of brevity, the term ‛catatonic symptoms’ refers to ‛catatonic signs and symptoms’)

Results

Discussion

Conclusion