Catatonia in a University Inpatient Service (1985-1990)

Catatonia is defined only as a subtype of schizophrenia in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) and DSM-III-revised (DSM-III-R), but catatonic symptoms are prominent in patients with psychoses, affective disorders, systemic illnesses, and neurotoxic states. We reviewed the case records of a 30-bed University Hospital adult inpatient psychiatric unit between 1985 and 1990, and identified 43 cases with admission or discharge diagnoses of schizophrenia, catatonic type (295.2). Of these, the records were adequate for detailed review in 19 cases. On discharge, seven were classified as schizophrenia, seven as affective disorder, and five as organic affective disorder. Eleven patients underwent electroconvulsive therapy (ECT), with excellent results in eight; 34 psychotropic medication trials were administered, with successful results in only two patients. Catatonia should be defined as a separate class in DSM-IV, thus encouraging the proper diagnosis and management of a treatable condition.