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Catatonic syndrome: From detection to therapy
J Madigand1, P Lebain2, G Callery3
1Service universitaire de psychiatrie, centre Esquirol, CHU de Caen, avenue Côte-de-Nace, CS 30001, 14000 Caen cedex, France; CNRS, UMR 6301, ISTCT, équipe ISTS, GIP Cyceron, 14074 Caen, France.
L'Encephale
|May 25, 2016
Summary
Catatonia is an under-diagnosed syndrome with varied symptoms and causes. Early diagnosis using scales and a lorazepam test, followed by appropriate treatment like benzodiazepines or electroconvulsive therapy, is crucial for managing this condition.
Area of Science:
- Psychiatry
- Neurology
Background:
- Catatonia is a complex psychomotor syndrome with diverse symptoms, often under-diagnosed despite significant morbidity and mortality.
- Historically linked to schizophrenia, catatonia is now recognized to have various psychiatric and organic etiologies.
Purpose of the Study:
- To review the diagnostic and therapeutic approaches to catatonia.
- To highlight the importance of recognizing the etiological diversity and clinical presentations of catatonia.
Main Methods:
- Review of diagnostic scales, including Bush and Peralta.
- Analysis of current first-line treatments (benzodiazepines) and alternative therapies (electroconvulsive therapy, lithium, atypical antipsychotics).
Main Results:
- Catatonia can be mistaken for other diagnoses due to its varied presentations.
- Lorazepam is a common first-line treatment, with electroconvulsive therapy reserved for severe or refractory cases.
- Atypical antipsychotics like clozapine and quetiapine show efficacy in patients with schizophrenia.
Conclusions:
- Catatonia requires greater practitioner awareness, especially with rapid symptom onset.
- Diagnostic scales and a lorazepam challenge are recommended for timely diagnosis.
- Further research is needed for second-line therapies, periodic catatonia, and catatonia in schizophrenia.
Keywords:
AdolescentAdolescentsAntipsychoticsAntipsychotiquesBenzodiazepinesBenzodiazépinesCatatoniaCatatonia rating scalesCatatonieCatatonie périodiqueChildrenClassification diagnostiqueDiagnostic classification systemDiazepamDiazépamElectroconvulsive therapyEnfantLorazepamPeriodic catatoniaSchizophreniaSchizophrénieZolpidemÉchelles d’évaluation de la catatonieÉlectroconvulsivothérapie
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