Catatonia-Induced Saddle Pulmonary Embolism.

Area of Science:

• Psychiatry
• Vascular Medicine
• Internal Medicine

Background:

• Catatonia is a neuropsychiatric condition often associated with mood disorders, including schizoaffective disorder.
• Deep venous thrombosis (DVT) and pulmonary embolism (PE) are serious complications that can arise from immobility.
• Schizoaffective disorder, depressive type, presents with symptoms of both mood disorder and psychosis.

Observation:

• A patient diagnosed with catatonia secondary to schizoaffective disorder, depressive type, developed bilateral DVT.
• The DVT progressed to a saddle PE, a life-threatening condition.
• The patient had no known hypercoagulable conditions beyond immobility and obesity.

Findings:

• Immobility and obesity in catatonic patients, even without other risk factors, can precipitate severe thromboembolic events.
• Catatonia, particularly the retarded subtype, necessitates careful consideration of DVT risk.
• This case underscores a potential link between catatonia and hypercoagulability secondary to profound psychomotor retardation.

Implications:

• Increased vigilance and proactive DVT screening are crucial for patients with catatonia.
• Prophylactic anticoagulation should be strongly considered for immobile catatonic patients.
• Further research is warranted to elucidate the pathophysiology linking catatonia and thromboembolism.