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Catatonia: "Fluctuat nec mergitur".

Gabor S Ungvari1,2, Stanley N Caroff3,4, Levente Csihi5

  • 1Division of Psychiatry, School of Medicine, University of Western Australia, Crawley 6009, Western Australia, Australia.

World Journal of Psychiatry
|June 12, 2023
PubMed
Summary

Catatonia was once thought to be disappearing but has resurged, now affecting about 10% of acute psychotic patients. This review examines the changing incidence of catatonia and its potential causes.

Keywords:
Bush-Francis Catatonia Rating ScaleCatatoniaDiagnostic and Statistical Manual of Mental Disorders-5Frequency of catatoniaHistorical overviewWernicke–Kleist-Leonhard school

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Area of Science:

  • Psychiatry and Neurology
  • Clinical Psychology

Background:

  • Historically, catatonia prevalence in inpatient samples ranged from 19.5% to 50% in the early 1900s.
  • By the mid-1900s, catatonia was widely believed to be declining due to medical advances and improved treatments.
  • Factors such as narrower diagnostic criteria and misattribution of symptoms to antipsychotic side effects contributed to its perceived decline.

Discussion:

  • The introduction of catatonia rating scales in the 1990s revealed a higher prevalence than previously recognized.
  • This led to a re-evaluation, with current research indicating catatonia affects approximately 10% of acute psychotic patients.
  • The apparent decline and subsequent resurgence highlight the importance of diagnostic tools and classification systems.

Key Insights:

  • Catatonia's incidence has fluctuated significantly over the past century.
  • Advances in neurology and psychiatry may have masked or altered the presentation of catatonia.
  • Modern diagnostic tools have uncovered a resurgence of catatonia, particularly in psychotic disorders.

Outlook:

  • Further research is needed to fully understand the complex factors influencing catatonia's incidence.
  • Refined diagnostic criteria and increased clinical awareness are crucial for accurate identification and management.
  • Investigating the interplay between neurological, pharmacological, and psychological factors is essential for future treatment strategies.