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The Development of a Pediatric Catatonia Clinical Roadmap for Clinical Care at Vanderbilt University Medical Center

Joshua Ryan Smith1, Tasia York2, Sarah Hart3

  • 1Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center at Village of Vanderbilt, Nashville, TN; Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN.

Journal of the Academy of Consultation-Liaison Psychiatry
|September 6, 2024
PubMed

Insights

Pediatric catatonia requires rapid identification and intervention to reduce severe outcomes. This study outlines a systematic clinical care roadmap for inpatient pediatric settings to improve early diagnosis and management.

Area of Science:

  • Pediatric Psychiatry
  • Child Neurology
  • Pediatric Rheumatology

Background:

  • Pediatric catatonia presents significant morbidity and mortality risks in children.
  • Early identification and intervention are crucial for effective treatment of pediatric catatonia.
  • A systematic approach to managing pediatric catatonia is currently lacking in published literature.

Purpose of the Study:

  • To develop a multidisciplinary clinical care roadmap for pediatric catatonia within an inpatient pediatric setting.
  • To standardize the assessment and management of pediatric catatonia.

Main Methods:

  • A multidisciplinary team including child psychiatry, rheumatology, neurology, hospital medicine, and psychology was formed.
  • The team reviewed existing literature on pediatric catatonia from 2022-2024.
  • Consensus recommendations were developed for key clinical domains.

Main Results:

  • Consensus was reached on initial assessment, medical and psychiatric workup, lorazepam challenge, behavioral considerations, and treatment options like electroconvulsive therapy (ECT) and psychopharmacology.
  • Specific recommendations were established for the inpatient pediatric setting.

Conclusions:

  • Pediatric catatonia is treatable with early diagnosis and intervention, despite its high morbidity and mortality.
  • The developed clinical care roadmap offers tools for inpatient clinicians to identify and manage pediatric catatonia effectively.
  • Implementing this roadmap can improve long-term outcomes and quality of life for affected children.
Abstract

Keywords:
catatoniachild psychiatryconsult-liaison psychiatrydiagnosispediatric medicine

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