Emergency Department Presentations for Catatonia: A 2019-2021 National Emergency Department Sample Study
James Luccarelli1, Mark Kalinich2, Jonathan P Rogers3
1Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA.
Journal of the Academy of Consultation-Liaison Psychiatry
|August 10, 2025
Summary
Catatonia is rarely diagnosed in emergency departments but affects all ages and leads to high hospital admission rates. Improved recognition and management in the ED are crucial for patient outcomes.
Area of Science:
- Neuroscience
- Psychiatry
- Emergency Medicine
Background:
- Catatonia is a neuropsychiatric disorder with significant morbidity and mortality.
- It is often underdiagnosed, especially in emergency departments (EDs).
- Limited data exists on catatonia's epidemiology and outcomes in ED settings.
Purpose of the Study:
- To characterize the epidemiology of catatonia in ED visits.
- To analyze healthcare utilization for catatonia in the ED.
- To use the National Emergency Department Sample for national estimates.
Main Methods:
- Analysis of the National Emergency Department Sample (2019-2021).
- Inclusion of ED visits with a discharge diagnosis of catatonia.
- Weighted analysis for national estimates.
Main Results:
- An estimated 51,671 ED visits (0.013%) involved catatonia.
- Bimodal age distribution (20-29 and 55-64 years); disproportionately diagnosed in Black patients.
- High hospital admission rate (82.6%); physical restraints used in 5.6%.
Conclusions:
- Catatonia is infrequently diagnosed in EDs but impacts all age groups.
- Catatonia ED visits have high hospital admission rates, similar to life-threatening conditions.
- Improved ED recognition and management of catatonia are necessary.
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