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Rising Prevalence of Pediatric Catatonia Presenting to Inpatient Care: A Retrospective Analysis
Joshua R Smith1,2, Isaac Baldwin1, Tasia York1,3
1Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center at Village of Vanderbilt, Nashville, Tennessee, USA.
Insights
Pediatric catatonia diagnoses surged tenfold between 2018 and 2023. This trend, affecting both medical and psychiatric causes, highlights the need for increased awareness and education on childhood catatonia.
Area of Science:
- Pediatric neurology
- Child psychiatry
- Medical diagnostics
Background:
- Recent concerns regarding increased catatonia diagnoses in children.
- Need to validate rising trends in pediatric catatonia at academic centers.
Purpose of the Study:
- To investigate the trend of catatonia diagnoses in a pediatric population.
- To analyze changes in diagnostic categories and severity scores over time.
Main Methods:
- Retrospective review of 131 pediatric patient records with catatonia diagnoses (2018-2023).
- Utilized ordinary least squares and linear regression analyses.
- Examined prevalence, underlying causes, and Bush-Francis Catatonia Rating Scale scores.
Main Results:
- Observed a 10-fold increase in pediatric catatonia diagnoses from 2018 to 2023.
- Found a statistically significant relationship between diagnosis year and prevalence (p=0.01, R²=0.83).
- Both medical and psychiatric catatonia causes showed upward trends; rating scale scores trended upward but not significantly.
Conclusions:
- Catatonia diagnoses in pediatric patients, encompassing both medical and psychiatric origins, significantly increased at the study center.
- Findings align with broader evidence suggesting a rise in pediatric catatonia.
- Potential contributing factors include the COVID-19 pandemic and heightened clinical awareness.
Purpose:
There has been recent concern for the rising rates of catatonia diagnosis in pediatric populations. We set out to determine if the rates of catatonia diagnosis have risen at an academic pediatric medical center.
Methods:
The clinical records of 131 patients were obtained from encounters during 2018-2023 in which a diagnosis of catatonia was made in the pediatric emergency department or inpatient medical hospital. Ordinary least squares regression and linear regression analyses were used to determine if the prevalence of catatonia diagnoses, underlying diagnostic category, and Bush-Francis Catatonia Rating Scale scores changed over time.
Results:
A 10-fold increase was observed in catatonia diagnoses between 2018 and 2023. A statistically significant relationship between the year of pediatric catatonia diagnoses was discovered (p = 0.01), with an R2 value of 0.83 suggesting that approximately 83% of the variance can be attributed to the passage of time. Both medical and psychiatric causes of catatonia showed an upward trend over the course of the study period. The average Bush-Francis Catatonia Rating Scale scores showed a slight upward trend but were not statistically significant.
Conclusion:
In this sample of pediatric patients hospitalized at a large academic medical center, the rate of catatonia diagnoses related to both medical and psychiatric causes rose between 2018 and 2023. These data are consistent with previous evidence highlighting an increase in catatonia diagnoses during this period. The COVID-19 pandemic and increasing awareness of catatonia in children may have contributed to this trend. These data support the importance of investigation into this trend and improving education on catatonia for clinicians and the public.
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