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Validation of the Catatonia Quick Screen in the Original Bush-Francis Catatonia Rating Scale Cohort
James Luccarelli1,2, Joshua Ryan Smith3,4, Mark Kalinich1,5
1Harvard Medical School, Boston, Massachusetts, USA.
Introduction:
Delayed catatonia diagnosis may cause preventable harm. The 4-item Catatonia Quick Screen (CQS) allows rapid screening, but its specificity requires evaluation. We assessed CQS sensitivity and specificity using the original Bush Francis Catatonia Rating Scale (BFCRS) cohort.
Methods:
Retrospective reanalysis of data from 215 consecutive inpatient psychiatric admissions. CQS classifications were compared against BFCRS, DSM-5-TR, and ICD-11 criteria. 95% confidence intervals (CIs) were calculated via Clopper-Pearson exact methods, treating the eight single-sign patients conservatively as false positives.
Results:
All 15 catatonia cases screened positive (true positives). The CQS demonstrated 100% sensitivity (95% CI: 78.2% to 100%), 96.0% specificity (95% CI: 92.3% to 98.3%), 65.2% positive predictive value (95% CI: 42.7% to 83.6%), and 100% negative predictive value (95% CI: 98.1% to 100%).
Conclusion:
The CQS showed excellent sensitivity and high specificity in this psychiatric cohort. It serves as a rapid, low-burden screening tool to accelerate clinical recognition, though positive results require formal diagnostic confirmation.