Subjective experiences of catatonia in acute psychiatric inpatients: An exploratory study

The subjective experience of patients during catatonic episodes is a relatively neglected area of research. The aims of this study were to contribute empirical data to the literature by assessing catatonic patients' subjective experiences and to explore how patients' subjective experiences vary according to their underlying medical and psychiatric conditions.

All 2,281 patients admitted to an acute psychiatric unit in a regional hospital during a 21-month period were screened for catatonia using the 14-item Bush-Francis Screening Instrument. Patients with catatonia were also examined using the 23-item Bush-Francis Catatonia Rating Scale at admission and discharge and assessed using the 14-item Northoff Scale for Subjective Experience in Catatonia at discharge. To examine the relationship between catatonia and the underlying medical and psychiatric conditions, patients were classified into four broad DSM-5 diagnostic groups.

One hundred and seventy patients met the criteria for catatonia. Less severely affected patients were remarkably overrepresented in the sample. Hypokinetic symptoms had the greatest effect on painful experiences, and immobility/stupor was identified as the strongest predictor of such experiences. The severity of negative experiences during catatonia clearly varied between the diagnostic categories. Significantly greater suffering was reported for catatonia associated with psychotic or affective/anxiety disorders than for catatonia occurring in the context of substance use or medical/neurological conditions. Subjective experiences remained relatively stable, even after the resolution of catatonia, with patients often showing long-lasting subjective and mostly negative experiences.

Assessing patients' subjective experiences of catatonia is essential to gain deeper insights into their experiences and to determine strategies to alleviate their suffering.