Catatonia in psychiatric illnesses

Dirk M. Dhossche, Lee Elizabeth Wachtel, Michal Goetz, Pascal Sienaert

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Increased interest in the demarcation of catatonia from other conditions such as schizophrenia and autism is shown in the new DSM-5 category Catatonia Not Elsewhere Classified (NEC) encompassing catatonia of uncertain origin or associated with developmental conditions. Catatonia NEC is an imminently relevant diagnosis in patients who meet criteria for catatonia but without clearly defined associated psychotic, affective, or medical disorders. Catatonia NEC should be considered when catatonic symptoms present in patients with autism spectrum disorders, developmental disorders such as Prader-Willi Syndrome and Down Syndrome, tic disorders and Tourette Syndrome, Kleine-Levin Syndrome, aseptic encephalitis such as Anti-N-methyl-D-aspartate Receptor encephalitis, Pervasive Refusal Syndrome, or complex posttraumatic conditions. Current experiences continue to support the use of benzodiazepines and ECT in catatonia as safe and effective treatments without the risk of worsening catatonia or precipitating Neuroleptic Malignant Syndrome as opposed to when antipsychotic medications are used as first-line or sole treatment Historical and contemporary clinical and experimental catatonia models are available for future research, focusing on motor circuitry dysfunction, abnormal neurotransmitters, epileptic discharges, genetics, neuroendocrine and immune abnormalities, fear reactions akin to the animal defense strategy of tonic immobility, and developmental risk factors. There have been advances in demarcating catatonia in a wide variety of patients as a treatable condition that requires prompt identification. Catatonia NEC in DSM-5 is likely to improve proper diagnosis and treatment of catatonia and to intensify research of this condition.

Original languageEnglish (US)
Title of host publicationThe Medical Basis of Psychiatry
Subtitle of host publicationFourth Edition
PublisherSpringer New York
Pages517-535
Number of pages19
ISBN (Electronic)9781493925285
ISBN (Print)9781493925278
DOIs
StatePublished - Jan 1 2016

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Keywords

  • Anti-N-methyl-D-aspartate Receptor encephalitis
  • Autism
  • Autism spectrum disorders
  • Autonomic symptoms
  • Benzodiazepines
  • Catatonia
  • Children and adolescents
  • Delirium
  • Developmental disorders
  • Electroconvulsive treatment (ECT)
  • Kleine-Levin Syndrome
  • Malignant
  • Mood disorder
  • Movement disorders
  • Neuroleptic Malignant Syndrome
  • Posttraumatic stress disorder
  • Psychomotor abnormalities
  • Psychosis
  • Schizophrenia
  • Self-injury
  • Tics
  • Tourette syndrome
  • Toxic Serotonergic Syndrome
  • Vagal nerve

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Dhossche, D. M., Wachtel, L. E., Goetz, M., & Sienaert, P. (2016). Catatonia in psychiatric illnesses. In The Medical Basis of Psychiatry: Fourth Edition (pp. 517-535). Springer New York. https://doi.org/10.1007/978-1-4939-2528-5_27