Incidence of Catatonia in Children and Adolescents in a Paediatric Psychiatric Clinic
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To investigate the incidence and phenomenology of catatonia in a child and adolescent population.Children and adolescents who had attended a paediatric psychiatric outpatient clinic between April and July 2001 were examined for catatonic signs with a formal catatonia rating scale, and patients who had at least two catatonic signs were included.Eleven patients met the criteria (5.5% of the entire sample and 17.7% of the patients with affective and nonaffective psychotic disorder); of them eight had an affective disorder and three a nonaffective disorder. The mean catatonic scores were significantly high for males and patients with mental retardation.This study shows that catatonia occurs in children and adolescents. Further studies are essential to clarify the distribution of catatonia across various diagnoses and the outcome of paediatric catatonia.Keywords:
Catatonia
Outpatient clinic
Although catatonia has been previously associated with schizophrenia, today it is more associated with mood disorders and general medical conditions. Periodic catatonia is a rare type of catatonic syndrome having frequently and constantly repeated catatonic episodes. In the pathogenesis of catatonia several mechanisms have been suggested. Benzodiazepines and electroconvulsive therapy (ECT) have been used as first line treatment in catatonia. We report about the case of a patient successfully treated with maintenance ECT in periodic catatonia.
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A retrospective case-control study was performed using the records of 59 catatonics, 59 non-catatonic schizophrenics, 59 manics, 59 depressives and 59 surgical controls. The findings suggest that prior brain injury and physical illness at onset of psychosis are much more common in subjects with catatonia. While these findings do not account for all cases of catatonia, they may indicate an aetiology for some phenotypic cases of catatonia.
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Emergence of catatonia during electroconvulsive therapy (ECT) is unexpected, as catatonia responds well to ECT. We report four cases with onset of catatonia during ECT. Four inpatients with affective disorders (three without prior catatonia) developed catatonia by Bush–Francis criteria during a course of ECT. All four patients had been taking benzodiazepines, which were stopped 5–15 days before ECT. Two became catatonic after ECT no. 4, one after ECT no. 1, and one after ECT no. 10. The episodes of catatonia resolved promptly with the resumption of benzodiazepines. Two patients completed a course of ECT, whereas two received neuroleptics and/or antidepressants without further ECT. All showed improvements in their affective and psychotic symptoms. The cases illustrate the appearance of catatonia during a course of ECT and suggest recent cessation of benzodiazepines as a risk factor. Benzodiazepines relieve the catatonia, and ECT may be continued.
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The authors review catatonia, especially malignant catatonia, suggest a revised nomenclature, and establish a basis for furthering our understanding and treatment of this syndrome. After a brief historical review of catatonia, they review all available recent (1986-1991) English-language reports on malignant catatonia and summarize 5 cases of psychiatric malignant catatonia seen at their institution. Although much has been written about malignant catatonia "due to neuroleptics," malignant catatonia caused by other factors has received less attention, hindering our ability to recognize and treat non-neuroleptic-induced malignant catatonia. Catatonia, including malignant catatonia, occurs infrequently, but recognition and management are essential with a syndrome that can be life-threatening.
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List of patient vignettes Preface Acknowledgments Chronology of catatonia concepts 1. Catatonia: a history 2. Signs of catatonia are identifiable 3. The many faces of catatonia 4. The differential diagnosis of catatonia 5. Catatonia is measurable and common 6. Past treatments for catatonia 7. Management of catatonia today 8. The neurology of catatonia 9. Back to the future Appendices References Index.
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The case of a patient who developed catatonia one week following Lysergic Acid Diethylamide (LSD) ingestion is presented. The psychosis developed two days after the intake. The catatonic syndrome resolved dramatically following one treatment of electroconvulsive therapy (ECT). This is perhaps the first case report of catatonia following the use of LSD. The need for a diagnostic category of organic catatonia is highlighted.
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Abstract
Catatonia was first described by Kahlbaum as a disorder of movement and speech .Kraeplin grouped catatonia along with other sub types of schizophrenia. In ICD-10 catatonia is mentioned as sub type of schizophrenia. DSM-5 gives independent status to catatonia. Catatonia may be caused by many medical conditions ,but in psychiatry it is associated more with mood disorders and schizophrenia. There are certain conditions with recurrent catatonia like the Periodic catatonia .We present a case of 35year old woman who has recurrent catatonia for the past 15 years .She was diagnosed with catatonic schizophrenia initially, treated with adequate trials of different antipsychotics , mood stabilisers and benzodiazepines with poor response. For the past several years she is being given maintainance ECT to which she is showing good response. ECT is effective in the treatment of recurrent catatonia and can be maintained.
Key words – recurrent catatonia, maintainance ECT, good response
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The case of a patient who developed catatonia one week following Lysergic Acid Diethylamide (LSD) ingestion is presented. The psychosis developed two days after the intake. The catatonic syndrome resolved dramatically following one treatment of electroconvulsive therapy (ECT). This is perhaps the first case report of catatonia following the use of LSD. The need for a diagnostic category of organic catatonia is highlighted.
Catatonia
Lysergic acid diethylamide
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