Resources on Symptoms & Diagnosis
General Diagnosis
Scholarly Articles
2023
Key recommendations from the British Association for Psychopharmacology (BAP) Catatonia Guideline, published in April 2023, emphasizing points from the guidelines that are of relevance to general physicians.
Rogers JP et al. Clinical Medicine Journal
2023
Case report of 61-year old with catatonia. Echo phenomenon often recognized when presenting as echopraxia or echolalia, but other echo phenomenon are well established in the literature.
Hamlin D & Maghoub Y BMC Psychiatry
2023
45-year-old male patient without previous medical history with multiple neuropsychiatric symptoms. Differentiation between catatonia, and delirium was central to the patient's care.
Martinez JCC et al. Revista Colombiana de PsiquiatrÍa
2023
In cases of diagnostic uncertainty, EEG should be used along with other investigations to ascertain whether the underlying cause of catatonia is medical.
Hosseini P et al. EClinicalMedicine
2023
The presentation of an acute onset of psychomotor symptoms in the absence of a history of mental illness warrants extensive workup to rule out medical causes to ensure effective treatment of any underlying illness.
Zick JL & Wichser L Journal of Medical Case Reports
2022
Clear, consistent definitions for catatonia features are essential for reliable detection. There are important limitations in the ICD and DSM, and differences across scales and criteria that stand in the way of reliable catatonia detection.
Oldham MA Schizophrenia Research
2022
Specific catatonia symptoms such as immobility/stupor and staring can be measured with actigraphy. This may aid the detection, staging, and monitoring of catatonia in clinical settings.
von Känel S et al. Frontiers in Psychiatry
2015
Examination of the prevalence of catatonia signs, estimation of the utility of diagnostic features, identification of core catatonia signs, and exploration of their underlying structure.
Wilson JE et al. Schizophrenia Research
2014
Sienaert P et al. Frontiers in Psychiatry
2014
There is a wide spectrum of speech and other neurological abnormalities seen in catatonia. Summary of the clinical features of catatonia, diagnostic challenges, possible mechanisms and available treatment options, .
Wijemanne S & Jankovic J Journal of Neurology, Neurosurgery, & Psychiatry
2012
Review of literature on catatonia with the aim of assisting emergency department doctors in considering this condition in the differential diagnosis of stupor due to its high frequency of association with organic pathology.
Jaimes-Albornoz W & Serra-Mestres J Emergency Medicine Journal
2000
Review suggests that organic catatonic disorder must be first considered in every patient with catatonic signs, particularly in a patient with new onset catatonia.
Ahuja N Indian Journal of Psychiatry
Rating Scales
Scholarly Articles
2024
Review of the nature of Catatonia diagnosis and different approaches to scoring on the rating scales. Clear, consistent definitions for Catatonia features are important for reliable detection. The Bush-Francis Catatonia Rating Scale and the Northoff Rating Scale can be converted to diagnostic criteria with limited modification.
Oldham M. Schizophrenia Research
2024
Systematic review to examine the frequency and distribution of diagnostic criteria and clinical rating scales for assessing catatonia used in scientific studies. DSM, ICD, BCFRS, and NCRS were mostly widely used and are recommended as valid instruments.
Hirjak D et al. Schizophrenia Research
2023
The Bush-Francis Catatonia Screening Instrument-Spain Version (BFCSI-SV) and Bush-Francis Catatonia Rating Scale - Spain Version (BFCRS-SV) are valid and reliable tools for the diagnosis of Catatonia.
Serrat F et al. The European Journal of Psychiatry
2023
NSSC is a useful tool for everyday clinical work to assess the subjective experience of catatonia patients.
Brandt GA et al. Schizophrenia Research
2023
Northoff Catatonia Rating Scale (NCRS) yields good accuracy in diagnosing catatonia by assessing affective alterations patients experience during catatonia. Catatonia is a multi-faceted truly psycho-motor syndrome.
Meda N et al. Rivista di Psychiatria
2021
Bush-Francis Catatonia Rating Scale has high inter-rater reliability with high correlation coefficients, while DSM-5 had deficiencies in screening for catatonia.
Zingela Z et al. International Journal of Mental Health Systems
2016
The Pediatric Catatonia Rating Scale (PCRS) was adapted from the Bush-Francis Catatonia Rating Scale for use in child and adolescent inpatients.
Benarous X et al. [Database record] APA PsycTests
2016
Reliability and validity of the PCRS in inpatient children and adolescents.
Benarous X et al. Schizophrenia Research
2011
Review of seven different rating scales for Catatonia. The Bush-Francis Catatonia Rating Scale is preferred because of its validity, reliability, and ease of administration.
Sienaert P et al. Journal of Affective Disorders
2008
Identifies the clinical features of katatonia and introduces the KANNER scale to improve conceptualization, detection, and measurement.
Carroll BT et al. Psychiatry
2001
Patients displaying three or more classical motor signs may be diagnosed with confidence as suffering from a catatonia.
Peralta V & Cuesta MJ Schizophrenia Research
2000
The Catatonia Rating Scale (CRS) is a reliable rating scale for the diagnosis of catatonia. Discusses advantages of the scale, areas of use, and clinical implications.
Brӓunig P et al. Comprehensive Psychiatry
Websites
2023
Wortzel J & Oldham M. University of Rochester Medical Center Department of Psychiatry
Videos
2022
URMC Department of Psychiatry
Lorazepam Challenge
Scholarly Articles
2022
Case report - 49-year-old male with rapid onset behavioral changes and no prior psychiatric history had marked resolution of his symptoms following single dose of lorazepam.
Gautham I & Wilson AW Psychiatry Research Case Reports
2022
2010
Lorazepam challenge administered via telehealth.
Luccarelli J et al. Schizophrenia Research
Case report - adolescent female whose catatonic state was confirmed with administration of benzodiazepines. Given
associated risks if left untreated, this case shows need for clinicians to be vigilant for such presentations.
Brake JA & Abidi SA Journal of the Canadian Academy of Child and Adolescent Psychiatry
Websites
2020
Beach, S.R. Psychopharmacology Institute
Videos
2020
Psychopharmacology Institute
Lab Tests of CSF or Blood Serum for Anti-NMDA Receptor Encephalitis
Scholarly Articles
2019
The diagnosis of anti-NMDA receptor encephalitis is determined by the detection of NMDAR IgG autoantibodies in the serum or cerebrospinal fluid of symptomatic patients,
Brooks J et al. Canadian Journal of Neurological Sciences
DSM-5
Scholarly Articles
2017
1 in 3 patients in ICU patients had both catatonia and delirium. This data prompts reconsideration of DSM-5 criteria for “Catatonic Disorder Due to Another Medical Condition” that precludes diagnosing catatonia in the presence of delirium.
Wilson JE et al. Critical Care Medicine
2013
Description of change to DSM-5 in regards to catatonia. These changes should improve the consistent recognition of catatonia across the range of psychiatric disorders and facilitate its specific treatment.
Tandon R et al. Schizophrenia Research
2010
Catatonia is a treatable syndrome. It occurs in children and adolescents as well as adults. Benzodiazepines and ECT are effective treatments for children, adolescents, and adults. Catatonia should be an independent category in psychiatric classification.
Dhossche DM et al. Primary Psychiatry
2010
As international scholars of catatonia, the authors advocate for a unique and broadly defined code for catatonia in the DSM. This would foster recognition of the catatonia syndrome and permit research on nosology, treatment, and outcome.
Francis A et al. The Journal of ECT
2010
A discussion of the classification of catatonia in the DSM.
Heckers S et al. Schizophrenia Bulletin
2010
The creation of a separate diagnostic class for catatonia is the safest approach to ensure proper diagnosis and treatment of this syndrome in patients of all ages and the best approach to promote research.
Dhossche D et al. Medical Hypotheses
2010
Rational basis for reconceptualizing catatonia in DSM-5 Reviews historical sources, the psychopathology of catatonia, and the relevance of catatonic schizophrenia in contemporary practice and research.
Ungvari GS et al. Schizophrenia Bulletin
2009
Catatonia is the psychiatric syndrome of disturbed motor functions amid disturbances in mood and thought. It is identified by symptom clusters, verified by the acute relief afforded by benzodiazepines, and validated by the remission with these agents and with ECT. It deserves a home of its own in the psychiatric classification.
Fink M. The Canadian Journal of Psychiatry
2006
Catatonia is an identifiable and treatable motor syndrome in clinical psychiatric patients. It warrants a home of its own in the nomenclature. Such designation will improve its recognition, optimize its treatment, reduce morbidity and mortality, and offer homogeneous samples for studies of pathophysiology.
Fink M & Taylor MA American Journal of Psychiatry
Complications of Catatonia
Scholarly Articles
2023
Higher catatonic traits are linked to higher suicidal tendencies, confirming the high risk of suicide for this population.
Dell’Osso L et al. Frontiers in Psychiatry
2014
Prototypical case to highlight medical complications of catatonia and review preventive guidelines for implementation in the inpatient setting.
Clinebell K et al. The Journal of Clinical Psychiatry
2008
Vignette and case discussion to enhance knowledge about the complications of catatonia and about strategies that can be employed to prevent and treat them.
Gross AF et al. Primary Care Companion to The Journal of Clinical Psychiatry
Challenges of Getting a Diagnosis
Scholarly Articles
2023
Catatonia and catatonia/delirium are underdiagnosed in inpatient wards and should be routinely assessed in patients with an altered mental status.
Appiani FJ et al. Journal of Clinical Psychopharmacology
2022
Several factors lead to the underdiagnosis of catatonia. Even life-threatening malignant catatonia is often not recognized when there is a mortality of about 50% if untreated.
Karl S et al. Der Nervenarzt
2022
Crowdsourcing between medical experts, or “collective intelligence,” allows clinicians to informally collaborate regarding complex clinical cases like Catatonia.
Bahadur A et al. Journal of the Academy of Consultation-Liaison Psychiatry
2022
Case study -3 patients (adolescent & adult) with challenging presentations of catatonia. History and a comprehensive workup and examination for accurate diagnosis and management
Najam S et al. Pakistan Journal of Neurological Sciences (PJNS)
2022
Diagnostic overshadowing clouding the efficient recognition of pediatric catatonia: a case series (Abstract)
3 pediatric patients with catatonia were victims of diagnostic overshadowing where catatonia is erroneously attributed to existing pathologies that lead to a prolonged disease state. More rigorous training and education is needed to improve recognition and treatment of catatonia.
Reinfeld S & Gill P CNS Spectrums
2022
Minor patient with catatonia transferred from Colorado to New Mexico to receive ECT and improved - shows challenges to receiving appropriate treatment.
Miller J et al. Journal of the American Academy of Child & Adolescent Psychiatry
2021
Significant inaccuracies in clinicians’ understanding of catatonic features irrespective of their stage of training and years of experience. Important implications for clinical research and patient care.
Wortzel JR et al. The Journal of Clinical Psychiatry
2021
Case of catatonia and COVID-19 association with malignant catatonia resolving after ECT. Shows value of close cooperation between internal medicine and psychiatry teams when severe psychiatric and clinical manifestations intertwine.
Deocleciano de Araujo C et al. Journal of the Academy of Consultation-Liaison Psychiatry
2021
Patient with COVID presented with exacerbation of underlying psychosis and Catatonia.
Zandifar A & Badrfam R Psychiatry and Clinical Neurosciences
2019
50-year-old female incorrectly diagnosed and treated for MDD. Correct diagnosis and benzodiazepine treatment resulted in improvement.
Jhawer H et al. Brain Sciences
2019
Why do neurologists miss catatonia in neurology emergency? A case series and brief literature review
Catatonia is under-diagnosed in the neurology/medicine departments.
Anand S. Clinical Neurology and Neurosurgery
2018
Pediatric catatonia is a potentially lethal disease that can be effectively treated if accurately identified early in its course. It should be regularly considered by all clinicians who care for children and adolescents.
Sorg EM et al. Psychosomatics
2014
Catatonia in the ICU: An Important and Underdiagnosed Cause of Altered Mental Status. A Case Series and Review of the Literature (Abstract only)
Catatonia can occur in a wide variety of critical care settings and may be exacerbated or induced by common intensive care practices. Psychomotor findings are imperative in examination of critically ill patients with altered mental status in order to diagnose catatonia.
Saddawi-Konefka D et al. Critical Care Medicine
2007
Barriers that exist in the detection, recognition, and diagnosis of catatonia. This review article illustrates the need for a new rating scale to screen and detect catatonia as it occurs in a variety of healthcare settings.
Kirkhart R. et al. Psychiatry
2005
Catatonia: Disappeared or Under-Diagnosed (Abstract)
Reviews prevalence of catatonic schizophrenia and catatonia in various populations. The results suggest that changes in diagnostic criteria and the diagnostic procedure itself are responsible for the under-recognition of catatonia.
van der Heijden F.M.M.A. et al. Psychopathology
2001
Classification issues in catatonia
Examination of the relationship between motor features and other syndromes of psychosis, the clinical validity of Kahlbaum's concept of catatonia, its relationship to schizophrenia and mood disorder, and its nosological position in relation to DSM-III-R, DSM-IV and Leonhard's classification of endogenous psychoses.