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Diagnostic overshadowing clouding the efficient recognition of pediatric catatonia: a case series

Published online by Cambridge University Press:  28 November 2022

Samuel Reinfeld Open the ORCID record for Samuel Reinfeld [Opens in a new window]  and
Poonamdeep Gill
Samuel Reinfeld*
Affiliation:
Department of Psychiatry and Behavioral Health, Stony Brook University Hospital, Stony Brook, NY, USA
Poonamdeep Gill
Affiliation:
Department of Psychiatry and Behavioral Health, Stony Brook University Hospital, Stony Brook, NY, USA
*
*Author for correspondence: Samuel Reinfeld Email: [email protected]
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Abstract

Catatonia is a neuropsychiatric condition that causes disruption of movement, emotion, and behaviors. Children and adults with underlying psychiatric conditions are particularly susceptible to developing catatonia, which may result in medical and psychiatric complications. Although catatonia research has been growing at a rapid rate in the last 20 years, it continues to be met with inefficiencies in its diagnosis and incertitude in its treatment. In the pediatric population, catatonia is plagued by diagnostic overshadowing, where the catatonia is erroneously attributed to existing pathologies that lead to a prolonged disease state. This paper describes three pediatric patients with catatonia that fell victim to diagnostic overshadowing. More rigorous training and education are imperative to improve the efficient recognition and treatment of children with catatonia.

Keywords

catatoniadiagnostic overshadowingchild and adolescent psychiatryelectroconvulsive therapybenzodiazepines
Type
Case based Review
Information
CNS Spectrums , Volume 28 , Issue 5 , October 2023 , pp. 587 - 591
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Starkstein, SE, Goldar, JC, Hodgkiss, A. Karl Ludwig Kahlbaum’s concept of catatonia. Hist Psychiatry. 1995;6(22 Pt 2):201–207. doi:10.1177/0957154x9500602205.Google Scholar
Taylor, MA, Fink, M. Catatonia in psychiatric classification: a home of its own. Am J Psychiatry. 2003;160(7):1233–1241. doi:10.1176/appi.ajp.160.7.1233.CrossRefGoogle ScholarPubMed
Diagnostic and Statistical Manual of Mental Disorders. Fifth ed. American Psychiatric Association; 2013.CrossRefGoogle Scholar
Dhossche, D, Cohen, D, Ghaziuddin, N, Wilson, C, Wachtel, LE. The study of pediatric catatonia supports a home of its own for catatonia in DSM-5. Med Hypotheses. 2010;75(6):558–560. doi:10.1016/j.mehy.2010.07.029.CrossRefGoogle Scholar
Northoff, G, Steinke, R, Czcervenka, C, et al. Decreased density of GABA-A receptors in the left sensorimotor cortex in akinetic catatonia: investigation of in vivo benzodiazepine receptor binding. J Neurol Neurosurg Psychiatry. 1999;67(4):445–450. doi:10.1136/jnnp.67.4.445.CrossRefGoogle ScholarPubMed
Bush, G, Fink, M, Petrides, G, Dowling, F, Francis, A. Catatonia. I. Rating scale and standardized examination. Acta Psychiatr Scand. 1996;93(2):129–136. doi:10.1111/j.1600-0447.1996.tb09814.x.CrossRefGoogle ScholarPubMed
Bräunig, P, Krüger, S, Shugar, G, Höffler, J, Börner, I. The catatonia rating scale I—Development, reliability, and use. Compr Psychiatry. 2000;41(2):147–158. doi:10.1016/s0010-440x(00)90148-2.CrossRefGoogle ScholarPubMed
Weleff, J, Barnett, BS, Park, DY, Akiki, TJ, Aftab, A. The state of the catatonia literature: employing bibliometric analysis of articles from 1965–2020 to identify current research gaps. J Acad Consult Liaison Psychiatry. 2022. doi:10.1016/j.jaclp.2022.07.002.CrossRefGoogle Scholar
Wing, L, Shah, A. Catatonia in autistic spectrum disorders. Br J Psychiatry. 2000;176:357–362. doi:10.1192/bjp.176.4.357.CrossRefGoogle ScholarPubMed
Wing, L, Shah, A. A systematic examination of catatonia-like clinical pictures in autism spectrum disorders. Int Rev Neurobiol. 2006;72:21–39. doi:10.1016/s0074-7742(05)72002-x.CrossRefGoogle ScholarPubMed
Breen, J, Hare, DJ. The nature and prevalence of catatonic symptoms in young people with autism. J Intellect Disabil Res. 2017;61(6):580–593. doi:10.1111/jir.12362.CrossRefGoogle ScholarPubMed
Ohta, M, Kano, Y, Nagai, Y. Catatonia in individuals with autism spectrum disorders in adolescence and early adulthood: a long-term prospective study. Int Rev Neurobiol. 2006;72:41–54. doi:10.1016/s0074-7742(05)72003-1.CrossRefGoogle ScholarPubMed
Billstedt, E, Gillberg, IC, Gillberg, C. Autism after adolescence: population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. J Autism Dev Disord. 2005;35(3):351–360. doi:10.1007/s10803-005-3302-5.CrossRefGoogle ScholarPubMed
Green, WH, Padron-Gayol, M, Hardesty, AS, Bassiri, M. Schizophrenia with childhood onset: a phenomenological study of 38 cases. J Am Acad Child Adolesc Psychiatry. 1992;31(5):968–976. doi:10.1097/00004583-199209000-00027.CrossRefGoogle ScholarPubMed
Thakur, A, Jagadheesan, K, Dutta, S, Sinha, VK. Incidence of catatonia in children and adolescents in a paediatric psychiatric clinic. Aust N Z J Psychiatry. 2003;37(2):200–203. doi:10.1046/j.1440-1614.2003.01125.x.CrossRefGoogle Scholar
Faedda, GL, Wachtel, LE, Higgins, AM, Shprintzen, RJ. Catatonia in an adolescent with velo-cardio-facial syndrome. Am J Med Genet A. 2015;167a(9):2150–2153. doi:10.1002/ajmg.a.37087.CrossRefGoogle Scholar
Ghaziuddin, N, Nassiri, A, Miles, JH. Catatonia in Down syndrome; a treatable cause of regression. Neuropsychiatr Dis Treat. 2015;11:941–949. doi:10.2147/ndt.s77307.CrossRefGoogle ScholarPubMed
Jap, SN, Ghaziuddin, N. Catatonia among adolescents with Down syndrome: a review and 2 case reports. J ECT. 2011;27(4):334–337. doi:10.1097/YCT.0b013e31821d37c6.CrossRefGoogle ScholarPubMed
Ishitobi, M, Kawatani, M, Asano, M, et al. Quetiapine responsive catatonia in an autistic patient with comorbid bipolar disorder and idiopathic basal ganglia calcification. Brain Dev. 2014;36(9):823–825. doi:10.1016/j.braindev.2013.12.005.CrossRefGoogle Scholar
Keshtkarjahromi, M, Palvadi, K, Shah, A, Dempsey, KR, Tonarelli, S. Psychosis and catatonia in Fragile X Syndrome. Cureus. 2021;13(1):e12843. doi:10.7759/cureus.12843.Google ScholarPubMed
Serret, S, Thümmler, S, Dor, E, Vesperini, S, Santos, A, Askenazy, F. Lithium as a rescue therapy for regression and catatonia features in two SHANK3 patients with autism spectrum disorder: case reports. BMC Psychiatry. 2015;15:107. doi:10.1186/s12888-015-0490-1.CrossRefGoogle ScholarPubMed
Remberk, B, Szostakiewicz, Ł, Kałwa, A, Bogucka-Bonikowska, A, Borowska, A, Racicka, E. What exactly is catatonia in children and adolescents. Psychiatr Pol. 2020;54(4):759–775. Czym jest katatonia u dzieci i młodzieży. doi:10.12740/pp/113013.CrossRefGoogle ScholarPubMed
Dhossche, DM, Wachtel, LE. Catatonia is hidden in plain sight among different pediatric disorders: a review article. Pediatr Neurol. 2010;43(5):307–315. doi:10.1016/j.pediatrneurol.2010.07.001.CrossRefGoogle ScholarPubMed
Cavanna, AE, Robertson, MM, Critchley, HD. Catatonic signs in Gilles de la Tourette syndrome. Cogn Behav Neurol. 2008;21(1):34–37. doi:10.1097/WNN.0b013e318165a9cf.CrossRefGoogle ScholarPubMed
Dhossche, DM, Reti, IM, Shettar, SM, Wachtel, LE. Tics as signs of catatonia: electroconvulsive therapy response in 2 men. J ECT. 2010;26(4):266–269. doi:10.1097/yct.0b013e3181cb5f60.CrossRefGoogle Scholar
Ghaziuddin, N, Dhossche, D, Marcotte, K. Retrospective chart review of catatonia in child and adolescent psychiatric patients. Acta Psychiatr Scand. 2012;125(1):33–38. doi:10.1111/j.1600-0447.2011.01778.x.CrossRefGoogle ScholarPubMed
Zaw, FK, Bates, GD, Murali, V, Bentham, P. Catatonia, autism, and ECT. Dev Med Child Neurol. 1999;41(12):843–845. doi:10.1017/s001216229900167x.CrossRefGoogle ScholarPubMed
Withane, N, Dhossche, DM. Electroconvulsive treatment for catatonia in autism spectrum disorders. Child Adolesc Psychiatr Clin N Am. 2019;28(1):101–110. doi:10.1016/j.chc.2018.07.006.CrossRefGoogle ScholarPubMed
Lyons, A, Allen, NM, Flanagan, O, Cahalane, D. Catatonia as a feature of down syndrome: an under-recognised entity? Eur J Paediatr Neurol. 2020;25:187–190. doi:10.1016/j.ejpn.2020.01.005.CrossRefGoogle ScholarPubMed
Wachtel, LE. Treatment of catatonia in autism spectrum disorders. Acta Psychiatr Scand. 2019;139(1):46–55. doi:10.1111/acps.12980.CrossRefGoogle ScholarPubMed
Park, SE, Grados, M, Wachtel, L, Kaji, S. Use of electroconvulsive therapy in autism. Child Adolesc Psychiatr Clin N Am. 2020;29(3):455–465. doi:10.1016/j.chc.2020.03.003.CrossRefGoogle ScholarPubMed
Ghaziuddin, N, Kaza, M, Ghazi, N, King, C, Walter, G, Rey, JM. Electroconvulsive therapy for minors: experiences and attitudes of child psychiatrists and psychologists. J ECT. 2001;17(2):109–117. doi:10.1097/00124509-200106000-00005.CrossRefGoogle ScholarPubMed
Ali, A, Scior, K, Ratti, V, Strydom, A, King, M, Hassiotis, A. Discrimination and other barriers to accessing health care: perspectives of patients with mild and moderate intellectual disability and their carers. PLoS One. 2013;8(8):e70855. doi:10.1371/journal.pone.0070855.CrossRefGoogle ScholarPubMed
Shefer, G, Henderson, C, Howard, LM, Murray, J, Thornicroft, G. Diagnostic overshadowing and other challenges involved in the diagnostic process of patients with mental illness who present in emergency departments with physical symptoms—A qualitative study. PLoS One. 2014;9(11):e111682. doi:10.1371/journal.pone.0111682.CrossRefGoogle ScholarPubMed
van Boekel, LC, Brouwers, EP, van Weeghel, J, Garretsen, HF. Inequalities in healthcare provision for individuals with substance use disorders: perspectives from healthcare professionals and clients. Journal of Substance Use. 2016;21(2):133–140.Google Scholar
Reinfeld, S. Are we failing to diagnose and treat the many faces of catatonia. Cur Psychiatry. 2022;1:e3–e5.Google Scholar
Carroll, BT, Kirkhart, R, Ahuja, N, et al. Katatonia: a new conceptual understanding of catatonia and a new rating scale. Psychiatry (Edgmont). 2008;5(12):42–50.Google Scholar
Benarous, X, Consoli, A, Raffin, M, et al. Validation of the pediatric catatonia rating scale (PCRS). Schizophr Res. 2016;176(2–3):378–386. doi:10.1016/j.schres.2016.06.020.CrossRefGoogle ScholarPubMed
Fink, M, Taylor, MA. The many varieties of catatonia. Eur Arch Psychiatry Clin Neurosci. 2001;251(Suppl 1):I8–I13. doi:10.1007/pl00014200.CrossRefGoogle ScholarPubMed
Dhossche, DM, Ross, CA, Stoppelbein, L. The role of deprivation, abuse, and trauma in pediatric catatonia without a clear medical cause. Acta Psychiatr Scand. 2012;125(1):25–32. doi:10.1111/j.1600-0447.2011.01779.x.CrossRefGoogle ScholarPubMed
Ahmed, GK, Elbeh, K, Karim, AA, Khedr, EM. Case report: catatonia associated with post-traumatic stress disorder. Front Psychiatry. 2021;12:740436. doi:10.3389/fpsyt.2021.740436.CrossRefGoogle ScholarPubMed
Dhossche, DM. Vagal intimations for catatonia and electroconvulsive therapy. J ECT. 2014;30(2):111–115. doi:10.1097/yct.0000000000000134.CrossRefGoogle ScholarPubMed
Dhossche, DM, Withane, N. Electroconvulsive therapy for catatonia in children and adolescents. Child Adolesc Psychiatr Clin N Am. 2019;28(1):111–120. doi:10.1016/j.chc.2018.07.007.CrossRefGoogle ScholarPubMed
Shorter, E, Fink, M. The Madness of Fear: A History of Catatonia. New York, NY: Oxford University Press; 2018.CrossRefGoogle Scholar
Fink, M. Electroconvulsive Therapy: A Guide for Professionals & Their Patients. Oxford University Press; 2009Google Scholar
Fink, M, Taylor, MA. The catatonia syndrome: forgotten but not gone. Arch Gen Psychiatry. 2009;66(11):1173–1177. doi:10.1001/archgenpsychiatry.2009.141.CrossRefGoogle Scholar
Kakooza-Mwesige, A, Wachtel, LE, Dhossche, DM. Catatonia in autism: implications across the life span. Eur Child Adolesc Psychiatry. 2008;17(6):327–335. doi:10.1007/s00787-008-0676-x.CrossRefGoogle ScholarPubMed
Ghaziuddin, N, Andersen, L, Ghaziuddin, M. Catatonia in patients with autism spectrum disorder. Child Adolesc Psychiatr Clin N Am. 2020;29(3):443–454. doi:10.1016/j.chc.2020.03.001.CrossRefGoogle ScholarPubMed
Fink, M. Expanding the catatonia tent: recognizing electroconvulsive therapy responsive syndromes. J ECT. 2021;37(2):77–79. doi:10.1097/YCT.0000000000000729.CrossRefGoogle ScholarPubMed
Wortzel, JR, Maeng, DD, Francis, A, Oldham, MA. Prevalent gaps in understanding the features of catatonia among psychiatrists, psychiatry trainees, and medical students. J Clin Psychiatry. 2021;82(5):21m14025. doi:10.4088/JCP.21m14025.CrossRefGoogle ScholarPubMed
Cooper, JJ, Roig Llesuy, J. Catatonia education: needs assessment and brief online intervention. Acad Psychiatry. 2017;41(3):360–363. doi:10.1007/s40596-016-0632-x.CrossRefGoogle ScholarPubMed
Wachtel, LE, Hermida, A, Dhossche, DM. Maintenance electroconvulsive therapy in autistic catatonia: a case series review. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34(4):581–587. doi:10.1016/j.pnpbp.2010.03.012.CrossRefGoogle ScholarPubMed
Coffey, CE, Figiel, GS, Djang, WT, Sullivan, DC, Herfkens, RJ, Weiner, RD. Effects of ECT on brain structure: a pilot prospective magnetic resonance imaging study. Am J Psychiatry. 1988;145(6):701–706. doi:10.1176/ajp.145.6.701.Google ScholarPubMed
Scalia, J, Lisanby, SH, Dwork, AJ, et al. Neuropathologic examination after 91 ECT treatments in a 92-year-old woman with late-onset depression. J ECT. 2007;23(2):96–98. doi:10.1097/YCT.0b013e31804bb99d.CrossRefGoogle Scholar
Dwork, AJ, Christensen, JR, Larsen, KB, et al. Unaltered neuronal and glial counts in animal models of magnetic seizure therapy and electroconvulsive therapy. Neuroscience. 2009;164(4):1557–1564. doi:10.1016/j.neuroscience.2009.09.051.CrossRefGoogle ScholarPubMed
Devanand, DP, Verma, AK, Tirumalasetti, F, Sackeim, HA. Absence of cognitive impairment after more than 100 lifetime ECT treatments. Am J Psychiatry. 1991;148(7):929–932. doi:10.1176/ajp.148.7.929.Google ScholarPubMed
Nakamura, M, Yasunaga, H, Miyata, H, Shimada, T, Horiguchi, H, Matsuda, S. Mortality of neuroleptic malignant syndrome induced by typical and atypical antipsychotic drugs: a propensity-matched analysis from the Japanese Diagnosis Procedure Combination database. J Clin Psychiatry. 2012;73(4):427–430. doi:10.4088/JCP.10m06791.CrossRefGoogle ScholarPubMed
Shalev, A, Hermesh, H, Munitz, H. Mortality from neuroleptic malignant syndrome. J Clin Psychiatry. 1989;50(1):18–25.Google ScholarPubMed
Silva, RR, Munoz, DM, Alpert, M, Perlmutter, IR, Diaz, J. Neuroleptic malignant syndrome in children and adolescents. J Am Acad Child Adolesc Psychiatry. 1999;38(2):187–194. doi:10.1097/00004583-199902000-00018.CrossRefGoogle ScholarPubMed
Tural, U, Onder, E. Clinical and pharmacologic risk factors for neuroleptic malignant syndrome and their association with death. Psychiatry Clin Neurosci. 2010;64(1):79–87. doi:10.1111/j.1440-1819.2009.02042.x.CrossRefGoogle ScholarPubMed