Response to Treatment in Patients with Catatonia Referred to a Liaison Psychiatry Service in a General Hospital.

Abstract

Introduction

Catatonia is a neuropsychiatric syndrome described in a variety of general medical, neurological and psychiatric conditions. Response to treatment has not been sufficiently studied in patients in this clinical setting.

Objectives

To determine the response to treatment of catatonia in patients referred to a liaison psychiatry service.

Aim

Prospective, descriptive study.

Method

All patients referred to liaison psychiatry were screened for catatonic phenomena with the Bush–Francis Catatonia Screening Instrument (BFCSI) between January and May 2012. Their response to treatment was recorded.

Results

236 patients were referred. Thirteen (5,5%) met research diagnostic criteria for catatonia and 10 (4,2%) DSM – IV criteria. Nine of the 13 patients received treatment with oral lorazepam. Five underwent total remission with doses between 1.5-3 mg/day within 5-13 days of treatment initiation. Two cases received up to 3 mg/day for more than 5 days resulting in a very mild improvement, one of them did not improve following eight sessions of ECT. One patient who received up to 10mg/day, died of the complications of the background health problem and complications. One patient died after the first day of treatment with lorazepam 1 mg/day. Another patient died the day after the diagnosis of catatonia and prior to starting treatment. Three patients with associated delirium improved completely with treatment for the underlying cause.

Conclusions

Catatonia can be effectively treated. 62% of our patients treated with lorazepam achieved complete resolution of symptoms. 100% of de catatonic patients with delirium also completely improved after treatment of the underlying condition.