What is Catatonia?
What type of syndrome is catatonia?
Psychomotor syndrome
What type involves mutism, posturing, and withdrawal?
Stuporous/Withdrawn
How is catatonia diagnosed?
Clinical observation — not labs/EEG
What medication class is the first-line treatment?
Benzodiazepines
Catatonia can affect which three domains?
Motor activity, emotions, communication
What type involves increased aimless motor activity?
Excited
What rating tool can assist with diagnosis?
Bush-Francis Catatonia Rating Scale
What non-pharmacologic treatment has a 59-100% response rate?
ECT
Name one autonomic symptom of catatonia.
Tachycardia, fever, blood pressure lability
What type of catatonia is life-threatening and involves autonomic instability?
Malignant
What is a common pitfall when observing mutism?
Mistaking it for malingering/volitional mutism
True or False: Outcome is often good if catatonia is recognized and treated.
True
True or False: Catatonia can only occur in schizophrenia.
False — multiple etiologies
In excited catatonia, name one example of odd or excessive behavior.
Pouring water, inappropriate toileting, denudativeness, impulsivity
Does a negative Ativan challenge rule out catatonia?
No — it does not fully rule it out
Why might early treatment be especially important?
Faster treatment leads to better outcomes; delayed treatment can risk fatal progression
What is the most common error in the evaluation of catatonia?
Omission — not considering it
Which form alternates between psychosis, catatonic and manic features, and delirium?
Delirious mania
Name one feature that might fluctuate in catatonia, making diagnosis tricky.
Speech, motor signs, autonomic signs, level of activity
Name one alternative treatment sometimes used besides benzos or ECT.
Zolpidem or NMDA antagonists