Document Detail


Catatonia: a syndrome appears, disappears, and is rediscovered.
MedLine Citation:
PMID:  19660165     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Catatonia is the psychiatric syndrome of disturbed motor functions amid disturbances in mood and thought first described in 1874. It was quickly found in 10% to 38% of psychiatric populations. After it was tied to schizophrenia as a type in the psychiatric classification, its recognition became increasingly limited and by the 1980s questions were asked as to where the catatonics had gone. The decline is largely owing to the change in venue for psychiatric practice from asylum to office, the rejection of physical examination, and the dependence on item rating scales for diagnosis. In the 1970s, broad surveys again showed that catatonia was as common as before among patients with mania and depression, and as a toxic response to neuroleptic drugs. The latter recognition, that the neuroleptic malignant syndrome is the same syndrome as malignant catatonia, and is effectively treated as such, sparked a renewed interest. Clinicians developed rating scales to identify the catatonia syndrome and applied the immediate relief afforded by a barbiturate or a benzodiazepine as a diagnostic test, the lorazepam test. Effective treatments were described as high doses of benzodiazepines and electroconvulsive therapy (ECT). Surveys using catatonia rating scales showed catatonia to have many faces. Catatonia is presently limited to a type of schizophrenia in the psychiatric classification. Its recognition as a disorder of its own, such as delirium and dementia, should now be recognized. This experience reinforced the utility of the medical model for diagnosis. An application for melancholia is described.
Authors:
Max Fink
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Canadian journal of psychiatry. Revue canadienne de psychiatrie     Volume:  54     ISSN:  1497-0015     ISO Abbreviation:  Can J Psychiatry     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-08-07     Completed Date:  2009-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7904187     Medline TA:  Can J Psychiatry     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  437-45     Citation Subset:  IM    
Affiliation:
State University of New York at Stony Brook, Stony Brook, New York, USA. mfink@attglobal.net
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MeSH Terms
Descriptor/Qualifier:
Antipsychotic Agents / adverse effects
Barbiturates / therapeutic use
Benzodiazepines / therapeutic use
Bipolar Disorder / diagnosis,  epidemiology
Catatonia / classification,  diagnosis*,  epidemiology,  therapy
Comorbidity
Cross-Sectional Studies
Diagnosis, Differential
Dose-Response Relationship, Drug
Electroconvulsive Therapy
Humans
Neuroleptic Malignant Syndrome / diagnosis,  epidemiology
Schizophrenia, Catatonic / diagnosis,  epidemiology
Syndrome
Chemical
Reg. No./Substance:
0/Antipsychotic Agents; 0/Barbiturates; 12794-10-4/Benzodiazepines

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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