Catatonia: demographic, clinical and laboratory associations. Issue 6 (2nd April 2023)

• Record Type: Journal Article
• Authors: Rogers, Jonathan P.; Pollak, Thomas A.; Begum, Nazifa; Griffin, Anna; Carter, Ben; Pritchard, Megan; Broadbent, Matthew; Kolliakou, Anna; Ke, Jessie; Stewart, Robert; Patel, Rashmi; Bomford, Adrian; Amad, Ali; Zandi, Michael S.; Lewis, Glyn; Nicholson, Timothy R.; David, Anthony S.
• Is Part Of: Psychological medicine. Volume 53:Issue 6(2023)
• Page Start: 2492
• Page End: 2502
• Publication Date: 2023-04-02
• Subjects: Catatonia -- epidemiology -- inflammation -- NMDA receptor -- mortality -- admission -- incidence; Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291721004402
• Languages: English
• ISSNs: 0033-2917

Abstract

Abstract: Background: Catatonia, a severe neuropsychiatric syndrome, has few studies of sufficient scale to clarify its epidemiology or pathophysiology. We aimed to characterise demographic associations, peripheral inflammatory markers and outcome of catatonia. Methods: Electronic healthcare records were searched for validated clinical diagnoses of catatonia. In a case–control study, demographics and inflammatory markers were compared in psychiatric inpatients with and without catatonia. In a cohort study, the two groups were compared in terms of their duration of admission and mortality. Results: We identified 1456 patients with catatonia (of whom 25.1% had two or more episodes) and 24 956 psychiatric inpatients without catatonia. Incidence was 10.6 episodes of catatonia per 100 000 person-years. Patients with and without catatonia were similar in sex, younger and more likely to be of Black ethnicity. Serum iron was reduced in patients with catatonia [11.6 v. 14.2 μmol/L, odds ratio (OR) 0.65 (95% confidence interval (CI) 0.45–0.95), p = 0.03] and creatine kinase was raised [2545 v. 459 IU/L, OR 1.53 (95% CI 1.29–1.81), p < 0.001], but there was no difference in C-reactive protein or white cell count. N -Methyl-d -aspartate receptor antibodies were significantly associated with catatonia, but there were small numbers of positive results. Duration of hospitalisation was greater in the catatonia group (median: 43 v. 25 days), but there was no difference in mortality after adjustment. Conclusions: In the largest clinical study of catatonia, we found catatonia occurred in approximately 1 per 10 000 person-years. Evidence for a proinflammatory state was mixed. Catatonia was associated with prolonged inpatient admission but not with increased mortality.