Clinical and demographic profile of catatonic patients who received electroconvulsive therapy in a South African setting

Odayar, Kavendren; Eloff, Ingrid; Esterhuysen, Willem

doi:10.4102/sajpsychiatry.v24i0.1100

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…In this study, the most common mental disorder associated with catatonia was schizophrenia, followed by major depressive disorder. This finding is similar to that of a study performed in the United States of America [34,35]; however, another study found that catatonia associated with mood disorder was more common than catatonia associated with schizophrenia [36]. In our study, there is no recorded catatonia sign of excitement, echopraxia/echolalia, stereotypy, mannerisms, verbigeration, stereotypy, impulsivity, grasp reflex, perseveration, and combativeness.…”

Section: Discussionsupporting

confidence: 91%

The Presentation and Treatment Response of Catatonia in Patients Admitted to the Psychiatric Inpatient Unit at Jimma University Medical Center, Ethiopia

2020

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Background. Catatonia is among the most mysterious and poorly understood neuropsychiatric syndrome. It is underresearched and virtually forgotten but still a frequent neuropsychiatric phenotype in both developed and low-income countries. Catatonia is associated with a number of medical complications like pulmonary embolism, dehydration, or pneumonia if it is not treated and managed adequately. In Ethiopia, however, almost no studies are available to describe the symptoms and the response to treatment in patients with catatonia. The aim of this retrospective study was therefore to describe the symptom profile of catatonia and to evaluate the treatment and outcome of catatonia in patients admitted to the psychiatric inpatient unit at Jimma University, Ethiopia. Method. Detailed treatment records of all inpatients were reviewed for the period from May 2018 to April 2019. All patients with catatonia at the inpatient unit of Jimma University Medical Center were assessed with the Bush-Francis Catatonia Rating Scale (BFCRS), and all comorbid psychiatric diagnoses were made according to the criteria of the Diagnostic Statistical Manual V. The presence and severity of catatonia were assessed by using the BFCRS at baseline and at discharge from the hospital. Result. In the course of one year, a total of 18 patients with the diagnosis of catatonia were admitted. The mean age of the participants was 22.8 years (SD 5.0; range: 15 to 34 years). The most common diagnosis associated with catatonia was schizophrenia (n=12; 66.7%), followed by severe depressive disorders (n=4; 22.2%). Mutism, posture, and withdrawal were registered in all patients (n=18, 100%). All patients received an injection of diazepam and had improved at discharge. Conclusion. Our study provides further evidence that catatonia is most commonly associated with schizophrenia, followed by major depressive disorder, and that mutism, posturing, and withdrawal are the most common signs and symptoms of catatonia.

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Section: Discussionsupporting

confidence: 91%

The Presentation and Treatment Response of Catatonia in Patients Admitted to the Psychiatric Inpatient Unit at Jimma University Medical Center, Ethiopia

2020

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“…Another study conducted in SA described the treatment of 42 patients with catatonia with ECT. 10 The current study represents the first stages of aiming to fill the gap in the existing research with a prospective study on prevalence and predictive data.…”

Section: Introductionmentioning

confidence: 99%

Protocol for a prospective descriptive prevalence study of catatonia in an acute mental health unit in urban South Africa

et al. 2020

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IntroductionCatatonia arises from serious mental, medical, neurological or toxic conditions. The prevalence range depends on the setting and the range is anything from 7% to 63% in other countries. South African prevalence rates are currently unknown. The proposed study is a quantitative descriptive study using the Bush Francis Catatonia Screening Instrument as a screening tool with a data capturing information sheet to extract clinical information from patient folders. The study will investigate: (1) prevalence of catatonia, (2) clinical and demographic correlates associated with catatonia, (3) predictors of catatonia, (4) response to treatment and (5) subjective experience of catatonia.Methods and analysisThe setting is an acute mental health unit (MHU) within a regional, general medical hospital in Nelson Mandela Bay, South Africa, which accepts referrals from within the hospital and from outlying clinics. Participants will be recruited from inpatients in the MHU from beginning of September 2020 to end of August 2021. Most admissions are involuntarily, under the Mental Health Care Act of 2002 with an age range of 13 to over 65 years. Participants who screen positive for catatonia will be followed up after discharge for 3 months to measure outcomes. Primary outcomes will include the 12-month prevalence rate of catatonia, descriptive and other data on presentation and assessment of catatonia in the MHU. Secondary outcomes will include data on treatment response, participants’ report of their subjective experience of catatonia and predictors of catatonia. Descriptive statistics, multivariate binomial logistic regression and univariate analyses will be conducted to evaluate associations between catatonia and clinical or demographic data which could be predictors of catatonia. Survival analysis will be used to examine the time to recovery after diagnosis and initiation of treatment. The 95% CI will be used to demonstrate the precision of estimates. The level of significance will be p≤0.05.Ethics and disseminationThe study has received ethical approval from the Research and Ethics Committees of the Eastern Cape Department of Health, Walter Sisulu University and Nelson Mandela University. The results will be disseminated as follows: at various presentations and feedback sessions; as part of a PhD thesis in Psychology at Nelson Mandela University; and in a manuscript that will be submitted to a peer-reviewed journal.

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“…Other studies have primarily included patients with catatonia due to affective disorders, in whom acute retarded catatonia—the so-called Kahlbaum phenotype—is the most frequent catatonia presentation 8 11 36 . However, there are also studies with higher frequencies of psychotic disorders in their samples of catatonia patients 37 38 39 . Clearly, the proportions of catatonia with different comorbid mental disorders will change with the revised diagnostic criteria in ICD-11 and DSM-5-TR.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Electroconvulsive Therapy on Specific Catatonia Symptoms and Predictors of Late Response

Bracht,

Walther,

Breit

et al. 2023

Pharmacopsychiatry

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Introduction Electroconvulsive therapy (ECT) is known to be effective in the treatment of catatonia, reaching response rates of about 80 to 100%. It is indicated in cases of treatment resistance to benzodiazepines and in life-threatening conditions such as malignant catatonia. Beneficial effects on specific symptoms or predictors of response are less clear. The objective of this retrospective study is to examine the ECT effect on specific catatonia symptoms in the acute phase of the illness and to identify predictors of response. Methods A retrospective study examined data from 20 patients with catatonia, 18 associated with schizophrenia and 2 with bipolar disorder, who underwent ECT from 2008 to 2021. Ten subjects had more than one ECT-series, resulting in a total of 31 ECT-series. Catatonia symptom severity was assessed with the Bush Francis Catatonia Rating Scale (BFCRS). Results ECT yielded excellent response. Nineteen of 20 patients and 30 of 31 ECT-series achieved response. The mean number of ECT sessions to response was 4.2. Response to ECT was more pronounced for motor inhibition symptoms such as stupor and mutism, while echophenomena, dyskinesia, stereotypy and perseveration responded less well. A predictor of late response was the presence of grasp reflex. Discussion The present study corroborates the high and rapid effectiveness of ECT in the treatment of catatonia. Focus on single catatonia signs may help to identify those who are most likely to achieve remission quickly, as well as those who might need longer ECT-series.

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Clinical and demographic profile of catatonic patients who received electroconvulsive therapy in a South African setting

Cited by 4 publications

References 15 publications

The Presentation and Treatment Response of Catatonia in Patients Admitted to the Psychiatric Inpatient Unit at Jimma University Medical Center, Ethiopia

The Presentation and Treatment Response of Catatonia in Patients Admitted to the Psychiatric Inpatient Unit at Jimma University Medical Center, Ethiopia

Protocol for a prospective descriptive prevalence study of catatonia in an acute mental health unit in urban South Africa

The Effect of Electroconvulsive Therapy on Specific Catatonia Symptoms and Predictors of Late Response

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