Update on Catatonia-View Presentation Slides

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The document is a comprehensive update from the American Psychiatric Association on catatonia, a complex neuropsychiatric syndrome characterized by symptoms such as immobility, mutism, and rigidity. It details historical perspectives on catatonia, referencing Kahlbaum's initial classification in 1874 and subsequent developments through DSM and ICD coding systems, which have iterated on catatonia's association with disorders like schizophrenia, affective disorders, and various medical illnesses.<br /><br />The update includes learning objectives centered around identifying signs, treatments, and understanding complications associated with untreated catatonia. Complications listed include aspiration pneumonia, renal failure, and cardiac arrest. Differential diagnoses are diverse, including metabolic, neurologic, and psychiatric causes.<br /><br />The seminar shared insights on manifestations like "waxen" flexibility and other motor abnormalities, using video vignettes and scales such as the Bush-Francis Catatonia Rating Scale for assessment. It underscores the absence of FDA-approved treatments, noting the use of off-label approaches like lorazepam and electroconvulsive therapy (ECT). A correlation was noted between catatonia and affective disorders, particularly mania, with reports of 20% to 31% of individuals with affective disorders displaying catatonic features.<br /><br />The webinar also tackled clinical questions on subtypes, prevalence, and differentiation from other motor syndromes. Notably, the discussion highlighted treatment challenges, including the risk of neuroleptic malignant syndrome when using antipsychotics.<br /><br />The seminar suggests lorazepam as an effective initial treatment, mentions potential secondary options like zolpidem, and points to ECT for severe cases. It also explored theoretical perspectives, such as catatonia being an evolutionary fear response.<br /><br />Additionally, the webinar provided practical instructions for participation, accessing content, and obtaining continuing education credits, encouraging participants to engage with experts and resources through platforms like SMI Adviser.

Keywords

catatonia

American Psychiatric Association

neuropsychiatric syndrome

Kahlbaum

Bush-Francis Catatonia Rating Scale

lorazepam

electroconvulsive therapy

affective disorders

neuroleptic malignant syndrome

SMI Adviser