• DOI:10.1017/s0033291721004402
• Corpus ID: 242076501

Catatonia: demographic, clinical and laboratory associations.

@article{Rogers2021CatatoniaDC,
  title={Catatonia: demographic, clinical and laboratory associations.},
  author={Jonathan P. Rogers and Thomas A. Pollak and Nazifa Begum and Anna Griffin and Ben Carter and Megan Pritchard and Matthew T. M. Broadbent and Anna Kolliakou and Jessie Ke and Robert J. Stewart and Rashmi Patel and Adrian Bomford and Ali Amad and Michael S Zandi and Glyn Lewis and Timothy R. Nicholson and Anthony S. David},
  journal={Psychological medicine},
  year={2021},
  pages={
          1-11
        }
}

• J. Rogers, T. Pollak, +14 authors A. David
• Published 2 November 2021
• Medicine, Psychology
• Psychological medicine

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.