Catatonia

Etiology

  • A syndrome that can occur alongside an array of psychiatric and medical conditions
  • Precise pathologic process unclear
  • Responds to treatment w/benzodiazepines

Risk Factors

  • Underlying psychiatric disorders (schizophrenia, bipolar, depression)

Symptoms

  • Psychomotor retardation (most common): immobility, mutism, staring, withdrawn, refuse to eat/drink, refusal to follow directions (negativism)
  • Presents acutely, though precise precipitant (e.g. med change, progression of underlying psychiatric dz) often not clear
  • Agitated or malignant form (much less common); similar to Neuroleptic-Malignant syndrome; psychomotor agitation, confusion, autonomic instability; w/significant risk morbidity/mortality

Physical Exam Findings

  • Staring, mutism, rigidity, waxy flexibility
  • Less commonly posturing, grimacing
  • Malignant form assoc w/more severe illness: agitation, fever, abnormal pulse and bp