Rozália Takács 1,2, Gábor Gazdag 3,4
1 Tóth Ilona Medical Service, Psychiatric Outpatient Service, Budapest, Hungary
2 School of Doctoral Studies, Semmelweis University, Budapest, Hungary
3 Jahn Ferenc Dél-pesti Hospital, Centre of Psychiatry and Addiction Medicine, Budapest, Hungary
4 Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
Introduction: Over the past years, increasing attention has been focused on catatonia. This is also reflected in DSM-5, which broadened the concept of catatonia and decoupled it from schizophrenia. Most often affective disorders serve as a background for a catatonic syndrome, but several medical conditions could also cause catatonic signs and symptoms.
Aims: The aim of this prospective study was to determine the prevalence of the catatonic syndrome in patients admitted to an acute psychiatric unit in Hungary.
Methods: As part of the comprehensive psychiatric assessment on admission, all patients admitted to the acute inpatient unit of the Centre of Psychiatry and Addiction Medicine, Szent Istvan and Szent Laszlo Hospitals in a 4-month period were screened for catatonic signs and symptoms. Catatonic signs/symptoms were scored according to both the DSM-5 diagnostic criteria and the Bush Francis Catatonia Rating Scale (BFCRS). Clinical diagnoses were established using the Structured Clinical Interview for DSM-IV Disorders, while cognitive performance was assessed with the Clock Drawing Test and the Mini Mental State Examination.
Results: During the study period, 342 patients were admitted to the above acute inpatient unit. The prevalence figures for the catatonic syndrome were 8.55% and 5.02% according to the BFCRS and the DSM-5, respectively.
Conclusion: The prevalence of catatonic syndrome in an acute inpatient setting is within the broad range of figures reported in the literature. The difference between the standardized assessment (BFCRS) and routine clinical judgment (DSM-5) is noteworthy and suggests that a significant minority of catatonic patients might not be identified in clinical practice. As acute catatonia can be effectively treated, and early treatment could prevent potentially life-threatening complications, recognition of catatonic symptoms is vitally important.
Doctoral School: Mental Health Studies
Title of the Program: Psychiatry
Supervisor: Gábor Gazdag MD, PhD