[Catatonia in childhood and adolescence: obstacles to diagnosis and treatment]

Abstract

Background: Catatonia in children and adolescents is the same as it is for adults; in other words it is a recognisable psychomotor syndrome that follows a characteristic course and responds favourably to treatment with benzodiazepines and/or ect. Therefore, one would not expect to encumber many obstacles to diagnosis and treatment. In fact, the obstacles are fairly numerous.

Aim: To explore the obstacles that can hinder a simple approach to diagnosis and treatment and to provide support for the clinicians involved.

Method: We studied the literature systematically using Limo and keywords.

Results: For several decades, particularly in the literature, catatonia was defined as a subtype of schizophrenia. This exclusive link to schizophrenia led to the under-diagnosis of catatonia in patients with other psychiatric conditions and to delays in the administration of the correct treatment. Not only this historical error but also other important problems are complicating the approach to catatonia even today. Among other factors hindering diagnosis and treatment are the belief that catatonia is a rare illness, often denied by family members and some clinicians, the use of neuroleptics and the stigmatisation of benzodiazepines and/or ect.

Conclusion: Controversy about catatonia continues. Although diagnosis and treatment are clearly defined, catatonia is still putting professionals to the test. In our essay we offer some practical guidance and advice.