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. 2023 Apr;53(6):2492-2502.
doi: 10.1017/S0033291721004402. Epub 2021 Nov 2.

Catatonia: demographic, clinical and laboratory associations

Jonathan P Rogers  1   2 , Thomas A Pollak  2   3 , Nazifa Begum  4 , Anna Griffin  4 , Ben Carter  5 , Megan Pritchard  2 , Matthew Broadbent  2 , Anna Kolliakou  6 , Jessie Ke  2 , Robert Stewart  2   6 , Rashmi Patel  3 , Adrian Bomford  7 , Ali Amad  8   9 , Michael S Zandi  10   11 , Glyn Lewis  1 , Timothy R Nicholson  3 , Anthony S David  10   12
Affiliations

Catatonia: demographic, clinical and laboratory associations

Jonathan P Rogers et al. Psychol Med. 2023 Apr.

Abstract

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.

Keywords: Catatonia; NMDA receptor; admission; epidemiology; incidence; inflammation; mortality.

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Conflict of interest statement

JPR has held one advisory meeting with Promentis Pharmaceuticals, Inc. in an unpaid capacity. MSZ reports receiving personal fees from UCB Pharma for lecturing, outside the submitted work. RS declares research support received in the last 36 months from Janssen, GSK and Takeda. RP has received grant funds from Janssen and consultancy fees from Induction Healthcare and Holmusk outside the present study. All other authors declare no competing interests.

Figures

Fig. 1.
Fig. 1.
Identification and screening of cases.
Fig. 2.
Fig. 2.
Catatonic episode per 100 000 local population by year.
See this image and copyright information in PMC

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