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. 2022 Jul 15;10(1):173.
doi: 10.1186/s40359-022-00885-7.

The psychological and subjective experience of catatonia: a qualitative study

Zukiswa Zingela  1 , Louise Stroud  2 , Johan Cronje  2 , Max Fink  3 , Stephan van Wyk  4
Affiliations

The psychological and subjective experience of catatonia: a qualitative study

Zukiswa Zingela et al. BMC Psychol. .

Abstract

Background: Catatonia is a severe psychomotor disorder that presents as abnormality of movement which may also be excessive or severely slowed. It often inhibits communication when protracted or severe. In this study we investigated the emotive and cognitive experience of patients with catatonia during a prevalence study in an acute mental health unit from August 2020 to September 2021. The value of this study is the addition of the inner and often unexplored cognitive and emotive experience of patients in the description of the catatonic state, which lends an additional dimension to complement the medical and psychopathological descriptors that have been the focus of most studies on catatonia.

Methods: Ethical approval was received from the Nelson Mandela University Human Research Committee and convenience sampling was undertaken to recruit participants admitted into an acute mental health unit with catatonia, four to eight weeks after discharge, following admission. The BFCSI and BFCRS and a pre-designed data collection sheet were used to assess n = 241 participants, and collect data on descriptions of thoughts, feelings, and behaviours they experienced during the catatonic episode.

Results: Forty-four (18.3%) of the total 241 participants who were assessed had catatonia. Thirty (68.2%) of the 44 participants with catatonia provided data on their experience of catatonia. Twenty-three were males (76.7% of 30) and seven were females (23.3% of 30). All were within the age range of 17 to 65 years. The dominant themes of thoughts, feelings, and behaviors described centered around yearning for or missing loved ones, heightened fear, intense anxiety, negative affect, aggression, obedience, and withdrawal.

Conclusions: The common themes that emerged from this study were overwhelming anxiety, fear, and depression. These were found to occur frequently in patients with catatonia when describing their psychological experience. These experiences may possibly relate to the flight, fight, freeze and fawn response, as described in prior studies on the subjective experience of catatonia.

Trial registration: Not applicable.

Keywords: Anxiety; Catatonia; Fear; Obedience; Psychological; Subjective; Withdrawal.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Decision Tree for feedback on participant experience during a catatonic episode
See this image and copyright information in PMC

References

    1. Northoff G. Catatonia and neuroleptic malignant syndrome: psychopathology and pathophysiology. J Neural Transm. 2002;109:1453–1467. doi: 10.1007/s00702-002-0762-z. - DOI - PubMed
    1. Sienaert P, Rooseleer J, De Fruyt J. Measuring catatonia: a systematic review of rating scales. J Affect Disord. 2011;135(1–3):1–9. doi: 10.1016/j.jad.2011.02.012. - DOI - PubMed
    1. Fink M, Taylor MA. Catatonia: a clinician’s guide to diagnosis and treatment. Cambridge: Cambridge University Press; 2003.
    1. Stuivenga M, Morrens M. Prevalence of the catatonic syndrome in an acute inpatient sample. Front Psych. 2014;3(5):174. - PMC - PubMed
    1. Zingela Z, Stroud L, Cronje J, Fink M, Van Wyk S. A prospective descriptive study on prevalence of catatonia and correlates in an acute mental health unit in Nelson Mandela Bay, South Africa. PLOS ONE. 2022;17(3):e0264944. doi: 10.1371/journal.pone.0264944. - DOI - PMC - PubMed

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