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Case 36: - Catatonia and Electroconvulsive Therapy

from Part 1: - Vignettes

Published online by Cambridge University Press:  04 September 2025

Howard CH Khoe
Affiliation:
National Psychiatry Residency Programme, Singapore
Cheryl WL Chang
Affiliation:
National University Hospital, Singapore
Cyrus SH Ho
Affiliation:
National University Hospital, Singapore
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Summary

Chapter 36 covers the topic of catatonia and electroconvulsive therapy . Through a case vignette with topical MCQs for consolidation of learning, readers are brought through the management of a patient with catatonia from first presentation to subsequent complications of the conditions and its treatment with electroconvulsive therapy (ECT) and other medications. Things covered include the symptoms, diagnosis, differential diagnoses, investigations, the evidence-based use and indications of pharmacological treatment such as benzodiazpines and ECT, adverse effects of ECT, management of adverse cognitive effects from ECT and use of ECT in pregnancy.

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Type
Chapter
Information
Practise Psychiatry
A Guide Through Vignettes and MCQs
, pp. 320 - 330
Publisher: Cambridge University Press
Print publication year: 2025

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References

World Health Organization. International classification of diseases, 11th edition (ICD-11). Geneva: World Health Organization; 2024. Available from: https://icd.who.int/enGoogle Scholar
Bush, G, Fink, M, Petrides, G, Dowling, F, Francis, A. Catatonia, I. Rating scale and standardized examination. Acta Psychiatr Scand. 1996 Feb;93(2):129–36.CrossRefGoogle ScholarPubMed
Oldham, MA. The probability that catatonia in the hospital has a medical cause and the relative proportions of its causes: a systematic review. Psychosomatics. 2018 Jul;59(4):333–40.CrossRefGoogle Scholar
Rogers, JP, Pollak, TA, Blackman, G, David, AS. Catatonia and the immune system: a review. Lancet Psychiatry. 2019 Jul;6(7):620–30.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Association Publishing; 2022. Available from: www.psychiatry.org/psychiatrists/practice/dsmGoogle Scholar
Huang, TL. Lorazepam and diazepam rapidly relieve catatonic signs in patients with schizophrenia. Psychiatry Clin Neurosci. 2005 Feb;59(1):52–5.CrossRefGoogle ScholarPubMed
Northoff, G. What catatonia can tell us about “top-down modulation”: a neuropsychiatric hypothesis. Behav Brain Sci. 2002 Oct;25(5):555–77; discussion 578–604.10.1017/S0140525X02000109CrossRefGoogle ScholarPubMed
Fink, M, Taylor, MA. The many varieties of catatonia. Eur Arch Psychiatry Clin Neurosci. 2001;251(Suppl 1):I8-13.10.1007/PL00014200CrossRefGoogle ScholarPubMed
Francis, A. Catatonia: diagnosis, classification, and treatment. Curr Psychiatry Rep. 2010 Jun;12(3):180–5.10.1007/s11920-010-0113-yCrossRefGoogle ScholarPubMed
Fink, M, Taylor, MA. The catatonia syndrome: forgotten but not gone. Arch Gen Psychiatry. 2009 Nov;66(11):1173–7.CrossRefGoogle Scholar
Falkai, P, Wobrock, T, Lieberman, J, Glenthoj, B, Gattaz, WF, Möller, HJ, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, Part 1: acute treatment of schizophrenia. World J Biol Psychiatry. 2005;6(3):132–91.10.1080/15622970510030090CrossRefGoogle ScholarPubMed
Bush, G, Fink, M, Petrides, G, Dowling, F, Francis, A. Catatonia II. Treatment with lorazepam and electroconvulsive therapy. Acta Psychiatr Scand. 1996 Feb;93(2):137–43.10.1111/j.1600-0447.1996.tb09815.xCrossRefGoogle ScholarPubMed
Koek, RJ, Mervis, JR. Treatment-refractory catatonia, ECT, and parenteral lorazepam. Am J Psychiatry. 1999 Jan;156(1):160–1; author reply 161.Google ScholarPubMed
Kellner, CH, Fink, M, Knapp, R, Petrides, G, Husain, M, Rummans, T, et al. Relief of expressed suicidal intent by ECT: a consortium for research in ECT study. Am J Psychiatry. 2005 May;162(5):977–82.CrossRefGoogle Scholar
Semple, D, Smyth, R. Oxford handbook of psychiatry, 4th edition. Oxford: Oxford University Press; 2019.10.1093/med/9780198795551.001.0001CrossRefGoogle Scholar
Rajagopalan, A, Lim, KWK, Tan, XW, Martin, D, Lee, J, Tor, PC. Predictors of cognitive changes in patients with schizophrenia undergoing electroconvulsive therapy. PLoS One. 2023;18(5):e0284579.CrossRefGoogle ScholarPubMed
Miller, LJ. Use of electroconvulsive therapy during pregnancy. Hosp Community Psychiatry. 1994 May;45(5):444–50.Google ScholarPubMed
Stern, TA, editor. Massachusetts General Hospital handbook of general hospital psychiatry, 7th edition. Edinburgh: Saunders/Elsevier; 2018.Google Scholar
Rose, S, Dotters-Katz, SK, Kuller, JA. Electroconvulsive therapy in pregnancy: safety, best practices, and barriers to care. Obstet Gynecol Surv. 2020 Mar;75(3):199203.10.1097/OGX.0000000000000763CrossRefGoogle ScholarPubMed

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