Prevalence of Catatonia in the Sample of Patients Admitted to the Psychiatric Institute of Ain Shams University Hospital: A 2 Year Hospital Based Descriptive Study

Abstract

Abstract Background Catatonia is characterized by a number of impressive motor phenomena (rigor, dyskinesia, posturing, catalepsy, gegenhalten, stereotypies, etc.) as much as flamboyant affective symptoms (anxiety, aggression, flat affect or affect incontinence) and bizarre behavioral abnormalities (autism, mutism, echolalia, echopraxia, etc.). Despite a renewed interest in the disorder over the last several decades, a number of questions remain regarding its prevalence, causes and treatment. Clinical manifestations of catatonia are extremely heterogeneous and at least 40 separate signs of catatonia have been described, making recognition challenging with frequent misdiagnoses. The difficulties in the clinical diagnosis, conceptualization and management of catatonia have been described as “The catatonic dilemma”. The relative prevalence and diagnostic significance of catatonic signs differ among studies and patient populations. This study aimed to measure the prevalence of catatonia in the patients admitted at the Institute of Psychiatry through the two years (2019 and 2020), to describe different causes, types of catatonia, to identify the most frequent cause and type during this period and to identify different clinical and demographic correlates affecting the prevalence and severity of the cases. It was held at the Institute of Psychiatry of Ain Shams University Hospital, located In Eastern Cairo, serve both urban and rural areas in Cairo and other governorates in Egypt. Methods The sample consisted of a group of patients diagnosed with catatonia (n = 49) and another group of all psychiatric patients without catatonia admitted at the Institute during these two years (n = 1056). The sample was assessed using The Structured Clinical Interview for DSM-V Axis I Disorders (SCID- 5), Structured Clinical Interview for the DSM V (SCID-5PD), The Bush- Francis Catatonia Rating Scale (BFCRS) and designed questionnaire. Results Patients with younger age, with abnormal prenatal history and with authoritarian paternal control showed significantly higher odds of experiencing catatonia than those with older age, normal history and authoritative paternal control. Moreover, patients using more than one substance had significantly lower odds of experiencing catatonia than those not using at all. Furthermore, patients who elicited depressive symptoms with psychotic features prior to catatonic symptoms onset had significantly higher catatonia rating scale (CRS) than those with psychotic symptoms. Also, patients with malignant catatonia showed significantly higher CRS than those with retarded catatonia. Conclusion The prevalence rate of catatonia was 4.4%. There are several socio-demographic and clinical correlates affecting the prevalence and the severity of catatonia