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Catatonia
Classification and external resources
ICD-10 F20. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings 2
ICD-9 295.2

Catatonia is a syndrome of psychic and motoric disturbances. In the current Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association (DSM-IV) it is not recognized as a separate disorder, but is associated with psychiatric conditions such as schizophrenia (catatonic type), bipolar disorder, post-traumatic stress disorder, depression and other mental disorders, as well as drug abuse and/or overdose. Schizophrenia ( from the Greek roots schizein (σχίζειν "to split" and phrēn Post traumatic stress disorder It is a severe and ongoing emotional reaction to Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Drug abuse has a wide range of definitions related to taking a Psychoactive drug or Performance enhancing drug for a non-therapeutic or non-medical effect The term drug overdose (or simply overdose or OD) describes the Ingestion or application of a Drug or other substance in quantities It may also be seen in many medical disorders including infections (such as encephalitis), autoimmune disorders, focal neurologic lesions (including strokes), metabolic disturbances and abrupt or overly rapid withdrawal from benzodiazepines. Benzodiazepine withdrawal syndrome is caused by stopping benzodiazepines or during dosage reduction of Benzodiazepines. [1] It can be an adverse reaction to prescribed medication. It bears similarity to conditions such as encephalitis lethargica and neuroleptic malignant syndrome. Encephalitis lethargica (EL or von Economo disease is an atypical form of Encephalitis. Neuroleptic malignant syndrome (NMS is a life-threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. There are a variety of treatments available, and depending on the case, one or more drugs may be used, including antipsychotics and benzodiazepines. Antipsychotics are a group of Psychoactive drugs commonly but not exclusively used to treat Psychosis, which is typified by Schizophrenia. The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic

Contents

Clinical features

Patients with catatonia may experience an extreme loss of motor ability or constant hyperactive motor activity. Catatonic patients will sometimes hold rigid poses for hours and will ignore any external stimuli. Patients with catatonic excitement can die of exhaustion if not treated. Patients may also show stereotyped, repetitive movements. They may show specific types of movement known as "waxy flexibility" in which they maintain positions after being placed in them by someone else, or gegenhalten (lit. "counterhold"), in which they resist movement in proportion to the force applied by the examiner. They may repeat meaningless phrases or speak only to repeat what the examiner says.

While catatonia is only identified as a form of schizophrenia in present psychiatric classifications, it is increasingly recognized as a syndrome with many faces. It appears as the Kahlbaum syndrome (retarded catatonia), malignant catatonia (neuroleptic malignant syndrome, toxic serotonin syndrome), and excited forms (delirious mania, catatonic excitement, oneirophrenia). [Fink M, Taylor MA: CATATONIA: A Clinician's Guide to Diagnosis and Treatment, Cambridge U Press, 2003]. It has also been recognized as grafted on to autistic spectrum disorders. [Dhossche D et al: Catatonia in Autism Spectrum Disorders, Elsevier, Amsterdam, 2006]

Diagnostic criteria

According to the DSM-IV, the "With catatonic features" specifier can be applied if the clinical picture is dominated by at least two of the following:

Subtypes

Stupor is a motionless, apathetic state in which one is oblivious or does not react to external stimuli. In Physiology, a stimulus is a detectable change in the internal or external environment Motor activity is nearly non-existent. A motor skill is generally agreed as a learned skill that involves voluntary movement to complete a task Individuals in this state make little or no eye contact with others and may be mute and rigid. Speech disorders or speech impediments, as they are also called are a type of Communication disorders where 'normal' speech is disrupted One might remain in one position for a long period of time, and then go directly to another position immediately after the first position.

Catatonic excitement is a state of constant purposeless agitation and excitation. Individuals in this state are extremely hyperactive although the activity seems to lack purpose.

A catatonia rating scale has been developed to identify the syndrome. [Fink M, Taylor MA: CATATONIA . . . ]. The diagnosis is verified by a benzodiazepine or barbiturate test. The diagnosis is validated by the quick response to either benzodizepines or ECT.

Treatment

Initial treatment is aimed at providing relief from the catatonic state. Benzodiazepines are the first line of treatment, and high doses are often required. The benzodiazepines (pronounced, often abbreviated to "benzos") are a class of Psychoactive drugs with varying Hypnotic A test dose of 1-2 mg intramuscular lorazepam will often result in marked improvement within half an hour. Lorazepam (also known by its brand name Ativan or Temesta) is a Benzodiazepine drug with short to medium duration of action In France, zolpidem has also been used in diagnosis and response may occur within the same time period. Zolpidem is a prescription medication used for the short-term treatment of Insomnia, as well as some brain disorders Ultimately the underlying cause needs to be treated.

Electroconvulsive therapy is an effective treatment for catatonia as well as for most of the underlying causes (e. Electroconvulsive therapy ( ECT) also known as electroshock, is a controversial psychiatric treatment in which Seizures are electrically induced g. psychosis, mania, depression). Psychosis (from the Greek ψυχή "psyche" for mind or soul and -οσις "-osis" for abnormal condition with adjective psychotic Mania (from Greek μανία and that from μαίνομαι - mainomai, "to rage to be furious" is a severe medical condition Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Antipsychotics should be used with care as they can worsen catatonia and are the cause of neuroleptic malignant syndrome, a dangerous condition that can mimic catatonia and requires the immediate discontinuation of the antipsychotic. Antipsychotics are a group of Psychoactive drugs commonly but not exclusively used to treat Psychosis, which is typified by Schizophrenia. Neuroleptic malignant syndrome (NMS is a life-threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs.

References

  1. ^ Rosebush PI; Mazurek MF. (Aug 1996). "Catatonia after benzodiazepine withdrawal. ". Journal of clinical psychopharmacology. 16 (4): 315–9. doi:10.1097/00004714-199608000-00007. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 883570.  

Caroff, Stanley N, MD (Editor); Mann, Stephen C (Editor); Francis, Andrew (Editor); Fricchioni, Gregory L, MD (Editor);Catatonia: From Psychopathology to Neurobiology; American Psychiatric Publishing, Inc. 2004

Fink M. , Taylor MA. Catatonia: A Clinician's Guide to Diagnosis and Treatment. Cambridge UK: Cambridge University Press, 2003.

Dhossche DM, Wing L, Ohta M, Neumärker, K-J (Editors): Catatonia in Autism Spectrum Disorders. Amsterdam: Elsevier, Int Rev Biol 72; 2006.

Dictionary

catatonia

-noun

  1. A severe psychiatric condition, often associated with schizophrenia, characterized by a tendency to remain in a rigid state of stupor for long periods which give way to short periods of extreme agitation
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