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Catatonia: the rise and fall of an intriguing psychopathological dimension

  • F. M. M. A. van der Heijden (a1), S. Tuinier (a1), L. Pepplinkhuizen (a2) and W. M. A. Verhoeven (a1) (a2)

Abstract

Background:

For at least 125 years the discussion about the clinical relevance of catatonic symptoms in psychiatry continues. It started from the original description by Kahlbaum and was revived by modern factor analytical studies, that identified the catatonic dimension in about 10% of newly admitted patients.

Objective:

Over a period of 2 years, four patients with an acute episodic psychosis and prominent catatonic symptoms were examined.

Methods:

A clinical description is given of the psychopathology and classification is performed according to the various diagnostic instruments.

Results:

All patients showed a circular fluctuation of their psychoses, with motor symptoms ranging from the excited to the inhibited pole within one episode. Their clinical pictures also comprised mood swings and anxieties as well as hallucinatory and delusional experiences, whereas the course of disease was characterized by complete recovery without residual symptoms.

Conclusions:

The significance of catatonic symptoms is not recognized in the current taxonomies despite the fact that this has major pharmacological treatment implications.

Copyright

Corresponding author

Vincent van Gogh Institute for Psychiatry, PO Box 5, 5800 AA, Venray, the Netherlands. Tel: 0031 478 527339; Fax: 0031 478 527110.

References

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1Kahlbaum, KL.Die Katatonie oder das Spannungsirresein, Eine klinische Form psychischer Krankheit. Nijmegen: Arts & Boeve, 2000 (1874).
2Wernicke, C.Grundriss der Psychiatrie in klinischen Vorlesungen. Nijmegen; Arts & Boeve, neuausgabe der zweiten auflage, 2000 (1906).
3Kleist, K.Die Katatonie. Nervenarzt 1943;16: 110.
4Leonhard, K.Aufteilung der endogenen Psychosen und ihre differenzierte Ätiologie. Stuttgart: Georg Thieme Verlag, 1995.
5Gjessing, RR.Contribution to the somatology of periodic catatonia. Oxford: Pergamon Press, 1976.
6Gjessing, LR.A review of periodic catatonia. Biol Psychiatry 1974;8: 2345.
7Kitamura, T, Okazaki, Y, Fujinawa, A.Symptoms of psychoses — a factor analytic study. Br J Psychiatry 1995;166: 236240.
8Van Os, J, Fahy, A, Jones, Pet al. Psychopathological syndromes in the functional psychoses. associations with course and outcome. Psychol Med 1996;26: 161176.
9Peralta, V, Cuesta, MJ.Motor features in psychotic disorders. I. Factor structure and clinical correlates. Schizophr Res 2001;47: 107116.
10Peralta, V, Cuesta, MJ.Motor features in psychotic disorders. II. Development of dimensional criteria for catatonia. Schizophr Res 2001;47: 117126.
11Leonhard, K.Is the concept of ‘schizo-affective psychosis’ prognostically of value? Psychiatr Clin 1983;16: 178185.
12Stöber, G, Franzek, E, Lesch, KP, Beckmann, H.Periodic catatonia: a schizophrenic subtype with major gene effect and anticipation. Eur Arch Psychiatry Clin Neurosci 1995;245: 135141.
13Stöber, G, Pfuhlmann, B, Nürnberg, Get al. Towards the genetic basis of periodic catatonia: pedigree sample for genome scan I and II. Eur Arch Psychiatry Clin Neurosci Suppl 2001;251: 2530.
14Stöber, G.Genetic predisposition and environmental causes in periodic and systematic catatonia. Eur Arch Psychiatry Clin Neurosci Suppl 2001;251: 2124.
15Beckmann, H, Franzek, E, Stöber, G.Genetic heterogeneity in catatonic schizophrenia: a family study. Am J Med Genet 1996;67: 289300.DOI: 10.1002/(sici)1096-8628(19960531)67:3<289::aid-ajmg5>3.0.co;2-i
16Peralta, V, Cuesta, MJ, Serrano, JF, Mata, I.The Kahlbaum syndrome. A study of its clinical validity, nosological status and relationship with schizophrenia and mood disorder. Compr Psychiatry 1997;38: 6167.
17Johnson, J.Stupor. a review of 25 cases. Acta Psychiatr Scand 1984;70: 370377.
18Raskin, DE, Frank, SW.Herpes encephalititis with catatonic stupor. Arch General Psychiatry 1974;31: 544546.
19Scamvougeras, A, Rosenbush, PI.AIDS-related psychosis with catatonia responding to low dose lorazepam [letter]. J Clin Psychiatry 1992;53: 414415.
20Carroll, BT, Anfinson, TJ, Kennedy, JC, Yendrek, R, Boutros, M, Bilon, A.Catatonic disorder due to general medical conditions. J Neuropsychiatr Clin Neurosci 1994;6: 122133.
21Luchins, DJ, Metz, JT, Marks, RC, Cooper, MD.Basal ganglia regional glucose metabolism asymmetry during a catatonic episode. Biol Psychiatry 1989;26: 725728.
22Burruss, JW, Chacko, RC.Episodically remitting akinetic mutism following subarachnoid hemorrhage. J Neuropsychiatr Clin Neurosci 1999;11: 100102.
23Ruff, RL, Russakoff, LM.Catatonia with frontal lobe atrophy. J Neurol Neurosurg Psychiatry 1980;43: 185187.
24Taylor, MA.Catatonia. A review of a behavioral neurologic syndrome. Neuropsychiatr Neuropsychol Behav Neurol 1990;3: 4872.
25Leentjens, AFG, Pepplinkhuizen, L.A case of periodic catatonia, due to frontal lobe epilepsy. Int J Psychiatr Clin Pract 1998;2: 5759.
26Cooper, AF, Schapira, K.Case report. depression, catatonic stupor and EEG changes in hyperparathyroidism. Psychol Med 1973;3: 509516.
27Lehmann, J.Mental disturbances followed by stupor in a patient with carcinoidosis. Acta Psychiatr Scand 1966;42: 153161.
28Fekkes, D, Pepplinkhuizen, L, Verhey, R.Abnormal plasma levels of serine, methionine, and taurine in transient acute polymorphic psychosis. Psychiatry Res 1994;51: 1118.
29Crimlisk, HL.The little imitator-porphyria: a neuropsychiatric disorder. J Neurol Neurosurg Psychiatry 1997;62: 319328.
30Francis, A.Catatonia. In: Henn, F, Sartorius, N, Helmchen, H, Lauter, H, eds. Contemporary psychiatry. Berlin: Springer Verlag, 2001: 366372.
31Bush, G, Fink, M, Petrides, G, Dowling, F, Francis, A.Catatonia I. Rating scale and standardized examination. Acta Psychiatr Scand 1996;93: 129136.
32Perris, C, Brockington, IF.Cycloid psychoses and their relation to the major psychoses. In: Perris, C, Struwe, G, Jansson, B, eds. Biol psychiatry. Amsterdam: Elsevier, 1981: 447450.
33Abrams, R, Taylor, MA.Catatonia: a prospective clinical study. Arch General Psychiatry 1976;33: 579581.
34Rosenbush, PI, Hildebrand, AM, Furlong, BG, Mazurek, MF.Catatonic syndrome in a general psychiatric inpatient population. frequency, clinical presentation, and response to lorazepam. J Clin Psychiatry 1990;51: 357362.
35Barnes, MP, Saunders, M, Walls, TJ, Saunders, I, Kirk, CA.The syndrome of Karl Ludwig Kahlbaum. J Neurol Neurosurg Psychiatry 1986;49: 991996.
36Fink, M, Taylor, MA.Catatonia: a separate category in DSM-IV? Integr Psychiatry 1991;7: 210.
37Van Praag, HM.A transatlantic view of the diagnosis of depressions according to the DSM-III. I. Controversies and misunderstandings in depression diagnosis. Compr Psychiatry 1982;23: 315329.
38Van Praag, HM.A transatlantic view of the diagnosis of depressions according to the DSM-III. II did the DSM-III solve the problem of depression diagnosis? Compr Psychiatry 1982;23: 330337.
39Van Praag, HM.Over the mainstream: diagnostic requirements for biological psychiatric research. Psychiatry Res 1997;72: 201212.
40Van Praag, HM, Asnis, GM, Kahn, RSet al. Nosological tunnel vision in biological psychiatry: a plea for functional psychopathology. Ann NY Acad Sci 1990;600: 501510.
41Fink, M.Catatonia: syndrome or schizophrenia subtype? Recognition and treatment. J Neural Transm 2001;108: 637644.
42Kleist, K.Schizophrenic symptoms and cerebral pathology. J Ment Sci 1960;106: 246255.
43Cummings, JL.Frontal–subcortical circuits and human behaviour. Arch Neurol 1993;50: 873880.
44Lauer, M, Schirrmeister, H, Gerhard, Aet al. Disturbed neural circuits in a subtype of chronic catatonic schizophrenia demonstrated by F-18-FDG-PET and F-18-DOPA-PET. J Neural Transm 2001;108: 661670.
45Fekkes, D, Pepplinkhuizen, L.Amino acid studies in transient acute polymorphic psychosis. Amino Acids 1997;12: 107117.
46Blumer, D.Catatonia and neuroleptics. Compr Psychiatry 1997;38: 193201.
47Gelenberg, AJ, Mandel, MR.Catatonic reactions to high-potency neuroleptic drugs. Arch Gen Psychiatry 1977;34: 947950.
48Perris, C.Morbidity suppressive effect of lithium carbonate in cycloid psychosis. Arch Gen Psychiatry 1978;35: 328332.
49Perris, C.The concept of cycloid psychotic disorder. Psychiatr Devel 1988;1: 3756.
50Lindvall, M, Axelsson, R, ÖHman, R.Incidence of cycloid psychosis: a clinical study of first-admission psychotic patients. Eur Arch Psychiatr Clin Neurosci 1993;242: 197202.
51Pfuhlmann, B.Das Konzept der zykloiden Psychosen. Fortschr Neurol Psychiatry 1998;66: 19.
52Ungvari, G, Kau, LS, Wai-Kwong, T, Shing, NF.The pharmacological treatment of catatonia: an overview. Eur Arch Psychiatr Clin Neurosci Suppl 2001;251: 3134.
53Beckmann, H, Franzek, E.Cycloid psychoses and their differentiation from affective and schizophrenic psychoses. In: Henn, F, Sartorius, N, Helmchen, H, Lauter, H, eds. Contemporary psychiatry. Berlin: Springer Verlag, 2001: 388398.
54Komori, T, Nomaguchi, M, Kodama, S, Takigawa, M, Nomura, J.Thyroid hormone and reserpine abolished periods of periodic catatonia;a case report. Acta Psychiatr Scand 1997;96: 155156.
55Ungvari, GA, Leung, CM, Wong, MK, Lau, J.Benzodiazepines in the treatment of catatonic syndrome. Acta Psychiatr Scand 1994;89: 285288.
56Bush, G, Fink, M, Petrides, G, Dowling, F, Francis, A.Catatonia. II. Treatment with lorazepam and electroconvulsive therapy. Acta Psychiatr Scand 1996;93: 137143.
57Kopala, LC, Caudle, C.Acute and long-term effects of risperidone in a case of first-episode catatonic schizophrenia. J Psychopharmacol 1998;12: 314317.
58Verhoeven, WMA, Tuinier, S.Cyclothymia or unstable mood disorder? A systematic treatment evaluation with valproic acid. J Appl Res Intellect Disab 2001;14: 147154.
59Verhoeven, WMA, Tuinier, S.Two steps forward, one step back; paradigmatic changes in psychiatry. J Neural Transm 2001;108: 617627.
60Van der Heijden, FMMA, Tuinier, S, Pepplinkhuizen, L, Van Praag, HM, Verhoeven, WMA.Beyond the mainstream. The heuristic value of the cycloid psychosis. Eur J Psychiatry 2002.
61Meyer, J, Huberth, A, Ortega, Get al. A missense mutation in a novel gene encoding a putative cation channel is associated with catatonic schizophrenia in a large pedigree. Mol Psychiatry 2001;6: 302306.

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