Treatment use in a prospective naturalistic cohort of children and adolescents with catatonia

Marie Raffin, Laetitia Zugaj-Bensaou, Nicolas Bodeau, Vanessa Milhiet, Claudine Laurent, David Cohen, Angèle Consoli

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50 Scopus citations

Abstract

We aimed to (1) describe the treatment used in a large sample of young inpatients with catatonia, (2) determine which factors were associated with improvement and (3) benzodiazepine (BZD) efficacy. From 1993 to 2011, 66 patients between the ages of 9 and 19 years were consecutively hospitalized for a catatonic syndrome. We prospectively collected sociodemographic, clinical and treatment data. In total, 51 (77 %) patients underwent a BZD trial. BZDs were effective in 33 (65 %) patients, who were associated with significantly fewer severe adverse events (p = 0.013) and resulted in fewer referrals for electroconvulsive therapy (ECT) (p = 0.037). Other treatments included ECT (N = 12, 18 %); antipsychotic medications, mostly in combination; and treatment of an underlying medical condition, when possible. For 10 patients, four different trials were needed to achieve clinical improvement. When all treatments were combined, there was a better clinical response in acute-onset catatonia (p = 0.032). In contrast, the response was lower in boys (p = 0.044) and when posturing (p = 0.04) and mannerisms (p = 0.008) were present as catatonic symptoms. The treatment response was independent of the underlying psychiatric or systemic medical condition. As in adults, BZDs should be the first-line symptomatic treatment for catatonia in young patients, and ECT should be a second option. Additionally, the absence of an association between the response to treatment and the underlying psychiatric condition suggests that catatonia should be considered as a syndrome.

Original languageEnglish
Pages (from-to)441-449
Number of pages9
JournalEuropean Child and Adolescent Psychiatry
Volume24
Issue number4
DOIs
StatePublished - 1 Apr 2015
Externally publishedYes

Keywords

  • Adolescence
  • Benzodiazepine
  • Benzodiazepine
  • Catatonia
  • Child
  • Electroconvulsive therapy
  • Electroconvulsive therapy
  • Pharmacological treatment
  • Pharmacological treatment
  • Youth

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