Catatonia Associated with Psychosis: A Retrospective Study of 164 Inpatients

Introduction

This study examines how inpatients with catatonia responded when treated with or without antipsychotic medications. It employs two metrics to account for both the catatonic symptoms and the more traditionally psychotic symptoms. Length of stay is a secondary metric.

Methods

The primary investigator retrospectively collected data on 164 patients diagnosed with catatonia on an academic inpatient service from July 2018 through September 2023. The treatments of these patients were separated into two distinct categories: Group A (n = 81) received antipsychotic medication with benzodiazepines and/or electroconvulsive therapy, and Group B (n = 83) received benzodiazepines and/or electroconvulsive therapy without antipsychotics. Scores on admission from the Bush Francis Catatonia Rating Scale and positive symptom subscale from the Positive and Negative Syndrome Scale were collected and compared with scores at discharge. ANOVA analysis was used to compare outcomes.

Results

The antipsychotic-treated group demonstrated significantly higher Bush Francis Catatonia Rating Scale scores (p < 0.0001) and positive scale of the Positive and Negative Syndrome Scale scores (p < 0.0001) at discharge than the group receiving only benzodiazepines and/or electroconvulsive therapy. Patients hospitalized multiple times and treated under both conditions were used as their own controls. Bush Francis Catatonia Rating Scale scores (p < 0.0001) and positive scale of the Positive and Negative Syndrome Scale scores (p < 0.0001) were higher at discharge when antipsychotics were added to treatment.

Conclusion

Patients treated without antipsychotics showed greater improvement in both their traditional catatonic symptoms and in their psychotic symptoms.