Catatonia

Creutzfeldt-Jakob disease (CJD) is a neurodegenerative disorder belonging to the group of transmissible spongiform encephalopathies. The transition of physiological, soluble, neuroprotective prion protein PrPc into its insoluble, misfolded isoform PrPSc remains its central pathogenic event. The progressive accumulation of isoform PrPSc within the brain tissue results in spongiform degeneration and a plethora of clinical symptoms. Typically, CJD manifests as progressive dementia with myoclonus, visual or cerebellar dysfunction, pyramidal/ extrapyramidal signs or akinetic mutism. However, a growing number of studies indicate that CJD may present with prodromal psychiatric manifestations including anhedonia, anxiety, irritability, depression, insomnia, psy-chosis and catatonic behavior. We present a case of CJD with a history of prodromal psychiatric symptoms and catatonic behavior diagnosed by brain biopsy. Creutzfeld-Jakob disease/brain biopsy/psychiatric symptoms

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Javad Setare1 , Aram Karimian2 , Maryam Shoja3 , Fereshteh Bakhshian4 , Seyed Reza Saadatmehr5*
1. Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
2. Department of Emergency Medical Sciences, School of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran.
3. Department of Nursing, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Iran.
4. Department of Psychology, Faculty of Social Science, Razi University, Kermanshah, Iran.
5. Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
* Corresponding Author:
Reza Saadatmehr, MSc.
Address: Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Tel: +98 (912) 1464553
E-mail: r_saadatmehr@yahoo.com
Research Paper:
Prevalence of Catatonic Schizophrenia Symptoms in a
Psychiatric Hospital: A Retrospective Study
Background: Catatonia occurs as a complication of various medical and psychological illnesses
that can be treated when diagnosed. Despite the high incidence of catatonia, the problem is poorly
recognized. This study aimed at investigating the prevalence of catatonia and related factors in its
diagnosis within a five year period in hospitalized patients of Zareh Psychiatric Center, Sari, Iran
using computerized archive of records.
Methods: It was a descriptive and retrospective study. The records of all patients with mental
disorders admitted to Zareh Hospital between 2010 and 2014 were assessed. The data were
collected using a demographic questionnaire and the Northoff Catatonia Scale (NCS). Then
analyzed by statistical tests of multivariate logistic regression in SPSS-PC V. 20.
Results: Only 0.26% (26 per 10000 population) of patients had experienced catatonic
schizophrenia during a five year period, including 42.11 men and 57.89 women. The prevalence
of catatonic schizophrenia was significantly correlated with gender and age (P<0.05). Of the
patients, 68.42% had a history of medication therapy and or hospitalization and 21.5% had a
history of physical disorders. There was no significant relationship between the mean score of
movement, emotional and behavioral changes with sex, education and age groups (P<0.05).
Conclusion: Because many catatonic patients had a combination of medical and psychiatric
problems, psychiatrists and psychiatric nurses are suggested to assess catatonia symptoms in
both internal and psychiatric wards.
Highlights
● The prevalence of catatonic symptoms in men was lower than that in women.
● The prevalence of catatonic schizophrenia symptoms is higher at younger ages.
● Reducing the duration of admission can greatly help in lowering the cost of treatment of catatonia symptoms.
Plain Language Summary
Catatonia is a complex neuropsychological disorder which refers to a number of abnormalities in movement, volition,
speech, and behavior. Historically, the term catatonia has been associated with schizophrenia and psychoses, but it can
occur with a wide range of conditions. Catatonia is potentially life threatening. The results obtained in the present study
have shown that only 0.26% of mental disorder patients who were hospitalized during past five years, were catatonic
schizophrenia, also gender and age are associated with the prevalence of catatonic schizophrenia.