The Variants of the Catatonia

Česká verzia

Authors: K. Látalová ^1,2; J. Praško ^{1 4}; M. Maršálek ⁵
Authors place of work: Klinika psychiatrie FN Olomouc ¹; LF UP v Olomouci ²; Centrum neuropsychiatrických studií, Praha ³; Psychiatrické centrum Praha ⁴; Psychiatrické léčebna Praha 8-Bohnice ⁵
Published in the journal: Cesk Slov Neurol N 2009; 72/105(6): 518-524
Category: Přehledný referát

Summary

Catatonia was originally described by Kahlbaum as a psychomotor syndrome involving motor, affective, and behavioral symptoms. At the beginning of the twentieth century it was generally accepted that catatonia is a motoric manifestation of schizophrenia. Today we see catatonia as an etiologically heterogeneous syndrome that may occur with many psychiatric disorders: organic, affective, psychological, and with schizophrenic psychosis. Catatonic symptoms may occur with disorders at borderline between psychiatry and neurology such as neuroleptic malignant syndrome, toxic serotonine syndrome, benign stupor, catatonic excitement and others. About 10% of patients with severe acute psychiatric illness exhibit motor signs of catatonia. Research implies that catatonia is a consequence of the hypoactivity of the dopaminergic system and its imbalance with the GABA system. Preexisting hypodopaminergic state has been proposed as a risk factor for catatonia. Such state may be a consequence of organic disorder, acute or chronic stress, antipsychotic treatment, or abrupt discontinuation of antipsychotics. Administration of benzodiazepines or electroconvulsive therapy are the primary treatment strategies.

Key words:
catatonia – neuroleptic malignant syndrome – serotonine syndrome – schizophrenia – mania

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