From the Guidelines
Catatonia is primarily caused by medical conditions, including neurological disorders, infections, and autoimmune diseases, as well as psychiatric disorders such as schizophrenia and bipolar disorder.
Medical Causes of Catatonia
- Neurological disorders, such as encephalitis lethargica, which may be related to viral infections like the 1918-1919 H1N1 pandemic 1
- Infections, including urinary tract infections and pneumonia, which are common precipitating factors for delirium, a condition that can present with catatonia 1
- Autoimmune diseases, which can cause catatonia as a symptom of an underlying medical condition 1
- Endocrine disorders, which can lead to catatonia due to hormonal imbalances 1
- Medication side effects, including neuroleptic malignant syndrome, which can cause catatonia as a symptom 1
Psychiatric Causes of Catatonia
- Schizophrenia, which can present with catatonia as a subtype, characterized by psychomotor disturbances such as stupor, catalepsy, and mutism 1
- Bipolar disorder, which can also present with catatonia, particularly during manic or depressive episodes 1
- Other psychiatric disorders, such as schizoaffective disorder and depression with psychotic features, which can also cause catatonia 1 It is essential to note that catatonia can be a symptom of various underlying medical conditions, and a thorough evaluation is necessary to determine the underlying cause. Treatment of catatonia is aimed at addressing the underlying medical condition and controlling symptoms with nonpharmacological approaches and medication when deemed appropriate 1.
From the Research
Medical Causes of Catatonia
The medical causes of catatonia are diverse and can be attributed to various underlying conditions. Some of the medical causes of catatonia include:
- Hyponatremia 2
- Cerebral venous sinus thrombosis 2
- Liver transplantation 2
- Neuroleptic Malignant Syndrome 2, 3
- Anti-NMDA receptor encephalitis 2, 4
- Autoimmune encephalitis, such as systemic lupus erythematosus 4
- Seizures 4
- Ciclosporin encephalitis 4
- Post hypoglycaemic coma encephalitis 4
- Genetic or metabolic conditions, such as chorea, 5HT cerebrospinal fluid deficit, storage disease, fatal familial insomnia, and PRODH mutations 4
Other Factors Associated with Catatonia
Other factors that can contribute to the development of catatonia include:
- Withdrawal from benzodiazepines or clozapine 2
- Exposure to neuroleptic medications 3
- Delirium or coma 3
- Underlying psychiatric conditions, such as schizophrenia, bipolar disorder, or depression 2, 3, 5
Treatment and Pathophysiology
The treatment of catatonia often involves the use of benzodiazepines, such as lorazepam, and electroconvulsive therapy (ECT) 2, 3, 6, 5. The pathophysiology of catatonia is not fully understood, but abnormalities in gamma-aminobutyric acid and glutamate signaling have been suggested as causative factors 5.