catatonia

(kat″ă-tōn′ē-ă)

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[cata- + tono- + -ia]
A state associated with a variety of mental health (e.g., affective and thought disorders) and medical disorders, and characterized by motor immobility, behavioral abnormalities, and stupor. In the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V), catatonia is not considered a separate disorder but is associated with psychiatric diseases such as schizophrenia, bipolar disorder, post-traumatic stress disorder, depression, and/or drug abuse or overdose (or both). Catatonia is also seen in infections (such as encephalitis), autoimmune disorders, focal neurologic lesions (including strokes), metabolic disturbances, or sudden withdrawal from alcohol or benzodiazepine.

DIAGNOSIS
Clinical observation of the patient is sufficient for diagnosis, once overlapping illnesses, such as stroke or other neurological diseases, are excluded.

SYMPTOMS AND SIGNS
Classic symptom clusters in catatonia include abnormal, rigid posturing; catalepsy; lack of speech; and negativism. Other features include repetition, exaggerated obedience, and other stereotypical behaviors. The patient is unresponsive, tends to assume and remain in a fixed posture, and lacks the ability to move or talk.

TREATMENT
Antipsychotic drugs with mood-stabilizing properties, e.g., anticonvulsant drugs used in bipolar disorder, are used to treat catatonia.

PATIENT CARE
The patient with acute catatonia must be observed in a hospital, preferably in an intensive care unit, for life-threatening illnesses such as neuroleptic malignant syndrome, encephalitis, or stroke. Once these conditions have been excluded, the patient may be transferred to other actively supervised environments, in which aggressive skin care and adequate nutrition are provided. Ambulation should be supervised to avoid falls or injury. Staff should be alert to sudden changes in behavior in order to prevent injury by the patient.
SYN: SEE: Kahlbaum disease; SEE: Kahlbaum syndrome

catatonic (kat-ă-ton′ik)
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, adj.

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