Academy of Psychosomatic Medicine
Annotated Abstracts of Journal Articles
Annotations by Lex Denysenko, MD, FAPM
PUBLICATION #1 — Catatonia
Prevalence and symptomatology of catatonia in elderly patients referred to a consultation-liaison psychiatry service
Kaelle J, Abujam A, Ediriweera H, Macfarlane MD
Australas Psychiatry 2016; 24(2):164-167.
The finding: Prevalence of catatonia in the C-L setting in patients over the age of 65 was 6 in 108 patients (5.5%). Rigidity and immobility were the most common symptoms. Most had delirium as well as catatonia. The authors conclude that it was unclear if use of the Bush Francis Catatonia Screening instrument was successful in capturing any additional cases of catatonia that would not have been identified by standard routine psychiatric interview and examination.
Strength: Prospective study across 6 hospitals in a 6 month period.
Relevance: Catatonia in the elderly population has been estimated to be higher in prevalence than in all age adults in at least one prior study, and this prospective study supports this. Delirium and catatonia were both present in 50% of the subjects. A better/easier screening instrument for detecting catatonia in the general medical setting is needed.
PUBLICATION #2 — Catatonia
The diagnostic criteria and structure of catatonia
Wilson JE, Niu K, Nicolson SE, Levine SZ, Heckers S
Schizophr Res 2015; 164(1-3):256-262
The finding: This study shows the Bush Francis Catatonia Rating Scale loses reliability when severity of catatonia was low. It proved difficult to reduce the symptoms to three factors and still maintain reliability, with 63% of the variance unexplained.
Strengths: Largest sample size yet for such a study. Study included subjects from variety of settings (inpatient, outpatient, and C-L settings). Included a large subset of patients with validated catatonia by treatment response. First study to use item response theory to estimate each element of catatonia scale in terms of utility and reliability.
Relevance: This study supports a conclusion that further work on creating a more improved rating or screening instrument for catatonia in all settings is necessary. Further exploration of the core components of catatonia has yet to be fully discovered.
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