Catatonia:A Clinician's Guide to Diagnosis and Treatment

-Albert Einstein College of Medicine, New York City, NY.
-Text describes the features of catatonia, how to identify and
treat the syndrome successfully, and its neurobiology.
-Includes patient vignettes to illustrate the principles of
diagnosing and describes in detail the various treatment
options.
-For psychiatrists and neurologists.
-DNLM: Catatonia--physiopathology.




Preface
Acknowledgments
Chronology of catatonia concepts
1 Catatonia: A history 1
Karl Kahlbaum (1828-1899) 3
Catatonia purloined: Emil Kraepelin 7
Other commentators 7
Catatonia disappears 10
Interest revives 11
Present status 15
2 Signs of catatonia are identifiable 19
Mutism 21
Stupor 22
Excitement 23
Features demonstrated in examination 25
Catatonic spectrum behaviors 30

3 The many faces of catatonia 33
Introduction 33
Subtypes of catatonia 34
Retarded catatonia (Kahlbaum syndrome) 38
Malignant catatonia 39
Neuroleptic malignant syndrome variant of malignant catatonia 45
Delirious mania, excited catatonia, and oneiroid state 51
Mixed affective states 57
Periodic catatonia 58
Toxic serotonin syndrome 63
Benign stupor 65
Primary akinetic mutism 66

4 The differential diagnosis of catatonia 71
Laboratory tests and catatonia 72
Conditions in which catatonia is expressed 75
Conditions that may be mistaken for catatonia 105

5 Catatonia is measurable and common 114
DSM classification of catatonia 114
An alternative classification for catatonia 116
Frequency of identification 120
Associated psychopathology 125
Factor analytic studies 127
Rating scales 129

6 Past treatments for catatonia 133
Fever therapy 134
Barbiturates 137
Benzodiazepines 139
Insulin coma therapy 140
Convulsive therapy 141
Other treatments of catatonia 143

7 Management of catatonia today 147
Acute treatment 148
Maintenance treatment protocol 167
Prophylaxis 171

8 The neurology of catatonia 177
Motor system dysfunction 179
Neurochemical aberrations 185
Epilepsy model 187
Synthesis and clinical implications 189

9 Back to the future 193
Catatonia is a stable syndrome 193
Catatonia is common 194
Catatonia has many faces 195
Neuroleptic malignant syndrome is malignant catatonia 195
Catatonia is not usually associated with schizophrenia 196
Catatonia is a good-prognosis condition 197
Catatonia is a syndrome of motor dysregulation 198
Future studies 199

App. I Rating scale of catatonia 204
App. II Examination for catatonia 210

References 211

Index 253