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P0089 - Recurrnet catatonia: Fluctuating between psychotic and catatonic dimensions

Published online by Cambridge University Press:  16 April 2020

A. Krivoy
Affiliation:
Geha Mental Health Center, Petah-Tikva, Israel
A. Weizman
Affiliation:
Geha Mental Health Center, Petah-Tikva, Israel Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
S. Kimchi-Nesher
Affiliation:
Geha Mental Health Center, Petah-Tikva, Israel
Z. Zemishlany
Affiliation:
Geha Mental Health Center, Petah-Tikva, Israel Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
T. Fischel
Affiliation:
Geha Mental Health Center, Petah-Tikva, Israel Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel

Abstract

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Background:

Catatonia is a disorder that is still under nosological controversy. There are several approaches to characterize this diagnostic entity. Of those, the dimensional approach makes it possible to address catatonia as a phenomenological aspect of schizophrenia, similar to psychosis.

Objective:

to describe a subtype of schizophrenia patients who manifest both psychosis and recurrent catatonia and to assess their management.

Methods:

a retrospective analysis of the records of 25 recurrent catatonia patients who were admitted at Geha Mental Health Center between 1995-2005, using demographic, clinical, laboratory and management data regarding their admissions through the years that was extracted from the records.

Results:

a total of 141 admissions, of which 96 (68%) were retrospectively diagnosed as presenting catatonia using Bush-Frances diagnostic criteria. Most frequent catatonic signs were: immobility/stupor, mutism, negativism, withdrawal and rigidity. There was no difference between catatonic and non-catatonic admissions with regard to serum Creatine Kinase (CK) peak levels and length of hospitalization. Seventy three percent of catatonic admissions were treated with antipsychotic monotherapy. Catatonic admissions treated by adding benzodiazepines to antipsychotics were shorter in length of hospitalization than ECT and antipsychotic monotherapy.

Conclusion:

dimensional approach allows perceiving this subtype of schizophrenia as fluctuating between two dimensions, i.e.: the psychotic and the catatonic (which is recurrent in nature). The clinical salience of one of the dimensions determines the management, albeit our data showing that it is probably beneficial to add benzodiazepines to antipsychotichs, in recurrent catatonia.

Type
Poster Session III: Diagnoses And Classification
Copyright
Copyright © European Psychiatric Association 2008
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