DSM-IV catatonia signs and criteria in first-episode, drug-naive, psychotic patients: Psychometric validity and response to antipsychotic medication

Psychiatric Unit, Virgen del Camino Hospital, Irunlarrea 4, 31008 Pamplona, Spain.
Schizophrenia Research (Impact Factor: 3.92). 05/2010; 118(1-3):168-75. DOI: 10.1016/j.schres.2009.12.023
Source: PubMed


To examine the prevalence, psychometric validity and response to antipsychotic drugs of DSM-IV catatonia signs and criteria in patients with a first-episode psychotic disorder.
Two-hundred antipsychotic-naive patients with a DSM-IV nonaffective psychosis were assessed for catatonia signs and criteria using the Modified Rogers Scale, and the psychometric validity of the 12 DSM-IV catatonia signs and diagnostic criteria was examined. Treatment response of catatonia was assessed in 173 patients who completed one-month trial with haloperidol (n=23), risperidone (n=93) or olanzapine (n=57).
Sixty-two patients (31%) endorsed at least one catatonia sign and 24 (12%) met DSM-IV criteria for catatonia. DSM-IV catatonia signs showed an excellent convergent validity (r>0.8) with other rating scales, and DSM-IV criteria showed moderate to fair concordance with other criteria (kappa from 0.57 to 0.77). The total number of signs reflected catatonia severity and demonstrated excellent diagnostic performance against alternative diagnostic criteria. The presence of at least any three signs accurately identified patients with catatonia. Three catatonia domains were identified (hyperkinesia, volitional and hypokinesia), which showed a different association pattern with external variables. Overall, catatonia ratings were particularly related to both dyskinesia and disorganization symptoms and lacked diagnostic specificity for schizophrenia. Patients with catatonia responded well to antipsychotic medication irrespective of the type of antipsychotic drug used, although treatment response was dependent upon the remission of psychotic symptoms.
These results may inform the DSM-V development on diagnosis and classification of catatonia, and indicate that catatonia signs and syndromes are highly responsive to antipsychotic drugs.

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    • "Delayed infant motor development, as well as involuntary movements during childhood, has been reported in subjects who later suffered from schizophrenia long before the first psychotic symptoms occur (Walker, 1994; Cannon et al., 2002; Ridler et al., 2006). In fact, motor abnormalities are observed in first episode medication naive patients (Whitty et al., 2009; Koning et al., 2010; Peralta et al., 2010a, 2010b). Schizophrenia motor behavior may be influenced by the negative syndrome or medication effects, and may involve Parkinsonism , abnormal involuntary movements, neurological soft signs or catatonic symptoms. "
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    Psychiatry Research 03/2012; 198(2). DOI:10.1016/j.psychres.2011.12.038 · 2.47 Impact Factor
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    • "Via kruisreferenties vonden we één extra schaal: de Modified Rogers Scale (Lund e.a. 1991). Naast deze beoordelingsschalen werden in 5 publicaties (Gelenberg 1976; Barnes e.a. 1986; Lohr & Wisniewski 1987; Rosebush e.a. 1990; Peralta e.a. 2010) lijsten met diagnostische criteria gepubliceerd . Deze 'criterialijsten' worden niet uitputtend in het overzicht opgenomen."
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    ABSTRACT: Despite increasing scientific and clinical interest in catatonia, there is still no precise definition of this psychiatric disorder. To study the relevant literature and review systematically the various rating scales that have been developed for assessing catatonia in clinical practice. Several searches were performed using Medline, the latest one in August 2010. RESULTS Seven catatonia rating scales were retrieved and studied: the Modified Rogers Scale, the Rogers Catatonia Scale, the Bush-Francis Catatonia Rating Scale (BFCRS), the Northoff Catatonia Rating Scale (NCRS), the Braunig Catatonia Scale (BCRS), the Bush-Francis Catatonia Scale- Revised version and the Kanner Scale. Several scales are suitable for assessing catatonia in clinical practice. The BFCRS, the NCRS and the BCRS are reliable scales for use in various clinical populations in which catatonia is prevalent. For routine use in clinical practice, the scale of choice is the BFCRS because it is well-founded, reliable and easy to administer.
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