Jo Ellen Wilson

• MD
• Instructor at Vanderbilt University

Catatonia is a highly morbid psychomotor and affective disorder, which can affect autistic individuals with and without intellectual disability. Catatonic symptoms are treatable with pharmacotherapy and electroconvulsive therapy, but the longitudinal effectiveness of these treatments in autistic individuals has not been described. We conducted a pr...

Introduction: Catatonia is a neuropsychiatric disorder marked by significant disturbances in motor, cognitive, and affective functioning and that is frequently under-diagnosed. To enhance clinical detection of catatonia, this study aimed to develop a rapid, sensitive Catatonia Quick Screen (CQS) using a reduced set of catatonic signs to facilitate...

Introduction: Catatonia is a highly morbid psychomotor and affective disorder which can affect autistic individuals with and without profound impairment. Catatonic symptoms are treatable with pharmacotherapy and electroconvulsive therapy, but the longitudinal effectiveness of these treatments has not been described. Methods: We conducted a prospect...

Catatonia is a neuropsychiatric disorder characterized by motor, affective and cognitive-behavioural signs, which lasts from hours to days. Intensive research over the past two decades has led to catatonia being recognized as an independent diagnosis in the International Classification of Diseases, 11th Revision (ICD-11) since 2022. Catatonia is fo...

Background: Catatonia, a form of acute brain dysfunction typically linked with severe affective and psychotic disorders, occurs in critical illness with delirium and coma. Delirium and coma are associated with mortality, though catatonia's relationship with mortality is unclear. We aim to describe whether catatonia, delirium, and coma are associat...

Brain dysfunction during critical illness (ie, delirium and coma) is extremely common, and its lasting effect has only become increasingly understood in the last two decades. Brain dysfunction in the intensive care unit (ICU) is an independent predictor of both increased mortality and long-term impairments in cognition among survivors. As critical...

Background: Catatonia is an under-recognized disorder characterized by psychomotor (increased, decreased, or abnormal) changes, affective symptoms, and disturbance of volition, which may arise in the setting of decompensated psychiatric or non-psychiatric medical disorders. Genetic studies of catatonia are limited, and to the best of our knowledge...

The British Association for Psychopharmacology developed an evidence-based consensus guideline on the management of catatonia. A group of international experts from a wide range of disciplines was assembled. Evidence was gathered from existing systematic reviews and the primary literature. Recommendations were made on the basis of this evidence and...

Importance: Sepsis is associated with long-term cognitive impairment and worse psychological and functional outcomes. Potential mechanisms include intracerebral oxidative stress and inflammation, yet little is known about the effects of early antioxidant and anti-inflammatory therapy on cognitive, psychological, and functional outcomes in sepsis s...

Objectives: Among critically ill patients, acutely depressed level of consciousness is associated with mortality, but its relationship to long-term outcomes such as disability and physical function is unknown. We investigated the relationship of level of consciousness during hospitalization with long-term disability and physical function in ICU su...

Catatonia is a clinical syndrome characterized by psychomotor, neurological and behavioral changes. The clinical picture of catatonia ranges from akinetic stupor to severe motoric excitement. Catatonia can occur in the setting of a primary psychiatric condition such as bipolar disorder or secondary to a general medical illness like autoimmune encep...

Introduction: Catatonia, characterized by motor, behavioral and affective abnormalities, frequently co-occurs with delirium during critical illness. Advanced age is a known risk factor for development of delirium. However, the association between age and catatonia has not been described. We aim to describe the occurrence of catatonia, delirium, and...

Objectives We examined whether preadmission history of depression is associated with less delirium/coma-free (DCF) days, worse 1-year depression severity and cognitive impairment. Design and measurements A health proxy reported history of depression. Separate models examined the effect of preadmission history of depression on: (a) intensive care u...

Objective: The phenotypes of several psychiatric conditions can very closely resemble delirium; the authors describe such presentations as pseudodelirium. However, because the clinical management of these conditions differs markedly from that of delirium, prompt differentiation is essential. The authors provide an educational review to assist clin...

Objectives: ICU delirium is a predictor of greater morbidity and higher mortality in the pediatric population. The diagnostic obstacles and validity of delirium monitoring among neonates and young infants have yet to be fully delineated. We sought to validate the Preschool Confusion Assessment Method for the ICU in neonates and young infants and d...

Background: The temporal association of delirium during critical illness with mortality is unclear, along with the associations of hypoactive and hyperactive motoric subtypes of delirium with mortality. We aimed to evaluate the relationship of delirium during critical illness, including hypoactive and hyperactive motoric subtypes, with mortality i...

Objective To examine the associations between posttraumatic stress symptoms (PTS) following a medically serious suicide attempt with suicidal ideation, related interpersonal constructs, and outpatient mental health service utilization. Methods The study utilized an existing data set from a clinical trial consisting of 66 patients recruited at a le...

Background: Pharmacologic agents are frequently utilized for management of intensive care unit (ICU) delirium, yet prescribing patterns and impact of medication choices on patient outcomes are poorly described. We sought to describe prescribing practices for management of ICU delirium and investigate the independent association of medication choic...

The novel coronavirus, SARS-CoV-2-causing Coronavirus Disease 19 (COVID-19), emerged as a public health threat in December 2019 and was declared a pandemic by the World Health Organization in March 2020. Delirium, a dangerous untoward prognostic development, serves as a barometer of systemic injury in critical illness. The early reports of 25% ence...

An Erratum to this paper has been published: https://doi.org/10.1038/s41572-020-00236-z.

Delirium, a syndrome characterized by an acute change in attention, awareness and cognition, is caused by a medical condition that cannot be better explained by a pre-existing neurocognitive disorder. Multiple predisposing factors (for example, pre-existing cognitive impairment) and precipitating factors (for example, urinary tract infection) for d...

Intensive Care Unit (ICU) survivorship is associated with long-term cognitive impairment (LTCI). Our work has found post-ICU depression in up to 30%, and Post-Traumatic Stress Disorder (PTSD) in up to 10% of Intensive Care Unit (ICU) survivors. We hypothesized that post-ICU depression and PTSD are independently associated with LTCI in ICU survivors...

Introduction Millions of Americans are admitted to the intensive care unit (ICU) per year. Many survivors of the ICU will experience posttraumatic stress disorder (PTSD); although volumetric hippocampal and amygdala studies have been conducted in other trauma survivors (i.e., veterans), the association between PTSD symptoms and hippocampal and amyg...

OBJECTIVES/GOALS: To explore the severity of posttraumatic stress disorder (PTSD) symptoms in association with hippocampal and amygdala volumes in ICU survivors. We hypothesize that the severity of posttraumatic stress symptoms in ICU survivors is associated with lower volumes of both the hippocampus and amygdala. METHODS/STUDY POPULATION: Secondar...

In March 2020, the World Health Organisation announced the COVID-19 pandemic caused by the SARS-CoV-2 virus. As well as respiratory failure, the SARS-CoV-2 may cause central nervous system (CNS) involvement, including delirium occurring in critically ill patients (ICU delirium). Due attention must be paid to this subject in the face of the COVID-19...

ICU Delirium management difficulties during COVID-19 pandemic. Problems and solutions.

Delirium is a neurologic syndrome which occurs in a wide array of settings, but which is particularly common in the context of critical illness. While delirium has been studied with respect to its impact on long-term cognitive outcomes, less attention has been paid to the often complex interplay between delirium and mental health outcomes. Delirium...

Critical illness brain injury is an acute form of brain dysfunction affecting the level of consciousness, cognition and/or psychomotor functioning. Such injury is associated with prolonged mechanical ventilation requirements, longer intensive care unit (ICU) stays, increased long-term mortality, and long-term cognitive impairment among survivors. C...

Objective: The aim of this study was to determine the health utility states of the most commonly used traumatic brain injury (TBI) clinical trial endpoint, the Extended Glasgow Outcome Scale (GOSE). Summary background data: Health utilities represent the strength of one's preferences under conditions of uncertainty. There are insufficient data t...

Introduction: Delirium, the most prevalent form of acute brain dysfunction in the Intensive Care Unit (ICU) is characterized by inattention, changes in cognition and at times thought and perceptual disturbances (e.g., delusions and hallucinations). Recent estimates of delirium prevalence suggest around 70% of patients on mechanical ventilation will...

Catatonia is a psychomotor syndrome associated with several psychiatric and medical conditions. Psychomotor signs range from stupor to agitation, and include pathognomonic features such as verbigeration and waxy flexibility. Disturbances of volition led to the classification of catatonia as a subtype of schizophrenia, but changes in nosology now re...

Objective Many patients with advanced serious illness or at the end of life experience delirium, a potentially reversible form of acute brain dysfunction, which may impair ability to participate in medical decision-making and to engage with their loved ones. Screening for delirium provides an opportunity to address modifiable causes. Unfortunately,...

The DSM-5 definition for delirium relies solely on clinical criteria. Recent developments in the National Institute on Aging-Alzheimer's Association (NIA-AA) research framework have challenged clinicians to reflect on their approach for major and mild neurocognitive disorders, particularly with regards to biomarkers and preclinical Alzheimer's dise...

OBJECTIVES/SPECIFIC AIMS: Delirium, a form of acute brain dysfunction, characterized by changes in attention and alertness, is a known independent predictor of mortality in the Intensive Care Unit (ICU). We sought to understand whether catatonia, a more recently recognized form of acute brain dysfunction, is associated with increased 30-day mortali...

Objective: To determine whether deficits in a key aspect of executive functioning, namely, initiation, were associated with current and future functional disabilities in intensive care unit survivors. Methods: A nested substudy within a 2-center prospective observational cohort. We used 3 tests of initiation at 3 and 12 months: the Ruff Total Un...

Objective: The aim of this study was to further evaluate the acceptability and feasibility of the Teachable Moment Brief Intervention (TMBI). Method: A single blind, pilot randomized controlled trial of the TMBI + care as usual (CAU) compared to CAU was conducted for patients who survived a recent suicide attempt that required medical inpatient...

Context: Many older adults discharged from an inpatient stay require postacute facility placement, which can be a barrier to hospice enrollment since the Medicare hospice benefit does not cover facility costs for patients under routine hospice care. Objectives: To evaluate the extent to which need for postdischarge facility care was a barrier to...

OBJECTIVES/SPECIFIC AIMS: Background: Delirium is a well described form of acute brain organ dysfunction characterized by decreased or increased movement, changes in attention and concentration as well as perceptual disturbances (i.e., hallucinations) and delusions. Catatonia, a neuropsychiatric syndrome traditionally described in patients with sev...

Background: We sought to determine how delirium subtyped by arousal affected 6-month function and cognition in acutely ill older patients. Methods: This was secondary analysis of a prospective cohort study which enrolled hospitalized patients ≥65 years old. Delirium and arousal were ascertained daily in the emergency department and the first 7 d...

Objective: Evidence suggests that suicide attempts by self-inflicted gunshot wound (GSW) are underreported and may in turn affect disposition following hospitalization. This study aimed to evaluate the clinical characteristics and use of services among individuals who do not disclose suicidal intent following a self-inflicted GSW. Methods: Elect...

Objectives: Catatonia, a condition characterized by motor, behavioral, and emotional changes, can occur during critical illness and appear as clinically similar to delirium, yet its management differs from delirium. Traditional criteria for medical catatonia preclude its diagnosis in delirium. Our objective in this investigation was to understand...

Purpose: Although executive dysfunction and depression are common among intensive care unit (ICU) survivors, their relationship has not been evaluated in this population. We sought to determine (1) if executive dysfunction is independently associated with severity of depressive symptoms or worse mental health-related quality of life (HRQOL) in ICU...

Objectives: To determine how delirium subtyped by level of arousal at initial presentation affects 6-month mortality. Design: This was a preplanned secondary analysis of two prospective cohort studies. Setting: Academic tertiary care emergency department (ED). Participants: 1,084 ED patients who were 65 years old or older. Measurements: At...

Cognitive impairment is a common occurrence that has been shown to occur in over 50 % of patients following critical illness. This impairment occurs across a range of domains including attention, memory, processing speed, and executive dysfunction. In this article, we will discuss the pathophysiology behind cognitive impairment including hypoxemia...

Background: Consultation-liaison psychiatrists are often asked to evaluate patients who refuse discharge from a medical facility. Literature to guide clinicians on the management of these patients is very limited. Objective: This article seeks to explain this phenomenon through a case series, provide a differential diagnosis of patients who requ...

The term schizoaffective was introduced to describe the co-occurrence of both psychotic and affective symptoms. Overtime, as the diagnosis schizoaffective disorder was added to diagnostic manuals, significant concerns were raised as to the reliability and clinical utility of the diagnosis. We recruited 134 psychiatrically hospitalized subjects who...

Severe bleeding is a major complication in the postoperative pediatric cardiac surgery patients. We evaluated the efficacy and safety of recombinant factor seven (rFVIIa) therapy in this patient population. A retrospective unmatched case-control study for the previous five years in a single institution was undertaken. Patients with severe bleeding...