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.

13 Reads
    • "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. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Motor symptoms in schizophrenia are frequent and relevant to diagnosis and antipsychotic therapy. To date motor symptoms are difficult to assess and their pathobiology is a widely unresolved issue. The Bern Psychopathology Scale for the assessment of system-specific psychotic symptoms (BPS) was designed to identify homogenous patient groups by focusing on three domains: language, affectivity and motor behavior. The present study aimed to validate the motor behavior domain of the BPS using wrist actigraphy. In total, 106 patients were rated with the BPS and underwent 24h continuous actigraphy recording. The ratings of the global severity of the motor behavior domain (GSM) as well as the quantitative and the subjective items of the motor behavior domain of the BPS were significantly associated with actigraphic variables. In contrast, the qualitative items of the motor domain failed to show an association with actigraphy. Likewise, scores of the language and the affectivity domains were not related to actigraphic measures. In conclusion, we provided substantial external validity for global, quantitative and subjective ratings of the BPS motor behavior domain. Thus, the BPS is suitable to assess the dimension of quantitative motor behavior in the schizophrenia spectrum.
    No preview · Article · Mar 2012 · Psychiatry Research
  • Source
    • "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."
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · Jan 2011 · Tijdschrift voor psychiatrie
  • [Show abstract] [Hide abstract]
    ABSTRACT: Using previously developed models for the bulk and SOI (silicon-on-insulator) MOSFETs, the authors compare and analyze the statistical variation of the threshold voltage V <sub>th</sub> in these MOSFETs with respect to variation of device parameters such as doping density, oxide thickness, and channel length. The statistical variation of the threshold voltage reduction Δ V <sub>th </sub> for three values of channel length is shown. The statistical distribution is broadened with a pronounced asymmetry toward the higher value of Δ V <sub>th</sub>. It is also noted that the statistical distribution in the SOI MOSFET is narrower than that of the bulk MOSFET. The optimized design region of a fully depleted SOI MOSFET with a threshold voltage distribution smaller than its bulk silicon counterpart is shown
    No preview · Conference Paper · Nov 1991
Show more