Journal Article Annotations
2017, 4th Quarter
Annotation by Lex Denysenko, MD, FAPM
Type of study: Cohort study
The finding: Comorbid delirium and catatonia were present in a third of ICU patients, with more catatonia signs associated with increased probability for the patient having delirium. The Bush Francis Catatonia Screening Instrument required a higher than normal cut-off threshold for determining catatonia with high specificity in the ICU setting.
Strength and weaknesses: Largest and most rigorous prospective study of catatonia in the critical care setting. Catatonia DSM-5 criteria and the Bush Francis Catatonia Rating Scale have not been specifically validated in the critical care setting. Catatonia and delirium assessments were not simultaneous, but rather a median of 2.2 hours lapsed between the delirium and catatonia assessments. It is unclear if meeting diagnostic criteria for catatonia would indicate having a catatonia syndrome that would respond to an intervention similarly to patients with catatonia in other psychiatric or medical settings.
Relevance: Catatonia can be reliably diagnosed in the ICU setting even in the presence of delirium, and the co-occurrence of delirium and catatonia is common.