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Câmara Pestana P, Estibeiro MJ, Côrte-Real B, Cordeiro C, Simões I, Duarte G, Simões do Couto F, Novais F. Catatonia in Dementia: A Systematic Review of Case Reports and Case Series. Am J Geriatr Psychiatry 2024:S1064-7481(24)00407-X. [PMID: 39179430 DOI: 10.1016/j.jagp.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/17/2024] [Accepted: 07/18/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Catatonia is a neuropsychiatric syndrome characterized by motor, behavioral, and autonomic abnormalities. It is often underdiagnosed in geriatric patients with dementia despite established diagnostic criteria and treatment options. OBJECTIVE This systematic review investigates catatonia in the elderly, particularly those with dementia, to examine their clinical presentation, treatment response, and prognosis compared to elderly patients without dementia. METHODS We comprehensively searched MEDLINE and EMBASE, including case reports and series on catatonia in elderly patients. Reviewers independently performed data extraction and quality assessments. Statistical significance was set at a p value ≤0.05, and a multivariate logistic regression model was used to analyze differences between patients with and without dementia. RESULTS Our review included 182 articles with 225 cases. We found no significant differences in the clinical presentation of catatonia between patients with and without dementia, with both groups commonly exhibiting the hypokinetic variant. However, patients with dementia were more frequently treated with NMDA receptor antagonists (OR: 3.27; CI: 1.05-10.11; p = 0.040) and had a lower complete response rate to treatment (OR: 0.37; CI: 0.19-0.75; p = 0.006). Patients with dementia also exhibited fewer acute medical conditions (OR: 0.17; CI: 0.05-0.65; p = 0.009). CONCLUSIONS Catatonia in dementia does not have a different syndromic presentation. However, the diagnosis of dementia leads to varying preferences regarding the choice of symptomatic therapy and seems to be a predictor of a poorer therapeutic response. Actively treating catatonia, particularly in patients with dementia, addressing the characteristics of these patients is of paramount importance.
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Affiliation(s)
- Pedro Câmara Pestana
- Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, European Union, Portugal (PCP, IS, FN); Serviço de Psiquiatria e Saúde Mental, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, Lisboa, European Union, Portugal (PCP, IS, FSDC, FN); Faculdade de Medicina, Universidade Católica Portuguesa, Sintra, European Union, Portugal (PCP, MJE, FSDC); PsyLab, Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, European Union, Portugal (PCP, FN).
| | - Maria João Estibeiro
- Faculdade de Medicina, Universidade Católica Portuguesa, Sintra, European Union, Portugal (PCP, MJE, FSDC)
| | - Beatriz Côrte-Real
- Serviço de Psiquiatria, Hospital de Cascais Dr. José de Almeida, Lisboa, European Union, Portugal (BCR)
| | - Catarina Cordeiro
- Serviço de Psiquiatria, Hospital Garcia de Orta, Unidade Local de Saúde Almada-Seixal, Almada, European Union, Portugal (CC)
| | - Inês Simões
- Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, European Union, Portugal (PCP, IS, FN); Serviço de Psiquiatria e Saúde Mental, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, Lisboa, European Union, Portugal (PCP, IS, FSDC, FN)
| | - Gonçalo Duarte
- Serviço de Farmacologia Clínica, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, Lisboa, European Union, Portugal (GD); Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, European Union, Portugal (GD)
| | - Frederico Simões do Couto
- Serviço de Psiquiatria e Saúde Mental, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, Lisboa, European Union, Portugal (PCP, IS, FSDC, FN); Faculdade de Medicina, Universidade Católica Portuguesa, Sintra, European Union, Portugal (PCP, MJE, FSDC)
| | - Filipa Novais
- Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, European Union, Portugal (PCP, IS, FN); Serviço de Psiquiatria e Saúde Mental, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, Lisboa, European Union, Portugal (PCP, IS, FSDC, FN); PsyLab, Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, European Union, Portugal (PCP, FN)
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Younes S, Khouadja S, Younes S, Zarrouk L. Catatonia in patients with dementia: a case report. Pan Afr Med J 2019; 33:117. [PMID: 31489095 PMCID: PMC6711697 DOI: 10.11604/pamj.2019.33.117.18629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/08/2019] [Indexed: 11/11/2022] Open
Abstract
Catatonia occurring as part of a clinical picture of dementia has been reported with almost all types of dementia. It remains under-diagnosed in older adults and those with dementia. We review a case of a young patient admitted in our psychiatric department for catatonia and after efficient treatment with Lorazepam, assessment revealed a dementia. Catatonia is a severe neuropsychiatric syndrome with an excellent prognosis if recognized and treated without delay.
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Affiliation(s)
- Samira Younes
- Department of Psychiatry, University Hospital of Mahdia, Mahdia, Tunisia
| | - Sabria Khouadja
- Department of Psychiatry, University Hospital of Mahdia, Mahdia, Tunisia
| | - Samia Younes
- Department of Neurology, University Hospital of Mahdia, Mahdia, Tunisia
| | - Lazhar Zarrouk
- Department of Psychiatry, University Hospital of Mahdia, Mahdia, Tunisia
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