To describe the data and outcome of patients clinically diagnosed with catatonia. In addition, a discussion is provided on a diagnostic work up protocol and therapeutic guidelines.

Retrospective case study on patients hospitalized for severe neuropsychiatric disorders.

Out of a total of 285 patients, treated during one or more episodes with ECT at our inpatient department of psychiatry, twenty seven were diagnosed with catatonia. An additional 7 patients were selected from our catatonia registry (2006-2009). These 34 patients had a total of 40 catatonic episodes. Catatonia was diagnosed in sixteen patients, and lethal catatonia in nine patients, while the remaining nine had a neuroleptic malignant syndrome. A total of 55 additional psychiatric diagnoses were present, and in half of the patients co-morbid somatic disorders were present. ECT resulted in a clinically complete remission in 61% of the patients. Average time (delay) between diagnosis and first treatment (lorazepam), and diagnosis and ECT was respectively 14 days and 60 days while the average duration of admission was 102 days.

A case series of 34 catatonic patients admitted to a neuropsychiatry department of a large general hospital revealed a great variety of psychiatric diagnosis and somatic co-morbidity. Such patients require a diagnostic work up and the presence of a specialized psychmed unit together with an instant availability of ECT and an intensive care unit. Treatment was effective in more than half of patients. Time delay between diagnosis and treatment, and duration of hospital stay is discussed.