Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-31T23:18:23.817Z Has data issue: false hasContentIssue false
  • English
  • Français

Increase of serum creatine phosphokinase in catatonia: an investigation in 32 acute catatonic patients

Published online by Cambridge University Press:  09 July 2009

G. Northoff ,
J. Wenke  and
B. Pflug
G. Northoff*
Affiliation:
Department of Psychiatry, University of Frankfurt, Germany
J. Wenke
Affiliation:
Department of Psychiatry, University of Frankfurt, Germany
B. Pflug
Affiliation:
Department of Psychiatry, University of Frankfurt, Germany
*
1Address for correspondence: Dr Georg Northoff, University of Frankfurt, Department of Psychiatry II, Heinrich-Hoffmann Strasse 10, 60528 Frankfurt/M, Germany.
Get access Rights & Permissions [Opens in a new window]

Synopsis

We investigated serum creatine phosphokinase (CPK) and associated parkinsonic (SEPS) and dyskinetic (AIMS) movements in 32 hospital admitted acute catatonic patients. Thirty-two (N = 24 without neuroleptics on admission) catatonic patients were compared with 32 non-catatonic dyskinetic psychiatric patients, 32 non-catatonic non-dyskinetic psychiatric patients and 32 healthy controls. CPK was significantly higher (p = 0·015) in catatonics (mean 255·75, s.d. ± 226·54) than in healthy controls (38·6, ± 27·4) and non-catatonic non-dyskinetic psychiatric patients (57·1, ± 120·8) whereas there was no significant difference between catatonics and non-catatonic dyskinetic psychiatric patients (453·4, ± 128·5). There were significantly positive correlations between CPK and AIMS, as well as significantly negative correlations between CPK and SEPS, in all three groups. Our results suggest that increased serum CPK in catatonia may be related to occurrence of dyskinetic movements. Furthermore, we were able to distinguish a parkinsonic (low CPK, low AIMS, high SEPS) and a dyskinetic (high CPK, high AIMS, low SEPS) subtype in catatonia.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 3 , May 1996 , pp. 547 - 553
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Addonizio, G., Susman, V. L. & Roth, S. D. (1987). Neuroleptic malignant syndrome: review and analysis of 115 cases. Biological Psychiatry 22, 1004–1020.CrossRefGoogle ScholarPubMed
Ainsworth, P. (1987). A case of lethal catatonia in a 14 year old girl. British Journal of Psychiatry 150, 110–112.CrossRefGoogle Scholar
Alexander, G. E., Cratcher, M. D. & DeLong, M. R. (1990). Basal ganglia thalamo cortical circuits. Progress in Brain Research 9, 1–50.Google Scholar
American Psychiatric Association (1987). Commitee on nomenclature and statistics, Manual of Mental Disorders, 3rd edn. APA: Washington. DC.Google Scholar
Bleuler, E. (1911). Dementia praecox oder die Gruppe der Schizophrenien. Deutricke: Wien.Google Scholar
Caroff, S. T. (1980). The neuroleptic malignant syndrome. Journal of Clinical Psychiatry 41, 79–83.Google ScholarPubMed
Castillo, E., Rubin, R. T. & Hoelsboer-Traechsler, E. (1989). Clinical differentiation between lethal catatonia and neuroleptic malignant syndrome. American Journal of Psychiatry 146, 324–328.Google ScholarPubMed
Cummings, J. L. (1985). Clinical Neuropsychiatry. Stratton: New York.Google Scholar
Editorial (1986). Catatonia. Lancet ii, 954–956.Google Scholar
El-Mallakh, R. S., Egan, M. & Wyatt, R. J. (1992). Creatine kinase and enolase: intracellular enzymes serving as markers of central nervous system damage in neuropsychiatric disorders. Psychiatry 55, 392–402.CrossRefGoogle ScholarPubMed
Endicott, J., Spitzer, R., Flies, J., Schwartz, U. & Fink, U. (1976). The Global Assessment Scale. Archives of General Psychiatry 33, 766–771.CrossRefGoogle ScholarPubMed
Fink, M., Bush, G. & Francis, A. (1993). Catatonia: a treatable disorder occasionally recognized. Directions in Psychiatry 13, 1–7.Google Scholar
Fleischhacker, W., Unterweger, B., Kane, J. M. & Hinterhuber, H. (1990). The neuroleptic malignant syndrome and its differentiation from lethal catatonia. Acta Psychiatrica Scandinavica 81, 3–5.CrossRefGoogle ScholarPubMed
Gelenberg, A. J. (1976). The catatonic syndrome. Lancet i, 1339–1341.CrossRefGoogle Scholar
Gelenberg, A. J. (1977). Criteria for the diagnosis of catatonia. American Journal of Psychiatry 134, 462–463.CrossRefGoogle ScholarPubMed
Goode, D. J. & Meltzer, H. J. (1976). Effects of isometric exercise on serum creatine phosphokinase activity. Archives of General Psychiatry 33, 1207–1211.CrossRefGoogle ScholarPubMed
Guy, W. (1976). Assessment Manual for Psychopharmacology. DHEW 76–338, NIH, Psychopharmacology Research: Rockville, TS.Google Scholar
Häfner, H. & Kasper, S. (1982). Akute lebensbedrohliche Katatonie. Nervenarzt 53, 385–394.Google Scholar
Hermle, L. & Oepen, G. (1986). Zur Differentialdiagnose der akut lebensbedrohlichen Katatonie und des malignen Neuroleptikasyndromsein kasuistischer Beitrag. Fortschritte der Neurologie und Psychiatrie 54, 189–195.CrossRefGoogle Scholar
Kahlbaum, K. L. (1874). Die Katatonie. Hirschwald: Berlin.Google Scholar
Kraepelin, E. (1905). Lehrbuch der Psychiatrie Barth: München.Google Scholar
Levenson, J. L. (1985). Neuroleptic malignant syndrome. American Journal of Psychiatry 142, 1137–1145.Google ScholarPubMed
Lohr, J. & Wisniewski, A. (1987). Movement Disorders. Wiley: Chichester.Google Scholar
McKenna, P., Lund, C., Mortimer, A. & Biggins, C. (1991). Motor, volitional, and behavioural disorders in schizophrenia. British Journal of Psychiatry 158, 323–336.CrossRefGoogle ScholarPubMed
Mann, S. C., Caroff, S. N., Bleier, H. R., Welz, W., Kling, M. & Hayashida, M. (1986). Lethal catatonia. American Journal of Psychiatry 143, 1374–1381.Google ScholarPubMed
Meltzer, H. Y. (1973). Creatine phosphokinase activity and clinical symptomatology. Archives of General Psychiatry 29, 589–593.CrossRefGoogle ScholarPubMed
Meltzer, H. Y. (1975). Neuromuscular abnormalities in the major mental illnesses. In Biology of the Major Psychoses (ed. Freedman, D. X.), pp. 54–72. Blackwell: New York.Google Scholar
Meltzer, H. Y. (1976). Serum creatine phosphokinase in schizophrenia. American Journal of Psychiatry 133, 192–197.Google ScholarPubMed
Menza, M. (1991). Lorazepam and catatonia. Journal of Clinical Psychiatry 52, 186–187.Google ScholarPubMed
Mortimer, A. M., Lund, C. & McKenna, P. (1990). The positive–negative dichotomy in schizophrenia. British Journal of Psychiatry 157, 41–49.CrossRefGoogle ScholarPubMed
Northoff, G. (1995). Effects of benzodiazepines in catatonia – a pathophysiological model. In Endogenous Psychosis (ed. Beckmann, H. and Neumärker, K. J.), pp. 145–159. Ullstein Mosby: New York.Google Scholar
Overall, J. E. & Gorham, D. R. (1962). The Brief Psychiatric Rating Scale. Psychological Reports 10, 799–812.CrossRefGoogle Scholar
Rosalki, S. E. (1967). An improved procedure for serum creatine phosphokinase determination. Journal of Laboratory Clinical Medicine 69, 696–705.Google ScholarPubMed
Rosebush, P. & Furlong, M. (1991). A consideration of the mechanisms by which lorazepam might treat catatonia. Journal of Clinical Psychiatry 52, 187–188.Google Scholar
Rosebush, P., Furlong, B. & Mazurek, M. (1990). Catatonic syndrome in a general psychiatric inpatient population: frequency, clinical presentation, and response to lorazepam. Journal of Clinical Psychiatry 51, 357–362.Google Scholar
Rosebush, P., Furlong, B. & Mazurek, M. (1992). The treatment of catatonia: benzodiazepines or ECT? American Journal of Psychiatry 149, 9–10.CrossRefGoogle ScholarPubMed
Sczesni, B., Schröder, J., Becker, H. & Przuntek, H. (1991). Das neuroleptische maligne Syndrom. Wiener Klinische Wochenschrift 103, 1–7.Google Scholar
Simpson, G. M. & Angus, J. W. S. (1970). A rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica (Suppl.) 212, 11–19.CrossRefGoogle ScholarPubMed
Stauder, K. H. (1934). Die tödliche Katatonie. Archiv für Psychiatrie 102, 614–634.CrossRefGoogle Scholar
Taylor, M. (1990). Catatonia: a review of the behavioral neurologic syndrome. Neuropsychiatry, Neuropsychology and Behavioral Neurology 3, 48–72.Google Scholar