Catatonia in Dementia: Case Series from France

 Out on PubMed, from authors in France, is this paper:

Catatonia in patients with dementia: A descriptive study of clinical profiles and treatment response.

Ramognino V, Fovet T, Horn M, Lebouvier T, Amad A.Asian J Psychiatr. 2024 Mar 27;96:104033. doi: 10.1016/j.ajp.2024.104033. Online ahead of print.PMID: 38564875
The abstract is copied below:

Background: Catatonia is a highly prevalent syndrome in patients presenting with major neurocognitive disorders (dementia). In this study, we aim to provide a comprehensive description of the clinical and therapeutic aspects of catatonia in patients with dementia.

Method: This descriptive study, conducted between September 2015 and June 2022, collected data from 25 patients diagnosed with dementia, out of 143 patients treated for catatonia in our specialized psychiatry department. We collected sociodemographic, clinical and treatment data for each patient.

Results: Dementia patients constituted 17% of the catatonic cases. Predominantly female, the cohort had a mean age of 65. Diagnoses included Alzheimer's (4 patients, 17%) and Parkinson's (1 patient, 4%) diseases, Lewy body dementia (5 patients, 21%), vascular dementia (4 patients, 17%) and frontotemporal lobar degeneration (10 patients, 41%). The mean Bush-Francis Catatonia Rating Scale score upon admission was 20/69. Overall, complete remission of catatonia was achieved in 75% of patients (n=18), with only 13% (n=3) responding to lorazepam alone, while others required additional interventions such as electroconvulsive therapy (ECT) and/or amantadine. Vascular dementia was predominantly observed in cases resistant to treatment.

Conclusion: The findings indicate a frequent co-occurrence of catatonia and dementia, highlighting treatability yet suggesting a potential for resistance to lorazepam, which varies by dementia diagnosis. Investigating the mechanisms underlying this resistance and the variability in treatment response is crucial for developing more precise therapeutic strategies.

Keywords: Catatonia; Dementia; Electroconvulsive therapy; Treatment.

The paper is here.
And from the text:







This is a very interesting retrospective case series (n=24). It should be noted that almost all patients (22/24) had lifetime diagnoses of psychiatric illness (uni-and bipolar depression, schizoaffective disorder); there was also high representation of fronto-temporal dementia (FTD,41%), so this may be quite an atypical population. It would be helpful to know if any patients had had episodes of catatonia earlier in life, before developing dementia.The authors' comments about lorazepam failure, use of ECT and amantadine are all worth reading.
Kudos to our French colleagues for this contribution to the ECT-catatonia literature.

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