Identification

The prevalence of catatonia (as much as 10-20% depending on setting) is far higher than the rate of identification. Catatonia is frequently missed, in part because of the historical perception of catatonia as a syndrome associated exclusively with schizophrenia. This has led to lack of awareness of the association with other conditions, some of which have a stronger association than that with schizophrenia. The DSM-V and ICD-11 have sought to address this problem by rationalising the diagnostic criteria and establishing catatonia as distinct from schizophrenia.

Psychiatry trainees should be familiarised with catatonia and instructed in the examination for signs of catatonia. This may be accomplished by formal teaching or workplace-based education. Ideally, competency in the recognition, assessment, and management of catatonia would be within training curricula.

There are several validated scales. The most commonly used is the Bush Francis Catatonia Rating Scale (BFCRS). It can be used as a screening tool or for monitoring treatment response. An interactive version with definitions of each catatonic sign is available online via MDCalc . ICD-11 also lists these within the diagnostic criteria.

Some patient groups may be better suited to other scales, such as the Paediatric Catatonia Rating Scale (PCRS).