Catatonic Stupor in Schizophrenic Disorders and Subsequent Medical Complications and Mortality

Michitaka Funayama, Taketo Takata, Akihiro Koreki, Satoyuki Ogino, Masaru Mimura

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective Although catatonia can occur secondary to a general medical condition, catatonia itself has been known to lead to various medical compolications. Although case reports on the association of catatonia with subsequent medical complications have been documented, no comprehensive large-scale study has been performed. To investigate specific medical complications after catatonia, we conducted a retrospective cohort study of specific medical complications of schizophrenia patients with catatonia. Methods The 1719 schizophrenia inpatients in our study were categorized into two groups: the catatonia group, i.e., those who exhibited catatonic stupor while they were hospitalized, and the noncatatonia group, i.e., those who never exhibited catatonic stupor. Differences between the two groups in the occurrence of subsequent medical complications were examined using linear and logistic regression analyses, and models were adjusted for potentially confounding factors. Results The catatonia group had an increased risk for mortality (odds ratio = 4.8, 95% confidence interval = 2.0-10.6, p <.01) and certain specific medical complications, i.e., pneumonia, urinary tract infection, sepsis, disseminated intravascular coagulation, rhabdomyolysis, dehydration, deep venous thrombosis, pulmonary embolism, urinary retention, decubitus, arrhythmia, renal failure, neuroleptic malignant syndrome, hypernatremia, and liver dysfunction (all p values <.01, except for deep venous thrombosis, p =.04 in the multiple linear regression analysis). Conclusions Catatonic stupor in schizophrenia substantially raises the risk for specific medical complications and mortality. Hyperactivity of the sympathetic nervous system, dehydration, and immobility, which are frequently involved in catatonia, might contribute to these specific medical complications. In catatonia, meticulous care for both mental and medical conditions should be taken to reduce the risk of adverse medical consequences.

Original languageEnglish
Pages (from-to)370-376
Number of pages7
JournalPsychosomatic Medicine
Volume80
Issue number4
DOIs
Publication statusPublished - 2018 May 1

Fingerprint

Catatonia
Stupor
Schizophrenia
Mortality
Dehydration
Venous Thrombosis
Linear Models
Logistic Models
Regression Analysis
Hypernatremia
Neuroleptic Malignant Syndrome
Rhabdomyolysis
Urinary Retention
Disseminated Intravascular Coagulation
Sympathetic Nervous System
Pulmonary Embolism
Urinary Tract Infections
Renal Insufficiency
Liver Diseases
Cardiac Arrhythmias

Keywords

  • catatonic stupor
  • dehydration
  • immobility
  • medical complications
  • schizophrenia
  • sympathetic nervous system.

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

Cite this

Catatonic Stupor in Schizophrenic Disorders and Subsequent Medical Complications and Mortality. / Funayama, Michitaka; Takata, Taketo; Koreki, Akihiro; Ogino, Satoyuki; Mimura, Masaru.

In: Psychosomatic Medicine, Vol. 80, No. 4, 01.05.2018, p. 370-376.

Research output: Contribution to journalArticle

Funayama, Michitaka ; Takata, Taketo ; Koreki, Akihiro ; Ogino, Satoyuki ; Mimura, Masaru. / Catatonic Stupor in Schizophrenic Disorders and Subsequent Medical Complications and Mortality. In: Psychosomatic Medicine. 2018 ; Vol. 80, No. 4. pp. 370-376.
@article{047856e742f845eebc2848bb991ab0e7,
title = "Catatonic Stupor in Schizophrenic Disorders and Subsequent Medical Complications and Mortality",
abstract = "Objective Although catatonia can occur secondary to a general medical condition, catatonia itself has been known to lead to various medical compolications. Although case reports on the association of catatonia with subsequent medical complications have been documented, no comprehensive large-scale study has been performed. To investigate specific medical complications after catatonia, we conducted a retrospective cohort study of specific medical complications of schizophrenia patients with catatonia. Methods The 1719 schizophrenia inpatients in our study were categorized into two groups: the catatonia group, i.e., those who exhibited catatonic stupor while they were hospitalized, and the noncatatonia group, i.e., those who never exhibited catatonic stupor. Differences between the two groups in the occurrence of subsequent medical complications were examined using linear and logistic regression analyses, and models were adjusted for potentially confounding factors. Results The catatonia group had an increased risk for mortality (odds ratio = 4.8, 95{\%} confidence interval = 2.0-10.6, p <.01) and certain specific medical complications, i.e., pneumonia, urinary tract infection, sepsis, disseminated intravascular coagulation, rhabdomyolysis, dehydration, deep venous thrombosis, pulmonary embolism, urinary retention, decubitus, arrhythmia, renal failure, neuroleptic malignant syndrome, hypernatremia, and liver dysfunction (all p values <.01, except for deep venous thrombosis, p =.04 in the multiple linear regression analysis). Conclusions Catatonic stupor in schizophrenia substantially raises the risk for specific medical complications and mortality. Hyperactivity of the sympathetic nervous system, dehydration, and immobility, which are frequently involved in catatonia, might contribute to these specific medical complications. In catatonia, meticulous care for both mental and medical conditions should be taken to reduce the risk of adverse medical consequences.",
keywords = "catatonic stupor, dehydration, immobility, medical complications, schizophrenia, sympathetic nervous system.",
author = "Michitaka Funayama and Taketo Takata and Akihiro Koreki and Satoyuki Ogino and Masaru Mimura",
year = "2018",
month = "5",
day = "1",
doi = "10.1097/PSY.0000000000000574",
language = "English",
volume = "80",
pages = "370--376",
journal = "Psychosomatic Medicine",
issn = "0033-3174",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Catatonic Stupor in Schizophrenic Disorders and Subsequent Medical Complications and Mortality

AU - Funayama, Michitaka

AU - Takata, Taketo

AU - Koreki, Akihiro

AU - Ogino, Satoyuki

AU - Mimura, Masaru

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Objective Although catatonia can occur secondary to a general medical condition, catatonia itself has been known to lead to various medical compolications. Although case reports on the association of catatonia with subsequent medical complications have been documented, no comprehensive large-scale study has been performed. To investigate specific medical complications after catatonia, we conducted a retrospective cohort study of specific medical complications of schizophrenia patients with catatonia. Methods The 1719 schizophrenia inpatients in our study were categorized into two groups: the catatonia group, i.e., those who exhibited catatonic stupor while they were hospitalized, and the noncatatonia group, i.e., those who never exhibited catatonic stupor. Differences between the two groups in the occurrence of subsequent medical complications were examined using linear and logistic regression analyses, and models were adjusted for potentially confounding factors. Results The catatonia group had an increased risk for mortality (odds ratio = 4.8, 95% confidence interval = 2.0-10.6, p <.01) and certain specific medical complications, i.e., pneumonia, urinary tract infection, sepsis, disseminated intravascular coagulation, rhabdomyolysis, dehydration, deep venous thrombosis, pulmonary embolism, urinary retention, decubitus, arrhythmia, renal failure, neuroleptic malignant syndrome, hypernatremia, and liver dysfunction (all p values <.01, except for deep venous thrombosis, p =.04 in the multiple linear regression analysis). Conclusions Catatonic stupor in schizophrenia substantially raises the risk for specific medical complications and mortality. Hyperactivity of the sympathetic nervous system, dehydration, and immobility, which are frequently involved in catatonia, might contribute to these specific medical complications. In catatonia, meticulous care for both mental and medical conditions should be taken to reduce the risk of adverse medical consequences.

AB - Objective Although catatonia can occur secondary to a general medical condition, catatonia itself has been known to lead to various medical compolications. Although case reports on the association of catatonia with subsequent medical complications have been documented, no comprehensive large-scale study has been performed. To investigate specific medical complications after catatonia, we conducted a retrospective cohort study of specific medical complications of schizophrenia patients with catatonia. Methods The 1719 schizophrenia inpatients in our study were categorized into two groups: the catatonia group, i.e., those who exhibited catatonic stupor while they were hospitalized, and the noncatatonia group, i.e., those who never exhibited catatonic stupor. Differences between the two groups in the occurrence of subsequent medical complications were examined using linear and logistic regression analyses, and models were adjusted for potentially confounding factors. Results The catatonia group had an increased risk for mortality (odds ratio = 4.8, 95% confidence interval = 2.0-10.6, p <.01) and certain specific medical complications, i.e., pneumonia, urinary tract infection, sepsis, disseminated intravascular coagulation, rhabdomyolysis, dehydration, deep venous thrombosis, pulmonary embolism, urinary retention, decubitus, arrhythmia, renal failure, neuroleptic malignant syndrome, hypernatremia, and liver dysfunction (all p values <.01, except for deep venous thrombosis, p =.04 in the multiple linear regression analysis). Conclusions Catatonic stupor in schizophrenia substantially raises the risk for specific medical complications and mortality. Hyperactivity of the sympathetic nervous system, dehydration, and immobility, which are frequently involved in catatonia, might contribute to these specific medical complications. In catatonia, meticulous care for both mental and medical conditions should be taken to reduce the risk of adverse medical consequences.

KW - catatonic stupor

KW - dehydration

KW - immobility

KW - medical complications

KW - schizophrenia

KW - sympathetic nervous system.

UR - http://www.scopus.com/inward/record.url?scp=85046901324&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046901324&partnerID=8YFLogxK

U2 - 10.1097/PSY.0000000000000574

DO - 10.1097/PSY.0000000000000574

M3 - Article

VL - 80

SP - 370

EP - 376

JO - Psychosomatic Medicine

JF - Psychosomatic Medicine

SN - 0033-3174

IS - 4

ER -