Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Feb 19, 2024; 14(2): 210-214
Published online Feb 19, 2024. doi: 10.5498/wjp.v14.i2.210
Catatonia: A deep dive into its unfathomable depths
Peter Phiri, Gayathri Delanerolle, Oliver Hope, Tharangini Murugaiyan, Geoffrey Dimba, Shanaya Rathod, Zukiswa Zingela
Peter Phiri, Gayathri Delanerolle, Oliver Hope, Shanaya Rathod, Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
Peter Phiri, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, Hampshire, United Kingdom
Tharangini Murugaiyan, Acute Inpatients Services, Southern Health NHS Foundation Trust, Basingstoke RG24 9RH, United Kingdom
Geoffrey Dimba, Home Treatment Team, South West, Surrey and Borders Partnerships NHS Foundation Trust, Guildford GU2 7XL, Surrey, United Kingdom
Zukiswa Zingela, Faculty of Health Sciences, Nelson Mandela University, Summerstrand 6001, Gqeberha, South Africa
Author contributions: Phiri P designed the overall concept and outline of the manuscript, and wrote first draft; Delanerolle G, Hope O, Murugaiyan T, Dimba G, Rathod S, and Zingela Z contributed to this paper; and all authors reviewed and approved the final version of the manuscript.
Conflict-of-interest statement: Phiri P has received research grants from Novo Nordisk, Janssen Cilag, and other, educational from QMUL, other from John Wiley & Sons, other from Otsuka, outside the submitted work. Rathod S reports other from Janssen, Lundbeck, Boehringer and Otsuka outside the submitted work. All other authors report no conflict of interest. The views expressed are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health and Social Care or the Academic institutions.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peter Phiri, BSc, PhD, RN, Academic Research, Director, Research Fellow, Research & Innovation Department, Southern Health NHS Foundation Trust, Botley Road, Southampton SO30 3JB, United Kingdom. peter.phiri@southernhealth.nhs.uk
Received: December 7, 2023
Peer-review started: December 7, 2023
First decision: December 17, 2023
Revised: December 22, 2023
Accepted: January 18, 2024
Article in press: January 18, 2024
Published online: February 19, 2024

This editorial addresses catatonia, a complex neuropsychiatric syndrome characterised by a spectrum of psychomotor disturbances. The editorial seeks to clarify the ambiguous aspects of catatonia, integrating recent research findings, including global studies and diagnostic advancements. It discusses catatonia’s clinical manifestations, prevalence, and associated psychiatric and medical conditions, with particular emphasis on its frequent co-occurrence with schizophrenia and mood disorders. The prevalence of catatonia, which varies across psychiatric populations, is illustrated by a significant study conducted in Nelson Mandela Bay, South Africa. This study provides valuable insights into the effectiveness of the Bush-Francis Screening Instrument compared to the Diagnostic and Statistical Manual 5 criteria in diagnosing catatonia. The editorial evaluates treatment approaches, primarily focusing on benzodiazepines and electroconvulsive therapy, and discusses emerging therapeutic strategies. It underscores the importance of robust diagnostic frameworks and early intervention in managing catatonia, as recommended by the latest evidence-based consensus guideline. Furthermore, it suggests future research directions, particularly in exploring the neurobiological and genetic factors of catatonia, to enhance our understanding and improve treatment outcomes. This editorial succinctly aims to demystify catatonia and provide valuable insights for clinicians and researchers in mental health care.

Keywords: Catatonia, Schizophrenia, Neuropsychiatry, Benzodiazepines, Electroconvulsive therapy, Bush-Francis screening instrument, Diagnosis

Core Tip: This editorial illuminates the complex nature of catatonia, emphasising its varied psychomotor symptoms. It highlights challenges in diagnosis, noting the effectiveness of the Bush-Francis screening instrument over the Diagnostic and Statistical Manual 5 criteria, and discusses the syndrome’s prevalence and associations with disorders like schizophrenia and mood disorders. Furthermore, it critically examines mainstay treatments such as benzodiazepines and electroconvulsive therapy and advocates for strong diagnostic criteria and prompt intervention. It calls for further research into catatonia’s neurobiological and genetic aspects, aiming to advance mental health care outcomes.