Clinical Practice Guidelines: Catatonia

CLINICAL PRACTICE GUIDELINES (FULL LIST)

CATATONIA (CPG)

Catatonia is a neuropsychiatric condition that presents in children and adults, impacting speech, psychomotor behaviors, and autonomic functioning. In children, catatonia is additionally recognized as a particular comorbidity for individuals with autism, neurodevelopmental disorders, and genetic conditions. Catatonia is associated with a high degree of morbidity and mortality for children. However, catatonia can respond to treatment if rapidly identified and appropriate interventions are administered. The aim of this Clinical Practice Guideline is to support best practice approaches for the assessment and treatment of pediatric catatonia in the inpatient pediatric setting.

Catatonia is a clinical diagnosis based on the presence of a constellation of symptoms. It is due to many different underlying medical and psychiatric etiologies. Patients can present in stuporous, excited, or agitated catatonic states.

Consider a diagnosis of catatonia if any of the following in the last 4 weeks (not explained by an alternative medical etiology):

  1. New onset fecal or urinary incontinence
  2. Aggression which is not directed toward any one individual
  3. Reduced intake of food or water
  4. Acute loss of a previously acquired skill
  5. New cold extremities not explainable by cold temperatures
  6. New grimacing

Authors:

  • Contact: Karisa Grizzle, Pediatric Hospital Medicine
  • Catherine Fuchs, Child and Adolescent Psychiatry
  • Josh Smith, Child and Adolescent Psychiatry
  • Tasia York, Child and Adolescent Psychiatry
  • Nadia Zaim, Child and Adolescent Psychiatry
  • Lindsay Pagano, Child Neurology
  • Kristina Betters, Pediatric ICU
  • Alison Herndon, Pediatric Hospital Medicine
  • Anuj Patel, Pediatric Hospital Medicine
  • Heather Kreth, Psychology
  • Katherine Spencer, Psychology
  • Brent Graham, Pediatric Rheumatology