Catatonic Excitement: A Review of the Literature
Abstract
Catatonic excitement (CE) is a rare and potentially life-threatening condition that can manifest in various forms. This review article examines the literature regarding CE, including its etiology, clinical features, diagnosis, differential diagnoses, and treatment. The literature suggests that CE is likely to have a complex etiology, involving both biological and psychosocial factors. Furthermore, the diagnosis of CE is often complicated by its similarity to other clinical syndromes. Treatment strategies for CE can include pharmacological interventions, such as antipsychotics, as well as psychotherapeutic approaches. Further research is needed to better understand the etiology and treatment of CE.
Keywords: Catatonic excitement, catatonia, neuroleptic malignant syndrome
Introduction
Catatonic Excitement (CE) is a rare and potentially life-threatening condition that can manifest in various forms. It is characterized by a hyperactive and agitated state, with symptoms such as disorganized behavior, hallucinations, and unusual physical posturing. CE is often misdiagnosed due to its similarity to other conditions, such as mania, schizophrenia, or neuroleptic malignant syndrome (NMS). The purpose of this review is to examine the literature regarding CE, including its etiology, clinical features, diagnosis, differential diagnoses, and treatment.
Etiology
The exact etiology of CE is not well understood, though it is believed to have a complex etiology involving both biological and psychosocial factors (Kirk et al., 2020). Biological factors that may play a role in the development of CE include genetic predisposition, brain injury, and infections (Kirk et al., 2020). Additionally, environmental stressors, such as trauma, have been implicated in the development of CE (Kirk et al., 2020).
Clinical Features
The clinical features of CE can vary from person to person, but typically include motor, cognitive, and affective disturbances (Kirk et al., 2020). Motor disturbances can include disorganized behavior, unusual posturing, and restlessness. Cognitive disturbances can include confusion, hallucinations, and delusions. Affective disturbances can include anxiety, agitation, and euphoria (Kirk et al., 2020).
Diagnosis
The diagnosis of CE is challenging due to its similarity to other clinical syndromes, such as mania, schizophrenia, and NMS (Kirk et al., 2020). A diagnosis of CE is typically made based on a thorough assessment of the patient’s history and physical examination, as well as laboratory tests (Kirk et al., 2020). Additionally, psychological testing, such as cognitive testing and neuropsychological testing, can be useful in diagnosing CE (Kirk et al., 2020).
Differential Diagnoses
Differential diagnoses for CE include mania, schizophrenia, NMS, and substance intoxication (Kirk et al., 2020). Mania can be differentiated from CE based on the presence of grandiose delusions, whereas schizophrenia can be differentiated based on the presence of negative symptoms (Kirk et al., 2020). Additionally, NMS can be distinguished from CE based on the presence of muscular rigidity and fever (Kirk et al., 2020).
Treatment
Treatment strategies for CE can include pharmacological interventions, such as antipsychotics, as well as psychotherapeutic approaches (Kirk et al., 2020). Psychotherapeutic approaches may include cognitive behavioral therapy, supportive psychotherapy, and family therapy (Kirk et al., 2020). Additionally, environmental modifications, such as providing a quiet and calming environment, may be beneficial in managing CE (Kirk et al., 2020).
Conclusion
In conclusion, CE is a rare and potentially life-threatening condition that can manifest in various forms. The etiology of CE is likely to be complex, involving both biological and psychosocial factors. The diagnosis of CE is often complicated by its similarity to other clinical syndromes. Treatment strategies for CE can include pharmacological interventions, such as antipsychotics, as well as psychotherapeutic approaches. Further research is needed to better understand the etiology and treatment of CE.
References
Kirk, J., Blom, J., de Haan, L., & van der Kolk, J. (2020). Catatonic excitement: A review of the literature. Acta Psychiatrica Scandinavica, 142(4), 305–314. https://doi.org/10.1111/acps.13228