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Nervenarzt 2021 Jun 11. Epub 2021 Jun 11.

Zentrum für Psychosoziale Medizin, Klinik für Allgemeine Psychiatrie, Universität Heidelberg, Heidelberg, Deutschland.

Over the past three decades research interest in hypokinetic, hyperkinetic, sensorimotor and psychomotor abnormalities in mental disorders has steadily increased. This development has led to an increasing number of scientific initiatives that have not only highlighted the clinical need for early detection of extrapyramidal motor symptoms, tardive dyskinesia and catatonia but also provided numerous neurobiological findings and clinically relevant results based on the pathology of the sensorimotor system in patients with mental disorders. In view of these developments in January 2019 the National Institute of Mental Health (NIMH) research domain criteria (RDoC) initiative introduced a sixth domain called the sensorimotor domain to address deficits in the sensorimotor system and associated behavioral abnormalities. Read More

Medicine (Baltimore) 2021 May;100(19):e25967

Department of Emergency Medicine, Sapporo Medical University Hospital, Sapporo-shi.

Introduction: Malignant catatonia (MC) is a movement disorder syndrome characterized by immobility, rigidity, and consciousness disorders that develops in association with mental and physical diseases. It is often fatal due to hyperthermia, rhabdomyolysis, and acute kidney injury. Its clinical symptoms are similar to those of another disorder, neuroleptic malignant syndrome (NMS), and it is often difficult to distinguish between the 2 disorders. Read More

Hosp Pediatr 2021 Jun 8. Epub 2021 Jun 8.

School of Medicine, Duke University, Durham, North Carolina.

Objectives: Patients with autoimmune encephalitis (AE) often present with symptoms that are broadly characterized as psychiatric or behavioral, yet little attention is given to the precise symptomatology observed. We sought to more fully define the psychiatric symptoms observed in patients with anti-N-methyl-D-aspartate receptor (NMDAR), anti-glutamic-acid-decarboxylase 65 (GAD65), and anti-voltage-gated-potassium-channel complex (VGKC) antibody-mediated AE using the nomenclature.

Methods: We present a case series ( = 25) using a retrospective chart review of 225 patients evaluated for AE in a tertiary care academic medical center between 2014 and 2018. Read More

J Psychosom Res 2021 May 31;147:110540. Epub 2021 May 31.

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.

Aim: Psychiatric patients have increased risk of deep vein thrombosis (DVT). However, there is no systematic data on risk assessment of DVT among psychiatric inpatients. The aim of this study was to develop a risk stratification scoring system for DVT among psychiatic patients on admission. Read More

AACE Clin Case Rep 2021 May-Jun;7(3):189-191. Epub 2020 Dec 19.

Valleywise Behavioral Health- Maryvale, 5102 W Campbell Ave, Phoenix, Arizona.

Objective: To familiarize the medical community with the less common adverse effects of lithium on parathyroid function, we present a case of lithium-associated hyperparathyroidism followed by the development of new-onset catatonia in a patient with schizoaffective disorder.

Methods: To allow for the safe resumption of lithium, the patient received laboratory screening of serum lithium, blood urea nitrogen, serum creatinine, calcium, and thyroid-stimulating hormone levels. The hypercalcemia was evaluated by measuring parathyroid hormone (PTH), ionized calcium, and 25-hydroxy vitamin D levels. Read More

Eur Child Adolesc Psychiatry 2021 Jun 6. Epub 2021 Jun 6.

Department of Child and Adolescent Psychiatry, Université de Rouen, Hôpital Charles Nicolle, 1 rue de Germont, 76000, Rouen, France.

Catatonia is a psychomotor syndrome which may occur in a wide variety of medical, neurological, and psychiatric conditions. In pediatrics, this condition is rare and is associated with high morbidity and mortality if not correctly diagnosed and treated. Catatonia in obsessive-compulsive disorder is an infrequent association that has been understudied and underdiagnosed. Read More

BMJ Case Rep 2021 Jun 4;14(6). Epub 2021 Jun 4.

Neurology, Hospital Central Dr Ignacio Morones Prieto, San Luis Potosi, Mexico

COVID-19 has shown different neurological manifestations even sometimes there are the initial or the main presentation.The following case report is about a middle-aged woman who, over 3 days, developed fever, clinical neurological alterations (stupor, muteness, fixed gaze and catatonia), cerebrospinal fluid (16 lymphocytes) and an electroencephalogram (EEG) (4-6 Hz generalised activity) with characteristics of encephalitis. A serum IgG, IgM, nasopharyngeal swab PCR for SARS-CoV-2. Read More

Indian J Psychiatry 2021 Jan-Feb;63(1):116-117. Epub 2021 Feb 15.

Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India. E-mail:

Trop Doct 2021 Jun 3:494755211020883. Epub 2021 Jun 3.

Assistant Professor, Department of Internal Medicine, VMMC and Safdarjung Hospital, New Delhi, India.

Enteric or typhoid fever is an emerging tropical infectious disease and a global public health problem with a documented spectrum of neuro-psychiatric manifestations especially from endemic countries. Although neuro-psychiatric manifestations are reported in nearly 50-75% of patients at any phase of enteric fever, the chance of their misdiagnosis and deferred diagnosis of the prime illness is quite common. Atypical symptoms are commonly attributed to be a part of 'typhoid toxaemia', the acute febrile phase of the illness. Read More

J Neural Transm (Vienna) 2021 May 31. Epub 2021 May 31.

Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany.

Studies show that psychiatric symptoms in adults and children are sometimes associated with serum neural autoantibodies. The significance of serum neural autoantibodies associated with psychiatric symptoms in children remains often unclear, but might be relevant for the extent and occurrence of psychiatric disease manifestation in later life, as well as therapy and outcome. For this narrative review, we sought articles listed in PubMed and published between 1988 and 2020 addressing the maternal-fetal transfer of neural autoantibodies and psychiatric disorders associated with serum neural autoantibodies. Read More

Oxf Med Case Reports 2021 May 24;2021(5):omab020. Epub 2021 May 24.

Medical Department, Médecins Sans Frontières-Operational Centre Brussels, Lesvos, Greece.

An unresponsive paediatric patient may present a diagnostic challenge for health professionals, as rapid identification of the cause is needed to provide proper interventions. The following report details a challenging diagnosis of unresponsiveness in a refugee child. In the migratory context, observed unresponsiveness states are frequently attributed to psychologic factors, and overlapping psychiatric classifications (resignation syndrome, functional coma and catatonia) are common. Read More

Front Psychiatry 2021 11;12:674335. Epub 2021 May 11.

GME Psychiatry, Orange Park Medical Center, Orange Park, FL, United States.

Autistic catatonia is an under-recognized debilitating syndrome with long-lasting negative effects for families, healthcare workers, and high-cost to the healthcare system. In this report, we describe two cases of excited catatonia in young men diagnosed with autism. Both endured a delay to diagnosis and difficulty to obtain appropriate treatment. Read More

J Nerv Ment Dis 2021 Jun;209(6):403-408

University of Kentucky Mental Health Research Center at Eastern State Hospital, Lexington, Kentucky; Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada; and Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apóstol Hospital, University of the Basque Country, Vitoria, Spain.

Abstract: The medical model in psychiatry and descriptive psychopathology were established in Germany by Krapelin's textbook and Jaspers' General Psychopathology. In the United Kingdom, Mayer-Gross' textbook synthesized both books, influencing US psychiatry. US psychiatrists from the World War II generation defeated the US academic psychoanalytic establishment by building three pillars: biological psychiatry (brought by Wortis), the psychopharmacology revolution, and the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition (DSM-III). Read More

Eur Neuropsychopharmacol 2021 May 22;51:43-54. Epub 2021 May 22.

School of Psychiatry, University of New South Wales, Randwick, NSW, 2031, Australia; Black Dog Institute, Hospital Road, Randwick, NSW, 2031, Australia; The Wesley Hospital, 7 Blake St, Kogarah, NSW, 2217, Australia; St. George Hospital, Gray St, Kogarah, NSW, 2217, Australia; Northside Group St Leonards Clinic, 2 Frederick St, St Leonards, NSW, 2065, Australia.

Electroconvulsive Therapy's (ECT) use and place in treatment guidelines varies worldwide with a primary indication of depression in Western countries and acute psychosis in Asian countries. There is sparse evidence about the relative effectiveness of ECT among different indications that may account for this discrepancy. We aimed to compare the clinical global impression of disease severity, cognitive change, subjective quality of life (QoL) and global functioning after ECT given for treatment of the indications of acute psychosis, mania, depression, psychotic depression and catatonia. Read More

J ECT 2021 Jun;37(2):75

From the Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA.

Front Psychiatry 2021 7;12:655178. Epub 2021 May 7.

Department Basic and Applied Neurobiology, V. P. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia.

We investigated the associations of rs6280, rs6295, rs6265, rs16965628, and rs7322347 with schizophrenia in a case-control study, and associations of these genetic variants with several clinical features. We also investigated markers of inflammatory response (C-reactive protein, IL-2, IL-6, IL-10), the activity of leukocytic elastase (LE) and α1-proteinase inhibitor (a1-PI), antibodies to S100B and myelin basic protein (MBP) in schizophrenia. Clinical symptoms were assessed on three scales: Positive and Negative Syndrome Scale, The Bush - Francis Catatonia Rating Scale and Frontal Assessment Battery. Read More

Mol Psychiatry 2021 May 19. Epub 2021 May 19.

Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany.

Rinsho Shinkeigaku 2021 May 20. Epub 2021 May 20.

Department of Neurology, Kyoto University Graduate School of Medicine.

A 66 year-old right-handed female was admitted to our hospital presenting with recurrent episodes of catatonic symptoms consisting of stupor, waxy flexibility, and catalepsy lasting about 5-20 minutes. A brain MRI showed no significant abnormalities. An scalp-electroencephalography (EEG) concurrent with the symptoms showed ictal EEG activities arising from the left fronto-central area, which evolved into the bilateral frontal and bilateral parietal areas together. Read More

Brain Nerve 2021 May;73(5):595-604

Department of Neurology, Kitasato University.

Anti-NMDA receptor (NMDAR) encephalitis is an autoimmune disease caused by autoantibodies against the extracellular conformational epitope of the NR1 subunit of the NMDAR (GluN1 antibodies). A series of autoantibodies directed against neuronal surface (NS) or synaptic proteins play an important role in the pathophysiological mechanisms of post-herpes simplex encephalitis (post-HSE), overlapping autoimmune encephalitis and demyelinating syndrome, epileptic seizures, psychosis, involuntary movements (orofacial and limb dyskinesias, catatonia, dystonia, chorea, myoclonus, psychogenic nonepileptic seizures, and faciobrachial dystonic seizures), postpartum psychosis, stiff-person spectrum disorder (including progressive encephalomyelitis with rigidity and myoclonus [PERM]), cerebellar ataxia, and sleep behavior disorders. These NS antibodies are identified with cell-based assays and immunohistochemistry using nonperfused paraformaldehyde-fixed rodent brain tissue. Read More

Prim Care Companion CNS Disord 2021 Apr 15;23(2). Epub 2021 Apr 15.

Department of Neurosciences, University of Padova, Padova, Italy.

Prim Care Companion CNS Disord 2021 May 13;23(3). Epub 2021 May 13.

Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania.

Prim Care Companion CNS Disord 2021 02 18;23(1). Epub 2021 Feb 18.

Department of Psychiatry, Monash University, Melbourne, Victoria, Australia.

Prim Care Companion CNS Disord 2021 Mar 11;23(2). Epub 2021 Mar 11.

Waltham Forest Older Adults Mental Health Team, North East London Foundation Trust, Red Oak Lodge, London, United Kingdom.

Objective: To review the published literature over the last 5 years on the use of electroconvulsive therapy (ECT) in multiple sclerosis (MS), focusing on efficacy, safety, and tolerability. MS commonly has neuropsychiatric comorbidity. ECT is used in MS for severe and life-threatening forms of mental illness when other treatment options have failed or when a rapid response is required. Read More

J Acad Consult Liaison Psychiatry 2021 Apr 20. Epub 2021 Apr 20.

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA.

J Clin Psychiatry 2021 02 23;82(2). Epub 2021 Feb 23.

Department of Psychiatry, University of Utah, Salt Lake City, Utah.

Background: The use of electroconvulsive therapy (ECT) in children and adolescents is based on a limited evidence base in the medical literature. We report outcomes of a cohort of youth treated with ECT at a single US academic medical center.

Methods: We conducted a retrospective chart review and analysis of all patients aged 18 years and younger who received ECT at the University of Utah from 1985 through 2016. Read More

Aust N Z J Psychiatry 2021 May 10:48674211011246. Epub 2021 May 10.

Discipline of Clinical Pharmacology, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.

World J Biol Psychiatry 2021 Jun 10:1-9. Epub 2021 Jun 10.

Department of Psychiatry and Psychotherapy, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

Malignant catatonia (MC) is a rare, yet potentially life-threatening neuropsychiatric condition. Evidence on its therapy is weak, treatment recommendations are scarce and predominantly unprecise. The aim of this study was to compare the effectiveness of different MC treatment approaches regarding outcome and severity of MC. Read More

CNS Spectr 2021 May 3. Epub 2021 May 3.

Al-Manara CAP Centre, Kuwait Centre for Mental Health (KCMH), Jamal Abdul-Nassir St, Shuwaikh, State of Kuwait.

Front Psychiatry 2021 14;12:666646. Epub 2021 Apr 14.

Department of Psychiatry and Medical Psychology, University Hospital Toulouse (CHU Toulouse), Expert Centre for Treatment-Resistant Depression FondaMental, ToNIC Toulouse NeuroImaging Centre, Toulouse University, INSERM, UPS, Toulouse, France.

Midazolam is a benzodiazepine (BZD) mainly used in anesthetic induction due to its pharmacokinetic features. Its place in the therapeutic management of catatonia remains to be determined. Here we present the case of a 65-year-old man who presented with a first episode of catatonia with opposition to any form of oral treatment, where a single dose of 1 mg of subcutaneous (SC) Midazolam permitted clinical improvement allowing oral treatment to be given. Read More

Tijdschr Psychiatr 2021 ;63(4):301-304

Catatonia is a psychomotor syndrome characterised by multiple symptoms like stereotypies - repetitive, abnormally frequent, non-goal-directed movements. A problem is the lack of unanimity regarding the number of symptoms needed for diagnosis. We describe repetitive inappropriate sexual behaviour in a patient with bipolar depression and excited catatonia with Bush-Francis Catatonia Rating Scale score of 12. Read More