Catatonia on the Consultation Liaison Service and Other Clinical Settings

Abstract

C atatonia is a syndrome of motor dysregulation that, once recognized, is gratifyingly treatable with high-dose benzodiazepines and electroconvulsive therapy (ECT). Catatonia occurs in the context of not just several underlying neuropsychiatric disorders but also many general medical disorders. Indeed, 1 review identified catatonia in association with more than 100 general medical disorders. Thus, it comes as no surprise that the diagnosis and management of catatonia are important competencies for the consultation liaison (CL) psychiatrist. One such CL psychiatrist, Brendan Carroll, first described catatonia on the CL service more than 25 years ago. Now, he has teamed up with David Spiegel, another CL psychiatrist, to edit a multiauthored volume dedicated to the topic of catatonia in general medical settings. The 112-page compilation consists of 10 concise chapters, many of which coauthored by one of the editors, as well as a helpful comprehensive index. The main strength of Catatonia on the Consultation Liaison Service and Other Clinical Settings is its up-to-date review of specific neuropsychiatric disorders where catatonia is increasingly recognized. There isawell-organizedchapteroncatatonia inautism spectrum disorders (ASDs) that moves logically from epidemiology and phenomenology to genetics and imaging and finally to treatment. There is another chapter dedicated to Creutzfeld-Jakob disease (CJD), which it takes the form of an extended case report and is less comprehensive than the chapter on catatonia in ASD. And there is an overview chapter that offers a thoughtful approach to thediagnosticworkup for catatonia in general medical settings. The fact that whole chapters are dedicated to ASD and CJD leaves the reader wondering why similar attention is not paid to neuropsychiatric disorders that are encountered on the CL service far more commonly than ASD or CJD. Indeed, the book’s primary opportunity for improvement is to expand substantially the discussions on