James Luccarelli , Jacqueline A. Clauss , Tasia York , Isaac Baldwin , Simon Vandekar , Trey McGonigle , Gregory Fricchione , Catherine Fuchs , Joshua R. Smith
{"title":"神经发散型和典型型儿童紧张症的住院治疗","authors":"James Luccarelli , Jacqueline A. Clauss , Tasia York , Isaac Baldwin , Simon Vandekar , Trey McGonigle , Gregory Fricchione , Catherine Fuchs , Joshua R. Smith","doi":"10.1016/j.genhosppsych.2025.05.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Catatonia is a neuropsychiatric disorder that occurs in pediatric patients with a range of associated medical, psychiatric, and neurodevelopmental disorders (NDDs). This study describes hospital care of pediatric catatonia patients and compares treatments for neurotypical patients and those with NDDs.</div></div><div><h3>Methods</h3><div>Retrospective cohort study from 1/1/2018 to 6/1/2023 of two academic medical centers of patients aged 18 and younger with catatonia. Patients were retrospectively assessed using the clinical global impressions-improvement (CGI-I) by two independent reviewers.</div></div><div><h3>Results</h3><div>One hundred sixty-five patients were hospitalized for catatonia, of whom 50.3 % had an NDD. Median age was 15. One hundred sixty-four patients were treated with a benzodiazepine, with a median maximum 24-hour dose of 6 mg lorazepam-equivalents, which did not differ for patients with and without NDDs. Electroconvulsive therapy (ECT) was utilized in 14.5 % of patients. Median length of medical hospitalization was 5 days and hospitalizations were longer in neurotypical patients than in patients with NDDs. In an ordinal regression model, the probability of observing at least “much improvement” (CGI < 3) was 88.3 % (95 % CI: 82.4 % to 92.3 %), with patients with a non-medical primary diagnosis and an NDD having a lower odds of response than non-medical primary diagnosis without an NDD.</div></div><div><h3>Conclusions</h3><div>The probability of patients achieving a CGI-I score indicating at least “much improvement” was 88.3 %. Administered benzodiazepine dose and ECT treatment were similar for all patients, but neurotypical patients had longer hospitalizations than those with NDDs and had a higher odds of a more favorable clinical response for patients with non-medical primary diagnoses. Research under controlled conditions is needed to optimize and endure equitable catatonia treatment in youth.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Pages 133-139"},"PeriodicalIF":3.7000,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hospitalizations for pediatric catatonia in neurodivergent and neurotypical patients\",\"authors\":\"James Luccarelli , Jacqueline A. Clauss , Tasia York , Isaac Baldwin , Simon Vandekar , Trey McGonigle , Gregory Fricchione , Catherine Fuchs , Joshua R. Smith\",\"doi\":\"10.1016/j.genhosppsych.2025.05.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Catatonia is a neuropsychiatric disorder that occurs in pediatric patients with a range of associated medical, psychiatric, and neurodevelopmental disorders (NDDs). This study describes hospital care of pediatric catatonia patients and compares treatments for neurotypical patients and those with NDDs.</div></div><div><h3>Methods</h3><div>Retrospective cohort study from 1/1/2018 to 6/1/2023 of two academic medical centers of patients aged 18 and younger with catatonia. Patients were retrospectively assessed using the clinical global impressions-improvement (CGI-I) by two independent reviewers.</div></div><div><h3>Results</h3><div>One hundred sixty-five patients were hospitalized for catatonia, of whom 50.3 % had an NDD. Median age was 15. One hundred sixty-four patients were treated with a benzodiazepine, with a median maximum 24-hour dose of 6 mg lorazepam-equivalents, which did not differ for patients with and without NDDs. Electroconvulsive therapy (ECT) was utilized in 14.5 % of patients. Median length of medical hospitalization was 5 days and hospitalizations were longer in neurotypical patients than in patients with NDDs. In an ordinal regression model, the probability of observing at least “much improvement” (CGI < 3) was 88.3 % (95 % CI: 82.4 % to 92.3 %), with patients with a non-medical primary diagnosis and an NDD having a lower odds of response than non-medical primary diagnosis without an NDD.</div></div><div><h3>Conclusions</h3><div>The probability of patients achieving a CGI-I score indicating at least “much improvement” was 88.3 %. Administered benzodiazepine dose and ECT treatment were similar for all patients, but neurotypical patients had longer hospitalizations than those with NDDs and had a higher odds of a more favorable clinical response for patients with non-medical primary diagnoses. 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Hospitalizations for pediatric catatonia in neurodivergent and neurotypical patients
Introduction
Catatonia is a neuropsychiatric disorder that occurs in pediatric patients with a range of associated medical, psychiatric, and neurodevelopmental disorders (NDDs). This study describes hospital care of pediatric catatonia patients and compares treatments for neurotypical patients and those with NDDs.
Methods
Retrospective cohort study from 1/1/2018 to 6/1/2023 of two academic medical centers of patients aged 18 and younger with catatonia. Patients were retrospectively assessed using the clinical global impressions-improvement (CGI-I) by two independent reviewers.
Results
One hundred sixty-five patients were hospitalized for catatonia, of whom 50.3 % had an NDD. Median age was 15. One hundred sixty-four patients were treated with a benzodiazepine, with a median maximum 24-hour dose of 6 mg lorazepam-equivalents, which did not differ for patients with and without NDDs. Electroconvulsive therapy (ECT) was utilized in 14.5 % of patients. Median length of medical hospitalization was 5 days and hospitalizations were longer in neurotypical patients than in patients with NDDs. In an ordinal regression model, the probability of observing at least “much improvement” (CGI < 3) was 88.3 % (95 % CI: 82.4 % to 92.3 %), with patients with a non-medical primary diagnosis and an NDD having a lower odds of response than non-medical primary diagnosis without an NDD.
Conclusions
The probability of patients achieving a CGI-I score indicating at least “much improvement” was 88.3 %. Administered benzodiazepine dose and ECT treatment were similar for all patients, but neurotypical patients had longer hospitalizations than those with NDDs and had a higher odds of a more favorable clinical response for patients with non-medical primary diagnoses. Research under controlled conditions is needed to optimize and endure equitable catatonia treatment in youth.
期刊介绍:
General Hospital Psychiatry explores the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the journal provides a forum for professionals with clinical, academic, and research interests in psychiatry''s role in the mainstream of medicine.