Definition:
Organic catatonic disorder is a disorder of diminished (stupor) or increased (excitement) psychomotor activity associated with catatonic symptoms. Additionally; The extremes of psychomotor disturbance may alternate. [2]
Overview
Epidemiologyxxx
Causes
Risk Factorsxxx
Pathogenesisxxx
Pathophysiologyxxx
Typesxxx
Clinical Featuresxxx
Sign & Symptoms
Clinical Examinationxxx
Diagnosis
Differential Diagnosisxxx
Complicationsxxx
Investigationsxxx
Treatment
Preventionxxx
Homeopathic Treatmentxxx
Diet & Regimenxxx
Do’s and Dont’sxxx
Terminologyxxx
References
FAQ
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Overview
Overview of Organic Catatonic Disorders
According to the ICD-10 (F06.1) disorder of either diminished (stupor) or increased (excitement) psycho-motor activity associated with catatonic symptoms.
Generally; The extremes of psycho-motor disturbance may alternate. [2] In detail; The presence of other catatonic symptoms and signs increases the confidence in the diagnosis. [1]
Epidemiologyxxx
Indian epidemiology then other
Causes
Causes of Organic Catatonic Disorder
1. Neurological Disorders i.e.:
- Post-encephalitic parkinsonism
- Limbic encephalitis
- Surgical procedures on basal ganglia
- Neoplasms in diencephalon, frontal lobe and limbic system
- Subacute sclerosing pan encephalitis (in other words; SSPE)
- General paresis of incomprehensible(GPI)
- Petit Mal status
- Post-ictal phase of epilepsy
- Subdural haematoma
- Cerebral malaria
- Cortical venous thrombosis
2. Systemic and Metabolic Disorders i.e.:
- Diabetic ketoacidosis
- Acute intermittent porphyria
- Hyperparathyroidism causing hypercalcaemia
- Pellagra
- Hepatic encephalopathy
- Systemic lupus erythematosus
- Homocystinuria
- Membranous glomerulonephritis
3. Drugs and Poisoning i.e.:
- Organic alkaloids
- Antipsychotics
- ACTH (therapeutic doses)
- Aspirin
- Illuminating gas
- Ethyl alcohol (especially large doses)
- Levodopa
- Disulfiram
- CO poisoning
- Lithium toxicity
- Methylphenidate
- Phencyclidine (specifically large doses)
- Mescaline
4. Psychiatric Disorders i.e.:
- Catatonic schizophrenia
- Depressive stupor wild stupor
- Periodic catatonia
- Conversion also dissociative disorder
- Reactive psychosis
- During hypnosis. [1]
Risk Factorsxxx
Risk factors are things that make you more likely to develop a disease in the first place.
Pathogenesisxxx
Pathogenesis refers to the development of a disease. It’s the story of how a disease gets started and progresses.
This is the entire journey of a disease, encompassing the cause but going beyond it.
Pathophysiologyxxx
Pathophysiology, on the other hand, focuses on the functional changes that occur in the body due to the disease. It explains how the disease disrupts normal physiological processes and how this disruption leads to the signs and symptoms we see.
Imagine a car accident. Pathogenesis would be like understanding how the accident happened – what caused it, the sequence of events (e.g., one car ran a red light, then hit another car). Pathophysiology would be like understanding the damage caused by the accident – the bent fenders, deployed airbags, and any injuries to the passengers.
In simpler terms, pathogenesis is about the "why" of a disease, while pathophysiology is about the "how" of the disease’s effects.
Typesxxx
AAA
Clinical Featuresxxx
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Sign & Symptoms
Sign & Symptoms of Organic Catatonic Disorder
1. Mutism i.e.:
In brief; Complete absence of speech.
2. Rigidity i.e.:
Maintenance of a rigid posture against efforts to be moved.
3. Negativism i.e.:
An apparently motiveless resistance to all commands and attempts either to be moved, or doing just the opposite.
4. Posturing i.e.:
Voluntary assumption of an inappropriate also often bizarre posture for long periods of time.
5. Stupor i.e.:
Akinesis (no movement) with mutism but with evidence of relative preservation of conscious awareness.
6. Echolalia i.e.:
Repetition, echo or mimic king of either phrases or words heard.
7. Echopraxia i.e.:
Repetition, echo or mimic king of actions observed.
8. Waxy flexibility i.e.:
In detail; Parts of body can be placed in positions that will be maintained for long periods of time, even if very uncomfortable; flexible like wax.
9. Ambitendency i.e.:
Due to ambivalence, conflicting impulses and tentative actions are made, but no goal directed action occurs, e.g. on asking to take out tongue, tongue is slightly protruded but taken back again
10. Other signs i.e.:
Such as mannerisms, stereotypies (verbal also behavioural), automatic obedience (commands are followed automatically, irrespective of their nature) and verbigeration (incomprehensible speech). [1]
Clinical Examinationxxx
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Diagnosis
Diagnosis of Organic Catatonic Disorder
According to the ICD-10(F06.1), the following features are required for the diagnosis of organic catatonic disorder, additionally to the general guidelines for the diagnosis of other organic mental disorders, described earlier:
1. Stupor (diminution or complete absence of spontaneous movement with partial or complete mutism, negativism, also rigid posturing).
2. Excitement (gross hyper-motility either with or without a tendency to assaultiveness).
3. Mixed (shifting rapidly also unpredictably from hypo- to hyperactivity). [1]
Differential Diagnosisxxx
Complicationsxxx
Complications are what happen after you have a disease. They are the negative consequences of the disease process.
Investigationsxxx
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Treatment
Treatment of Organic Catatonic Disorder
1. Treatment of the underlying cause, if amenable to treatment.
2. Symptomatic treatment with low dose of a short acting benzodiazepine (e.g. Lorazepam), or electroconvulsive therapy (if needed).
Anti-psychotics should usually be avoided as they can make catatonic features worse; however small doses of atypical anti-psychotics such as Risperidone, Olanzapine, Aripiprazole or Quetiapine can be used with care. [1]
Preventionxxx
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Homeopathic Treatmentxxx
Diet & Regimenxxx
Do’s and Dont’sxxx
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Terminologyxxx
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References
- A Short Textbook of Psychiatry by Niraj Ahuja / Ch 3/ Ch 5/ Ch 19.
- http://apps.who.int/classifications/icd10/browse/2016/en#/F00-F09
FAQ
Frequently Asked Questions
What is Organic Catatonic Disorder?
It is a disorder of diminished (stupor) or increased (excitement) psychomotor activity associated with catatonic symptoms.
What causes Organic Catatonic Disorder?
- Neurological Disorders
- Systemic and Metabolic Disorders
- Drugs and Poisoning
- Psychiatric Disorders
What are the symptoms of Organic Catatonic Disorder?
- Mutism
- Rigidity
- Negativism
- Posturing
- Stupor
- Echolalia
- Echopraxia
- Waxy flexibility
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