Catatonia in the peripartum: A cohort study using electronic health records

Schizophr Res. 2024 Jan:263:252-256. doi: 10.1016/j.schres.2023.02.022. Epub 2023 Mar 3.

Abstract

Background: Due to limited existing literature available on the presentation and treatment of catatonia in the peripartum, this retrospective descriptive cohort study aimed to examine demographic data, catatonic features, diagnoses pre- and post-catatonic episodes, treatment and the presence of obstetric complications.

Methods: Individuals with catatonia were identified in a previous study using anonymised electronic healthcare records from a large mental health trust in South-East London. The presence of features from the Bush-Francis Catatonia Screening Instrument was coded by the investigators and longitudinal data were extracted from structured fields and free text.

Results: 21 individuals were identified from the larger cohort, each of whom experienced one episode of catatonia in the postpartum period, and all had had an inpatient psychiatric admission. 13 patients (62 %) presented after their first pregnancy and 12 (57 %) experienced obstetric complications. 11 (53 %) attempted breastfeeding and 10 (48 %) received a diagnosis of a depressive disorder following the episode of catatonia. The majority presented with immobility or stupor, mutism, staring and withdrawal. All were treated with antipsychotics and 19 (90 %) received benzodiazepines.

Conclusions: This study suggests that signs and symptoms of catatonia during the peripartum are similar to other catatonic presentations. However, the postpartum may be a period of high risk for catatonia and obstetric factors, such as birth complications, may be relevant.

Keywords: Catatonia; Electroconvulsive therapy; Perinatal; Peripartum; Postnatal; Postpartum.

MeSH terms

  • Catatonia* / diagnosis
  • Catatonia* / epidemiology
  • Catatonia* / etiology
  • Cohort Studies
  • Electronic Health Records
  • Female
  • Humans
  • Peripartum Period
  • Retrospective Studies