Abstract
Introduction Electroconvulsive therapy (ECT) is known to be effective in
the treatment of catatonia, reaching response rates of about 80 to 100%.
It is indicated in cases of treatment resistance to benzodiazepines and in
life-threatening conditions such as malignant catatonia. Beneficial effects on
specific symptoms or predictors of response are less clear. The objective of
this retrospective study is to examine the ECT effect on specific catatonia
symptoms in the acute phase of the illness and to identify predictors of
response.
Methods A retrospective study examined data from 20 patients with
catatonia, 18 associated with schizophrenia and 2 with bipolar disorder, who
underwent ECT from 2008 to 2021. Ten subjects had more than one ECT-series,
resulting in a total of 31 ECT-series. Catatonia symptom severity was assessed
with the Bush Francis Catatonia Rating Scale (BFCRS).
Results ECT yielded excellent response. Nineteen of 20 patients and 30 of
31 ECT-series achieved response. The mean number of ECT sessions to response was
4.2. Response to ECT was more pronounced for motor inhibition symptoms such as
stupor and mutism, while echophenomena, dyskinesia, stereotypy and perseveration
responded less well. A predictor of late response was the presence of grasp
reflex.
Discussion The present study corroborates the high and rapid effectiveness
of ECT in the treatment of catatonia. Focus on single catatonia signs may help
to identify those who are most likely to achieve remission quickly, as well as
those who might need longer ECT-series.
Key words
catatonia - electroconvulsive therapy - bush francis catatonia rating scale - grasp reflex
