The Probability That Catatonia in the Hospital has a Medical Cause and the Relative Proportions of Its Causes: A Systematic Review

Objective: The objective of this review is to determine the probability that catatonia in the hospital has a secondary cause (medical catatonia) and to calculate the relative proportions of these causes stratified by hospital setting. Methods: PRISMA systematic review of PubMed. Results: Eleven studies were included. Hospital-wide, 20% of catatonia was medical. In acute medical and surgical settings, medical catatonia comprised more than half of cases. At least 80% of older adults seen by consult psychiatry and critically ill patients had a medical cause. Two thirds of medical catatonia involved CNS-specific disease including encephalitis, neural injury, developmental disorders, structural brain pathology, or seizures. Conclusions: Patients in acute medical and surgical settings with catatonia deserve a medical workup that prioritizes CNS etiologies.