Clinical and demographic profile of catatonic patients who received electroconvulsive therapy in a South African setting

Abstract

Background: Catatonia is a psychomotor dysregulation syndrome seen in several illnesses. Uncertainties exist regarding its prevalence and causes. While some research shows a strong association with mood disorders, other data show catatonia to be strongly associated with schizophrenia. Data from low- and middle-income countries are required.

Aim: To determine the clinical and demographic profile of patients with catatonia that received electroconvulsive therapy (ECT) between 01 January 2012 and 31 December 2014.

Setting: The study was conducted at Elizabeth Donkin Psychiatric Hospital in Port Elizabeth, Eastern Cape. The hospital has mostly patients admitted under the Mental Health Care Act 17 of 2002 as Involuntary Mental Health Care Users.

Method: A retrospective chart review was conducted. Using the hospital ECT database, all files of patients who received ECT for catatonia were identified. Demographics, psychiatric and medical diagnoses, signs of catatonia and other data were abstracted from these files.

Results: Forty-two patients received ECT for catatonia, of whom 34 (80.95%) were diagnosed with a psychotic illness. Schizophrenia was the most common diagnosis (n = 19; 45.24%), followed by psychotic disorder owing to a general medical condition (n = 8; 19.05). Human immunodeficiency deficiency virus was the cause in 75.00% of the patients whose medical conditions caused catatonia. Seven (16.67%) patients had mood disorders, with bipolar I disorder accounting for 6 (14.29%) of these.

Conclusion: Psychotic disorders were more frequent than mood disorders in the sample. Schizophrenia was the most common diagnosis, followed by psychotic disorder owing to a general medical condition.