CATATONIA IN DEPRESSION - PREVALENCE, CLINICAL CORRELATES, AND VALIDATION OF A SCALE

Objectives-To examine the clinical correlates of catatonia in depressi on, to validate a scale for catatonia, and to assess the validity of t he DSM-IV criteria of the catatonic features specifier for mood disord ers. Methods-A series of 79 consecutive patients with depression and 4 1 patients with Parkinson's disease without depression were examined u sing the modified Rogers scale (MRS), the unified Parkinson's disease rating scale (UPDRS), and the structured clinical interview for DSM-II I-R (SCID). Results-Sixteen of the 79 depressed patients (20%) had cat atonia. Depressed patients with catatonia had significantly higher sco res on the MRS than non-catatonic depressed patients matched for sever ity of depression, or non-depressed patients with Parkinson's disease matched for severity of motor impairment. Depressed patients with cata tonia were older, had a significantly higher frequency of major depres sion, more severe cognitive impairments, and more severe deficits in a ctivities of daily living than depressed non-catatonic patients. The D SM-IV criteria of catatonia separated depressed catatonic patients pat ients with Parkinson's matched for motor impairment, with a specificit y of 100%. Catatonic signs did not improve after apomorphine. Conclusi ons-catatonia is most prevalent among elderly patients with severe dep ression. The study showed the validity of the MRS for the diagnosis of catatonia in depressed patients, as well as the specificity ficity of the DSM-IV criteria of the catatonic features specifier.