ECT IN THE TREATMENT OF THE CATATONIC SYNDROME

Objective: To determine the efficacy of ECT in the treatment of the ca tatonic syndrome and to identify predictors of good response. Method: 28 cases of catatonia in 22 patients admitted to a psychiatry or medic afpsychiatry inpatient unit between January 1989 and June 1992 were re trospectively evaluated. Cases were included if they met criteria for catatonia as described by Kahlbaum, i.e., 4 or more signs including im mobility, mutism, withdrawal, staring, rigidity, posturing/gimacing, n egativism, waxy flexibility, echo phenomena; stereotypy, and verbigera tion. Primary diagnoses were: Major Depressive Disorder (8), Bipolar A ffective Disorder (5), schizophrenia (5), schizoaffective disorder (2) and organic mental disorder (2). Mean age was 54.5 years; sex ratio w as 15 females to 7 males. Patients received a mean of 12.0 treatments with mean seizure duration 50.9 s (by EEG) per treatment. Results: By Kahlbaum criteria, resolution of the catatonic syndrome occurred in 26 out of 28 cases (93%). The mean number of signs present per patient p rior to ECT was 5.6 verses 0.93 following ECT (p=0.00001). Overall, EC T brought about resolution of 83.5% of all symptoms with 98% resolutio n of primary symptoms and 74% resolution of secondary symptoms. Conclu sions: ECT is an effective treatment of the catatonic syndrome. ECT is effective in the resolution of both cardinal (primary) and secondary signs of catatonia. In this study, there is not a statistically signif icant difference in the effectiveness of the resolution of catatonic s ymptoms in persons with affective disorder verses schizophrenia.