CATATONIC SCHIZOPHRENIA: SOCIODEMOGRAPHIC, CLINICAL CHARACTERISTICS, AND PREDISPOSING FACTORS FOR THE FIRST EPISODE

Objectives. The concept of catatonia has changed in the late 20th century, although catatonic
schizophrenia (CS) has received less attention in recent decades. The aim of this study was to evaluate the
clinical characteristics, course and predisposing factors in the acute phase of CS.
Materials and Methods. This retrospective cross-sectional study was conducted at the Riga Psychiatry
and Narcology Center in 2021. The study included inpatients with a primary diagnosis of CS, aged 18 to
65 years. The first and last medical records of hospitalization were analysed in a time frame of 2012–2021.
Results. A total of 24 medical records were examined, (67% of men, 33% of women). The majority
of patients had the onset of the disease in the age group of 26–35 years (29%). Prodromal symptoms were
observed in 32% of patients, the most common symptom was social isolation (100%). The stupor and
numbness were observed in 79,2% of conditions at the first exacerbation of the CS, while motor agitation
(70,6%) dominated during the last hospitalisations (p = 0.002). In 58.3% of patients, a use of dopamine
blockers was detected, in 50% – long-term use of anticholinergic drugs with recent withdrawal or dose
reduction, in 37.5% – an increased level of psycho-emotional stress and in 33.3% adverse heredity as a risk
factor for the development of CS.
Conclusions. The clinical profile of the first onset inpatient with CS were a man aged 26-35 years, with
catatonic stupor, but the symptoms of catatonic agitation prevail in the dynamics of the disease. CS showed
associations with use of dopamine blockers, long-term use of anticholinergic drugs with recent withdrawal
or dose reduction, adverse heredity, and increased levels of psycho-emotional stress during the life. It is
important to emphasize the role of preventive measures that could improve the early detection and planning
the care strategies of patients with CS.