{
  "abstract": "Background Catatonia is a severe neuropsychiatric disorder characterised by motor and behavioural abnormalities. Though classically associated with schizophrenia, catatonia can occur across a diverse range of psychiatric and general medical conditions. Given this potential historical misclassification, we aimed to explore ‘catatonic schizophrenia’ in a large, real-world dataset to better understand its comorbidities and clinical outcomes.Methods A retrospective analysis was conducted using the TriNetX network, comparing 6,338 individuals with catatonic schizophrenia to 485,443 with non-catatonic schizophrenia. Prevalence of comorbidity was compared directly between these groups, before propensity score matching was used to explore clinical outcomes and risk of mortality.Results Catatonic schizophrenia accounted for 2.6% of all schizophrenia cases. Individuals with catatonic schizophrenia exhibited significantly higher rates of medical and neuropsychiatric comorbidities compared to those with non-catatonic schizophrenia. Neurodevelopmental conditions were markedly enriched, including pervasive developmental disorders (6% vs 2%; p < 0.0001), intellectual disabilities (4% vs 2%; p < 0.0001), and congenital abnormalities (7% vs 2%; p < 0.0001). Neurological disorders, such as inflammatory diseases of the CNS (3% vs 0.3%) and epilepsy (7% vs 4%), were also overrepresented. Comorbidities spanned multiple organ systems, with higher rates of endocrine and metabolic conditions (46% vs 25%; p < 0.0001), circulatory diseases (40% vs 24%; p < 0.0001), and blood disorders (23% vs 10%; p < 0.0001). Notably, catatonic schizophrenia was associated with increased risks of neurodegenerative conditions compared to non-catatonic schizophrenia, including Parkinson’s disease (HR = 1.6, 95% CI 1.2–2.1) and Alzheimer’s disease (HR = 1.6, 95% CI 1.1–2.3), even after adjusting for confounders. Mortality was significantly higher in the catatonic cohort (HR = 1.2, 95% CI 1.1–1.4).Conclusion These findings highlight the substantial medical and neuropsychiatric burden of catatonia. The transdiagnostic nature of these comorbidities supports catatonia’s existence as a distinct clinical entity. Further research is needed to elucidate mechanisms and improve outcomes for this complex and under-recognised phenotype.",
  "authors": [
    {
      "affiliations": [
        "Institute of Psychiatry, Psychology and Neuroscience, King’s College, London"
      ],
      "name": "Cameron J Watson"
    },
    {
      "affiliations": [
        "Institute of Psychiatry, Psychology and Neuroscience, King’s College, London"
      ],
      "name": "Danish Hafeez"
    },
    {
      "affiliations": [
        "Institute of Psychiatry, Psychology and Neuroscience, King’s College, London"
      ],
      "name": "Katharine Lynch-Kelly"
    },
    {
      "affiliations": [
        "Institute of Psychiatry, Psychology and Neuroscience, King’s College, London"
      ],
      "name": "Jonathan P Rogers"
    },
    {
      "affiliations": [
        "Institute of Psychiatry, Psychology and Neuroscience, King’s College, London"
      ],
      "name": "Mark Edwards"
    },
    {
      "affiliations": [
        "Institute of Psychiatry, Psychology and Neuroscience, King’s College, London"
      ],
      "name": "Thomas A Pollak"
    }
  ],
  "title": "#8191 Revisiting catatonic schizophrenia: insights from large-scale electronic health records",
  "uid": "53e73420-f9a4-5046-ab02-95cd1c9292b7"
}