Much-needed national guidelines for Catatonia developed with UCL academics

13 April 2023

UCL academics have played a key role in producing the first ever UK national guidelines for catatonia, a condition that affects a person’s movement, speech, behaviour and emotions.

Doctor Reading a Medical Chart. Photo by RODNAE Productions

The guidelines, produced for the British Association for Psychopharmacology, were drawn up by many of the world’s top experts on Catatonia. They include Dr Jonathan Rogers and Professor Glyn Lewis of the Division of Psychiatry and Professor Anthony David of the Institute of Mental Health, as well as Dr Michael Zandi from the Queen Square Institute of Neurology.

People with catatonia might be stuck in one position or unable to speak. It can occur in some mental disorders, such as major depression, bipolar affective disorder and schizophrenia, but it may also occur in some medical conditions, such as brain inflammation or infections.

Although a person with catatonia may not be able to respond, they are often aware of their surroundings and what is being said, so the way in which you communicate with them is very important.

For much of the 20th Century, catatonia was considered a subtype of schizophrenia, but, in recent decades, emerging evidence has shown that catatonia can occur in a range of psychiatric, neurological, and general medical conditions. Yet, despite this increased understanding of the condition, researchers have noted that awareness is still relatively poor, and knowledge about the condition and its distinctive treatments is frequently limited among clinicians.

The authors hope that these guidelines will help clinicians with diagnoses and treatment decisions and provide a lay summary for patients and carers.

Among the recommendations in the guidelines, is that clinicians assessing a person with catatonia, should ask the person - and their carers - questions about what has been happening. They should also physically examine the person, which might involve trying to move their arms or listening to their chest. Depending on what they find, it might be appropriate to request tests such as a blood test or brain scan.

One of the most important treatments for catatonia are a group of medications called benzodiazepines. Although they are usually thought of as sedative drugs, many studies in catatonia have found that they can have the opposite effect and seemingly wake people up.

Dr Jonathan Rogers, of UCL’s Division of Psychiatry, said: “These guidelines are a collaboration between many of the world’s most distinguished catatonia experts and represent a significant step forward in recognising this important and severe neuropsychiatric disorder.

“However, there is still a lot that we do not know about catatonia. Much of what we recommend is based on years of clinical experience, rather than rigorous research studies, so there is a need to research catatonia a lot more.”