Section - Video Lectures

05. Medical Complications and Prognostic Considerations in Catatonia

Published on July 1, 2025 Certification expiration date: July 1, 2028

Scott R. Beach, M.D.

Associate Professor of Psychiatry - Harvard Medical School - Massachusetts General Hospital

Key Points

Catatonia increases risk of medical complications, especially DVT and PE. Consider compression stockings, IV fluids, and possible anticoagulation while weighing bleeding risks.
Patients with catatonia have higher rates of respiratory complications like pneumonia. Consider chest physiotherapy, nebulization, regular oral care, and minimizing aspiration risk.
Most catatonic patients recover with treatment within days to weeks. Malignant catatonia typically requires more aggressive intervention.

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Slides and Transcript

Slide 1 of 14

Next, we’re going to talk about medical complications and prognostic considerations in catatonia. One of the most important things for us to be aware of as psychiatrists caring for patients with catatonia is that catatonia places patients at risk for a variety of medical complications and significantly increases rates of morbidity and mortality.

Medical Complications and Prognostic Considerations in Catatonia Slide 1 of 14

Slide 2 of 14

As psychiatrists, we need to think about ways to minimize these events for our patients who are catatonic. Some residents that I work with have been doing a systematic review of case report literature looking at medical complications of catatonia, and what they found is that while catatonia can be associated with a variety of medical complications, rates of things like respiratory disease as well as clotting disorders are particularly high in patients with catatonia.

References:

Rogers, J. P., Oldham, M. A., Fricchione, G., Northoff, G., Ellen Wilson, J., Mann, S. C., Francis, A., Wieck, A., Elizabeth Wachtel, L., Lewis, G., Grover, S., Hirjak, D., Ahuja, N., Zandi, M. S., Young, A. H., Fone, K., Andrews, S., Kessler, D., Saifee, T., Gee, S., … David, A. S. (2023). Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology, 37(4), 327–369. https://doi.org/10.1177/02698811231158232
Clinebell, K., Azzam, P. N., Gopalan, P., & Haskett, R. (2014). Guidelines for preventing common medical complications of catatonia: Case report and literature review. The Journal of Clinical Psychiatry, 75(6), 644–651. https://doi.org/10.4088/JCP.13r08870

Medical Complications and Prognostic Considerations in Catatonia Slide 2 of 14

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06. Catatonia Pharmacotherapy: The Role of Benzodiazepines

Learning Objectives:

After completing this activity, the learner will be able to:

Recognize the clinical features of catatonia using validated assessment tools.
Implement evidence-based pharmacologic interventions for catatonia.
Identify and manage medical complications associated with catatonia.

Original Release Date: July 1, 2025
Expiration Date: July 1, 2028

Expert: Scott Beach, M.D.
Medical Editor: Flavio Guzmán, M.D.

Relevant Financial Disclosures:
None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

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Participants must complete the activity online during the valid credit period that is noted above.

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Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement
Medical Academy designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Artificial Intelligence (AI) Use DisclosureArtificial intelligence (AI) tools may have been used in limited stages of developing this activity (e.g., drafting or language refinement). The specific tool, version, and date of use are documented internally.AI does not determine clinical recommendations. All content is reviewed, verified, and approved by the listed faculty and medical editors, and reflects independent human clinical judgment consistent with ACCME Standards for Integrity and Independence in Accredited Continuing Education.