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A dramatic case of a woman discovered after 7 months of untreated catatonia

Published online by Cambridge University Press:  07 December 2016

M. Ratzlaff*
Affiliation:
Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
M. Harrington
Affiliation:
Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
*
*Address for correspondence: M. Ratzlaff, MB, BCh, BAO, Department of Psychiatry, University of Manitoba, 771 Bannatyne Ave, Winnipeg, Manitoba, Canada R3E 3N4. (Email: matt_ratzlaff@hotmail.com)

Abstract

Described is an unusually severe case of catatonia in the context of a major depressive episode. The patient is a 49-year-old Caucasian female who was living with her husband in an urban apartment. In March 2015, she experienced a major depressive episode in the context of financial hardship after being dismissed from her job. She became catatonic and did not leave her apartment for 7 months. For the first 4 months she lay in bed, then after losing bowel and bladder continence, she was transferred by her husband to the bedroom floor where she lay prone for another 3 months before paramedics were notified. She subsequently underwent a 4-month admission to an intensive care unit, surgical ward, and psychiatric ward. This case shows the extreme extent of psychiatric and physical sequelae that can result from prolonged delay of treatment of severe catatonia in the context of depression.

Type
Case Report
Copyright
© College of Psychiatrists of Ireland 2016 

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References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Publishing: Arlington pp. 119–120.Google Scholar
Bauer, M, Pfennig, A, Severus, E, Whybrow, PC, Angst, J, Möller, HJ, and the Task Force on Unipolar Depressive Disorders (2013). World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, Part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World Federation of Societies of Biological Psychiatry. (http://www.wfsbp.org/fileadmin/user_upload/Treatment_Guidelines/WFSBP_TG_Unipolar_depressive_disorders_Bauer_et_al_2013.pdf). Accessed 20 October 2016.Google Scholar
Bush, G, Fink, M, Petrides, G, Dowling, F, Francis, A (1996). Catatonia I: rating scale and standardized examination. Acta Psychiatrica Scandinavica 93, 129136.Google Scholar
Coffey, MJ (2015). Catatonia: treatment and prognosis. UpToDate, updated 22 December (http://www.uptodate.com.uml.idm.oclc.org/contents/catatonia-treatment-and-prognosis?source=search_result&search=catatonia&selectedTitle=1~56). Accessed 15 May 2016.Google Scholar
Dare, FY, Rasmussen, KG (2015). Court-approved electroconvulsive therapy in patients unable to provide their own consent: a case series. Journal of ECT 31, 147149.CrossRefGoogle ScholarPubMed
Dyer, CB, Pavlik, VN, Murphy, KP, Hyman, DJ (2000). The high prevalence of depression and dementia in elder abuse or neglect. Journal of the American Geriatric Society 48, 205208.Google Scholar
Enns, MW, Reiss, JP, Chan, P (2010). Electroconvulsive therapy. Canadian Psychiatric Association (http://www.cpa-apc.org/wp-content/uploads/ECT-CPA_position_paper_27-revision_1-web-EN.pdf). Accessed 20 October 2016.Google Scholar
Gelenberg, AJ, Freeman, MP, Markowitz, JC, Rosenbaum, JF, Thase, ME, Triveda, MH, Van Roads, RS, Reus, VI, Depaulo, JR, Fawcett, JA, Schneck, CD (2010). Practice Guidelines for the Treatment of Patients With Major Depressive Disorder, 3rd edn. American Psychiatric Association. (http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf). Accessed 20 October 2016.Google Scholar
Kennedy, SH, Lam, RW, McIntyre, RS, Tourjman, SV, Bhat, V, Blier, P, Hashain, M, Jollant, F, Levitt, AJ, MacQueen, GM, McInerney, SJ, McIntosh, D, Milev, RV, Müller, DJ, Parikh, SV, Pearson, NL, Ravindran, AV, Uher, R, and the CANMAT Depression Work Group (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 3. Pharmacological treatments. The Canadian Journal of Psychiatry 61, 540560.Google Scholar
Mankad, M (2015). Informed consent for electroconvulsive therapy – finding balance. Journal of ECT 31, 143146.Google Scholar
Moksnes, KM (2013). Electroconvulsive therapy without consent. Journal of the Norwegian Medical Association 133, 20472050.Google Scholar
National Institute for Health and Care Excellence (2009). Depression in adults: recognition and management (https://www.nice.org.uk/guidance/cg90). Accessed 20 October 2016.Google Scholar
Sienaert, P, Dhossche, DM, Vancampfort, D, De Hert, M, Gazdag, G (2014). A clinical review of the treatment of catatonia. Frontiers in Psychiatry 5, 19.CrossRefGoogle ScholarPubMed
Tang, VM, Duffin, J (2014). Catatonia in the history of psychiatry: construction and deconstruction of a disease concept. Perspectives in Biology and Medicine 57, 524537.Google Scholar
Wilcox, JA, Duffy, PR (2014). The syndrome of catatonia. Behavioral Sciences 5, 576588.Google Scholar