The Differential Diagnosis and Treatment of Catatonia in Children and Adolescents

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Abstract

Learning objectives

After participating in this activity, learners should be better able to:

Learning objectives

• Assess the etiologies associated with catatonia in children and adolescents

Learning objectives

• Evaluate the differential diagnosis of pediatric catatonia

Learning objectives

• Interpret the literature regarding the treatment of children and adolescents with catatonia

Objective

Pediatric catatonia is associated with many medical and psychiatric conditions. Mortality is high, and proper treatment can be lifesaving. Catatonia is increasingly recognized in pediatric populations, in which about 20% of cases are related to underlying medical conditions. To minimize morbidity, clinicians must rule out underlying disorders while simultaneously managing symptoms and causes. In our review we discuss (1) recommendations to aid rapid decision making, both diagnostic and therapeutic, (2) emergent conditions and management, (3) disorders associated with pediatric catatonia, including developmental, acquired, idiopathic, and iatrogenic etiologies, (4) available treatments, and (5) medicolegal considerations.

Methods

Initial PubMed search without date constraints using MeSH terms related to pediatric catatonia, with subsequent searches on pertinent subtopics using PubMed and Google Scholar.

Results

Pediatric catatonia is a dangerous but treatable neuropsychiatric condition. Psychiatrists need to be aware of differential diagnoses and to be able determine appropriate treatment within a short time frame. With prompt diagnosis and treatment, outcomes can be optimized.

Conclusion

Pediatric catatonia is underdiagnosed and requires rapid evaluation and management.

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