PsychEd Episode 67: Catatonia with Dr. Patricia Rosebush

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.

This episode covers catatonia with Dr. Patricia Rosebush. Dr. Rosebush is a Professor in the Department of Psychiatry & Behavioural Neurosciences at McMaster University. She is the distinguished author of numerous articles on clinical neuroscience, including considerable work on mitochondrial disorders in mental illness and over 30 papers on catatonia, and practices consultation-liaison psychiatry at St. Joseph’s Healthcare Hamilton.

The learning objectives for this episode are as follows:

By the end of this episode, the listener will be able to…

1. Develop a conceptual understanding of catatonia
2. Have an approach for diagnosing catatonia
3. Have an approach for treating catatonia

Guest: Dr. Patricia Rosebush

Hosts: Dr. Alastair Morrison (PGY1), Dr. Angad Singh (PGY1)

Audio editing: Dr. Angad Singh

Show notes: Dr. Alastair Morrison

Interview content:

(01:20) Clinical features of catatonia (high level overview)

(04:15) Clinical anecdote - an index case of catatonia

(06:00) History of approaches to catatonia

(10:00) Approach to different catatonia phenotypes

(15:00) Categorization and ideas of mechanism

(18:00) Assessing clinical signs of catatonia 

(24:00) Preserved awareness in catatonia

(27:00) Investigations and differential diagnosis

(30:00) First interventions: benzodiazepines and benzodiazepine withdrawal

(41:30) Managing medical considerations in catatonia

(45:00) Treating other psychiatric illnesses in the catatonic patient

(49:00) Acute, chronic, and refractory treatments

References:

• Barnes MP, Saunders M, Walls TJ, Saunders I, Kirk CA. The syndrome of Karl Ludwig Kahlbaum. J Neurol Neurosurg Psychiatry. 1986 Sep;49(9):991-6. https://doi.org/10.1136/jnnp.49.9.991
• Bush G, Fink M, Petrides G, Dowling F, Francis A. Catatonia. I. Rating scale and standardized examination. Acta Psychiatr Scand. 1996 Feb;93(2):129-36. https://doi.org/10.1111/j.1600-0447.1996.tb09814.x
• PsychDB. (2023, November 23). Catatonia. https://www.psychdb.com/cl/0-catatonia
• Rosebush PI, Mazurek MF. Catatonia and its treatment. Schizophr Bull. 2010 Mar;36(2):239-42. https://doi.org/10.1093/schbul/sbp141

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