Assessment and differential #
Describe observed signs, onset, fluctuation and baseline function; obtain collateral history. Assess consciousness, vital signs, hydration and medication/substance exposure.
Consider delirium, seizures, neurological/medical illness, mood or psychotic disorders and medication effects. Investigations follow the presentation; a first or unexplained episode may require neurological evaluation.
Treatment and physical care #
Benzodiazepines and ECT are major treatment options under specialist assessment. A supervised challenge may support the formulation, but response alone is not diagnostic.
Treat the underlying condition and prevent complications: review nutrition, fluid balance, pressure injury, thromboembolism, aspiration and infection. Coordinate nursing, medical and psychiatric care.
Reassessment and continuity #
Record change in signs, intake, mobility and physical findings across reviews. Escalate deterioration or inadequate response; avoid assuming immobility represents voluntary noncooperation.
Plan continuation and any medication reduction with recurrence monitoring. Communicate examination findings and outstanding investigations during transfers.
References · 2
- BAP evidence-based consensus guideline on catatonia, 2023 · United Kingdom; professional consensus · Supports: Clinical essentials, Assessment and differential, Treatment and physical care
- NHS Lothian catatonia guideline · Scotland; local service guideline · Supports: Treatment and physical care, Reassessment and continuity