TYPE Editorial PUBLISHED 12 December 2022 DOI 10.3389/fpsyt.2022.1048715 Editorial: Catatonia across the OPEN ACCESS lifespan EDITED AND REVIEWED BY Gisela Sugranyes, Hospital Clinic of Barcelona, Spain Jorge Cuevas-Esteban1,2,3,4*, Jordi Serra-Mestres5 , *CORRESPONDENCE Sandeep Grover6 and Walter Jaimes-Albornoz7 Jorge Cuevas-Esteban jcuevasesteban@gmail.com 1 Hospital Germans Trias i Pujol, Badalona, Spain, 2 Germans Trias i Pujol Health Science Research Institute (IGTP), Barcelona, Spain, 3 Universitat Autònoma de Barcelona, Barcelona, Spain, 4 Centro de SPECIALTY SECTION Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain, 5 Cardinal Clinic, This article was submitted to Windsor, United Kingdom, 6 Post Graduate Institute of Medical Education and Research (PGIMER), Adolescent and Young Adult Chandigarh, India, 7 Donostia University Hospital, San Sebastian, Spain Psychiatry, a section of the journal Frontiers in Psychiatry KEYWORDS RECEIVED 19 September 2022 ACCEPTED 17 November 2022 catatonia, cognition, neuropsychiatry, transcranial electric stimulation, elderly, child- PUBLISHED 12 December 2022 age CITATION Cuevas-Esteban J, Serra-Mestres J, Grover S and Jaimes-Albornoz W (2022) Editorial: Catatonia across the lifespan. Front. Psychiatry 13:1048715. Editorial on the Research Topic doi: 10.3389/fpsyt.2022.1048715 Catatonia across the lifespan COPYRIGHT © 2022 Cuevas-Esteban, Serra-Mestres, Grover and Jaimes-Albornoz. This is an A neuropsychiatric syndrome called Catatonia comprises motor, emotional, open-access article distributed under the terms of the Creative Commons behavioral, and autonomic abnormalities. It is hence a psychomotor syndrome as it Attribution License (CC BY). The use, does not only affect motility. Therefore, it can be distinguished from other pure motor distribution or reproduction in other disorders such as extrapyramidal syndromes (1). Since the initial description of catatonia forums is permitted, provided the original author(s) and the copyright by Kahlbaum in 1874, it has also been connected to affective and medical conditions (2). owner(s) are credited and that the The DSM-5 enhances diagnostic standards and the capacity to identify catatonia in the original publication in this journal is cited, in accordance with accepted setting of any mental or medical condition (3). academic practice. No use, distribution Despite having a prominent clinical presentation and being a prevalent or reproduction is permitted which condition, catatonia is, nevertheless, underdiagnosed and undertreated. does not comply with these terms. Its mean prevalence, regardless of the underlying condition, was 9.2% (4). Medical conditions have a higher prevalence rate (20.6%), followed by bipolar disorder (20.2%), postpartum psychosis (20%), autism (11.1%), schizophrenia (9.8%), and mixed psychiatric conditions (5.5%) (4). Catatonia can occur at any stage in life linked to a wide range of physical and mental health conditions, having specific characteristics in children and in older adults (5). Between 0.6 and 1.7% of children and adolescents who are hospitalized for mental health pathologies have diagnosis of catatonia (6). It can occur in up to 37% of persons with NMDA receptor antibody encephalitis (7) and in 17% of patients with autistic spectrum disorders (8). Depending on the diagnostic criteria used, the frequency of catatonia in hospitalized psychiatric patients over the age of 65 ranges from 39.6 to 17.9% (9). In aged individuals, co-morbidity and neurodegeneration increase the likelihood of catatonic symptoms. Frontiers in Psychiatry 01 frontiersin.org Cuevas-Esteban et al. 10.3389/fpsyt.2022.1048715 All this raises unresolved questions such as differences in the entities at the same time due to the DSM-5 diagnostic criteria. clinical presentation of catatonia, its symptomatic treatment, or Finally, they discuss the therapeutic problems arising when there the choice of the most appropriate screening instruments. are doubts in the diagnosis. The Research Topic “Catatonia across the lifespan” aims to Dawkins et al. investigated the psychopathological and compile contributions reflecting new insights emerging from phenomenological aspects of catatonia in a retrospective catatonia research across different age groups and populations. descriptive cross-sectional study, using information from a large This Research Topic comprises 7 contributions; 4 original dataset obtained from electronic healthcare records. Cluster research articles, 1 systematic review, and 2 opinion articles. The analysis confirmed positive and negative symptom clusters, manuscripts on this topic range from epidemiological, clinical, whilst component analysis revealed parakinetic, hypokinetic, cognitive, to diagnostic and therapeutic aspects of catatonia in and withdrawal components, all associated with diagnostic and the different phases of life. prognostic variables. Fear was reported by a large minority of The correct diagnosis of catatonia remains a challenge for patients although narrative explanations were more common the clinician. Von Kanel et al. look into the connection between and varied. actigraphy-derived movement characteristics and symptoms of Haroche et al., reported on 8 patients with catatonia catatonia clinically evaluated. Contrary to clinical assessments, treated with transcranial direct current stimulation instrumental measurements lack observer bias, demand little (tDCS) targeting the left dorsolateral prefrontal cortex and training, and provide continual long-term assessments. The temporoparietal junction, and who experienced significant authors demonstrate how actigraphy can be used to measure symptomatic improvement. They also undertook a literature particular catatonic symptoms including immobility/stupor and review on the topic, ascertaining 5 further cases treated gazing. This might make it easier to detect catatonia, stage with tDCS who had improved. The authors suggested it, and monitoring catatonia in a therapeutic context. In that their results indicate that tDCS, in addition to another interesting paper in this Research Topic, Luccarelli pharmacotherapy, seems to effectively reduce catatonic et al., report the incidence of diagnosis, demographics, symptoms, and conclude that the specific efficacy of tDCS comorbidities, and inpatient procedures used in pediatric in catatonia remains to be demonstrated in randomized catatonic patients in general hospitals. The data extracted controlled trials. from their 900 patients generally agrees with the results of previous studies with much smaller populations. In this age group, catatonia is rarely diagnosed, it is more Author contributions common in males and it is associated with significant and severe psychiatric and medical comorbidities. This severity All authors listed have made a substantial, direct, increases significantly the cost of diagnosis and treatment, and intellectual contribution to the work and approved it and this makes catatonia the most expensive pediatric mental for publication. health condition. Serrat et al. undertook a systematic review of cognitive Conflict of interest impairment in catatonic patients, analyzing evidence from 14 studies. The authors conclude that the most assessed cognitive The authors declare that the research was conducted in the domains on catatonia research are: attention, visuospatial absence of any commercial or financial relationships that could and executive functions. These results, provide evidence be construed as a potential conflict of interest. supporting the frontal lobe syndrome theory proposed by Taylor (10). Two opinion papers focus on challenges in the differential Publisher’s note diagnosis: catatonia and dystonia, and catatonia and delirium. Ishizuka et al. propose focusing on molecular neurogenetic All claims expressed in this article are solely those of the commonalities between catatonia and dystonia as a model to authors and do not necessarily represent those of their affiliated investigate the high co-morbidity of catatonia in patients with organizations, or those of the publisher, the editors and the neurogenetic disorders. Tachibana et al. explain the difficulty reviewers. Any product that may be evaluated in this article, or of distinguishing delirium and catatonia, given their frequent claim that may be made by its manufacturer, is not guaranteed overlap. They point out the impossibility of diagnosing both or endorsed by the publisher. Frontiers in Psychiatry 02 frontiersin.org Cuevas-Esteban et al. 10.3389/fpsyt.2022.1048715 References 1. Peralta V, Cuesta MJ. Motor abnormalities: from neurodevelopmental to 6. Hauptman AJ, Benjamin S. The differential diagnosis and treatment of neurodegenerative through “Functional” (Neuro)psychiatric disorders. Schizophr catatonia in children and adolescents. Harv Rev Psychiatry. (2016) 24:379– Bull. (2017) 43:956–71. doi: 10.1093/schbul/sbx089 95. doi: 10.1097/HRP.0000000000000114 2. Kahlbaum, K. (1874). Die Katatonie oder das Spannungsirresein. Eine klinische 7. Serra-Mestres J, Villagrasa-Blasco B, Thacker V, Jaimes-Albornoz W, Sharma Form psychischer Krankheit. Vol Erstdruck Berlin: A. Hirschwald. P, Isetta M. Catatonia in N-methyl-d-aspartate receptor antibody encephalitis: phenomenological characteristics from a systematic review of case reports. Gen 3. Tandon R, Heckers S, Bustillo J, Barch DM, Gaebel W, Gur RE, et al. Catatonia Hosp Psychiatry. (2020) 64:9–16. doi: 10.1016/j.genhosppsych.2020.01.002 in DSM-5. Schizophr Res. (2013) 150:26–30. doi: 10.1016/j.schres.2013.04.034 8. Ghaziuddin N, Andersen L, Ghaziuddin M. Catatonia in patients with 4. Solmi M, Pigato GG, Roiter B, Guaglianone A, Martini L, autism spectrum disorder. Child Adolesc Psychiatr Clin N Am. (2020) 29:443– Fornaro M, et al. Prevalence of catatonia and its moderators in 54. doi: 10.1016/j.chc.2020.03.001 clinical samples: results from a meta-analysis and meta-regression analysis. Schizophr Bull. (2018) 44:1133–50. doi: 10.1093/schbul/sb 9. Serra-Mestres J, Jaimes-Albornoz W. Recognizing catatonia in x157 medically hospitalized older adults: Why it matters. Geriatrics. (2018) 3:37. doi: 10.3390/geriatrics3030037 5. Cuevas-Esteban J, Sanagustin D, Iglesias-González M. Catatonia: Back to the future of the neuropsychiatric syndrome. Med Clin. (2022) 158:369– 10. Taylor MA. Catatonia: a review of a behavioral neurologic syndrome. 77. doi: 10.1016/j.medcle.2022.03.005 Neuropsychiatry Neuropsychol Behav Neurol. (1990) 3:48–72. Frontiers in Psychiatry 03 frontiersin.org