The following is a summary of the “Catatonia in adult anti-NMDAR encephalitis: an observational cohort study,” published in the February 2023 issue of Psychiatry by Wu, et al.
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is connected to catatonia and is one of the most common types of autoimmune encephalitis. With this research, the authors hoped to learn more about the symptoms and prognosis of adults with catatonic anti-NMDAR encephalitis. The study included adult patients diagnosed with anti-NMDAR encephalitis between January 2013 and October 2021. Patients were classified as having catatonia (as determined by the Bush Francis Catatonia screening instrument) or not having catatonia (who were treated as 2 separate groups). Patients were evaluated using the Neuropsychiatric Inventory (NPI), the Patient Health Questionnaire-9 (PHQ-9), and the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) during follow-up. The differences between the two groups were analyzed using the Mann-Whitney U (nonparametric) test, the Student’s t (parametric), and the chi-squared test.
Around 25 catatonic individuals and 59 non-catatonic patients were among the 84 patients recruited. Among these, 28 only showed positive antibody levels in their CSF, 4 only in their serum, and 52 in both. Patients who were diagnosed as catatonic had a higher incidence of consciousness disturbance (P = 0.01), aggressiveness (P = 0.046), and emotional disorders (P = 0.043) compared to those who were not diagnosed as catatonic. In addition, admission mRS scores for the group with catatonia were lower than those without catatonia (P = 0.045).
Deep vein thrombosis (P = 0.003), decubitus (P = 0.046), pneumonia (P = 0.025), and intensive care unit (ICU) admission (P = 0.011) were all more common in catatonic patients than in non-catatonic patients. The catatonia group had 100% adherence to the first treatment. However, patients in the catatonia group did not do well during the 24-month follow-up. In addition, more people in the catatonia group experienced relapses and had neuropsychiatric issues at the most recent follow-up (P = 0.014, P = 0.035, respectively). Patients with catatonia have a different illness history from those without catatonia, and they are more likely to develop relapses and long-term neuropsychiatric disorders.