Catatonia in a tertiary psychiatric setting: a prospective study of clinical patterns and early treatment results

Background Catatonia is a complex neuropsychiatric syndrome characterised by diverse motor, affective, behavioural, and cognitive disturbances. Despite its significant clinical relevance, catatonia remains understudied in Kashmir. Aim This prospective hospital-based study aimed to examine the sociodemographic and clinical profile, symptom patterns, and short-term treatment outcomes of patients diagnosed with catatonia at a tertiary psychiatric hospital in Kashmir. Methods The study was conducted over 18 months at the Institute of Mental Health and Neurosciences-Kashmir. A total of 118 patients aged above 15 years, fulfilling Bush–Francis Catatonia Rating Scale (BFCRS) criteria, were recruited using purposive sampling. Diagnosis was confirmed by a consultant psychiatrist and a lorazepam challenge test. Data on sociodemographic details, clinical presentation, symptom severity, treatment, and outcomes were collected through a semi-structured interview and clinical assessments. Results Of the 118 patients, 53.4% were male, with a mean age of 31.8 years (SD ± 13.7). The majority were from rural areas and lower socioeconomic backgrounds. Mood disorders (52.5%) were the most common underlying diagnosis, followed by schizophrenia (35.6%). Retarded catatonia was predominant (93.2%). The most common symptoms were mutism (90.7%), withdrawal (87.3%), staring (83.1%), and immobility (78.0%). Lorazepam was administered in 88.1% of cases; one-third (33.1%) required ECT. Most patients (76.2%) recovered and were discharged within two weeks. Conclusion The study underscores that catatonia is frequently linked to mood and psychotic disorders and responds well to timely lorazepam administration and ECT. Strengthening awareness, early detection, and timely intervention, especially in rural settings, can improve outcomes.