Catatonic Syndrome in Adult Patients at Basurto Hospital: A Descriptive Study of Incidence, Comorbidity, and Short-Term Outcomes

Catatonic syndrome is a severe neuropsychiatric condition characterized by motor, behavioral, and speech abnormalities, frequently accompanied by autonomic and affective disturbances. Although historically conceptualized as a subtype of schizophrenia, current diagnostic classifications (DSM-5, ICD 11) recognize catatonia as a transdiagnostic syndrome that may occur in association with a wide range of psychiatric, neurological, metabolic, toxic, autoimmune and other medical conditions. Early recognition is clinically relevant, as catatonia is potentially reversible and timely treatment is associated with improved short-term outcomes.

Available epidemiological data indicate marked variability in the reported incidence and prevalence of catatonia across populations and clinical settings. Population-based studies from high-income countries (UK, USA) have reported incidence rates of approximately 4-5 catatonic episodes per 100,000 person-years. In contrast, studies conducted in acute psychiatric inpatient settings have described substantially higher prevalence rates, ranging from approximately 20% to over 40% of admitted patients.

In Spain, published data are limited to selected hospital-based subpopulations. Prevalence rates of approximately 8-9% have been reported in older adults assessed by liaison psychiatry services in general hospitals, while markedly higher rates have been described in specific psychiatric inpatient samples, including geriatric psychiatry wards (nearly 40%) and patients hospitalized for first-episode psychosis (approximately 20-25%). These findings highlight the influence of age, clinical setting, and underlying diagnosis on observed prevalence estimates.

To date, however, no studies have been conducted in Spain that systematically examine the incidence or prevalence of catatonic syndrome across an unselected adult hospital population, irrespective of underlying diagnoses or specific clinical subgroups. Consequently, the epidemiology and short-term clinical course of catatonia in a general hospital setting encompassing all medical and psychiatric services remain insufficiently characterized.

This prospective observational cohort study aims to address this gap by describing the incidence, sociodemographic and clinical characteristics, comorbidity profile, treatment response, and short-term outcomes of adult patients diagnosed with catatonic syndrome at Basurto University Hospital, a general university hospital providing secondary-level care to the Bilbao area (Spain). The study includes patients attended in any hospital service, including the emergency department and inpatient medical or psychiatric units.