Catatonic Episodes Related to Substance Use: A Cross-Sectional Study Using Electronic Healthcare Records

Figures & data

Table 1. Demographic and clinical characteristics of substance and non-substance related catatonic episodes.

	Substance-related catatonia	Non-substance-related catatonia	p
Number of episodes	108	2,028	–
Number of patients	100	1,388	–
Age at first episode, years (S.D.)	31.3 (12.2)	35.7 (16.3)	0.01
Gender, n (%) of patients			<0.001
Men	74 (74.0)	754 (54.3)
Women	26 (26.0)	634 (45.7)
Ethnicity, n (%) of patients			0.32
White	30 (30.0)	473 (34.1)
Mixed/Multiple ethnic groups	5 (5.0)	44 (3.2)
Asian/Asian British	2 (2.0)	92 (6.6)
Black/African/Caribbean/Black British	56 (56.0)	669 (48.2)
Other	5 (5.0)	83 (6.0)
Not stated	2 (2.0)	27 (2.0)
Bush-Francis Catatonia Screening Instrument score in episode
Total, median (IQR)	3 (2–5)	3 (2–5)	0.21
Positive features, median (IQR)	0 (0–1)	0 (0–1)	0.26
Negative features, median (IQR)	3 (2–4)	3 (2–4)	0.86
Duration of admission, mean (S.D.) in days^a	4.2 (1.3) 156	4.4 (1.3) 225	0.17

^aDue to positive skew, these results underwent natural logarithm transformation. Log_n results are in normal text with original scores in italics (analyses performed using log_e results).

Table 2. Substances related to episodes of catatonia.

Drug	Acute intoxication without chronic use	Acute intoxication with chronic use	Withdrawal	Chronic use (without acute intoxication or withdrawal)
Alcohol	2	1	2	0
Amphetamines	0	1	0	0
Benzodiazepines	0	0	2	1
Cannabis	24	7	0	37^a
Cocaine	2	3^b	1^c	2
GBL	0	1	0	0
Khat	0	0	0	3
Opioids	1^d	1	2	0
Synthetic cannabinoids	2^e	0	0	0
Mixed	5 Cannabis and cocaine: 2 Cannabis and ketamine: 1 Cocaine and amphetamines: 1 Cocaine, alcohol and opioids: 1	4 Alcohol and synthetic cannabinoids: 1 Cannabis and synthetic cannabinoids: 2 Cannabis and opioids: 1	1 Alcohol and opioids: 1	7 Cannabis and alcohol: 3 Cannabis and cocaine: 1 Cannabis and khat: 1 Cannabis, alcohol, ketamine and psilocybin: 1 Cannabis, cocaine and opioids: 1
Total	36	18	8	50

Overlap with other substance use (number of cases): a—cocaine acute intoxication with chronic use (1), cocaine withdrawal (1), opioid intoxication without chronic use (1), synthetic cannabinoid intoxication without chronic use (1); b—chronic cannabis use (1); c—chronic cannabis use (1); d—chronic cannabis use (1); e—chronic cannabis use (1).

Data availability statement

Data are owned by a third party, Maudsley Biomedical Research Center (BRC) Clinical Records Interactive Search (CRIS) tool, which provides access to anonymised data derived from South London and Maudsley NHS Foundation Trust electronic medical records. These data can only be accessed by permitted individuals from within a secure firewall (i.e., the data cannot be sent elsewhere), in the same manner as the authors. For more information please contact: [email protected].