Abstract: Objective To analysis the clinical characteristics of catatonia in psychiatric emergency department. Methods Patients were recruited from the psychotic emergency observation ward in Beijing Anding Hospital, Capital Medical University, between March 2018 and February 2019. The study sample consisted of 123 patients, including 46 catatonic patients and 77 psychotic patients without catatonia features. They were assessed at the admission to determine their catatonia diagnosis and the severity of psychiatric symptoms. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) were used to establish the diagnosis; the Bush-Francis Catatonia Rating Scale (BFCRS) and the Positive and Negative Syndrome Scale (PANSS) were used to determine the severity of catatonic and other psychiatric symptoms, respectively. Results ①The prodromal infection is more common in patients with catatonia (19.6% vs 1.3%). Catatonia patients also had longer stay in hospital[(4.3±2.7) vs (2.1±1.5)]d, higher score on PANSS negative subscale[(26.6±8.6) vs (10.52±5.7)], more urinary incontinence/retention (5.2% vs 1.3%) and incontinence/constipation (58.7% vs 23.4%), higher number of total white blood cells (47.8% vs 26.0%) and higher plasma creatine kinase level (58.7% vs 28.6%). The difference was statistically significant. ② The primary diagnosis included 18 (39.1%) cases of schizophrenia, 10 (21.7%) cases of mood disorder in the group with catatonia, 6 patients (13.0%) with organic catatonia. Negativism, mutism, stupor, agitation, and stereotype were the most common catatonic signs in our sample. Conclusion Patients with catatonia were often brought to psychiatric emergency room as their initial treatment. Catatonia patients presented more severe symptoms, which were often rated as negative symptoms, and were often comorbid with mental and general medical conditions.

Key words: catatonia, emergency department, schizophrenia, mood disorder, N-methyl-D-aspartate receptor (NMDAR), encephalitis