TOP 25 - Characteristics of Pediatric Catatonia

Publication Number: 1785.TOP 25

Melissa D. Johnnidis, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME, United States; Roslyn Gerwin, Maine Medical Center, Portland, ME, United States; Matthew E. Nilsson, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME, United States; Shadia Kawkabani, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME, United States

Background: Pediatric catatonia is a severe neuropsychiatric condition characterized by disturbances in motor, behavioral, and affective function. It occurs across a range of underlying disorders, including mood, psychotic, and neurodevelopmental conditions. Although national data show a rise in pediatric hospitalizations for catatonia, the condition is still often missed in children and adolescents. This underdiagnosis leads to delays in treatment, which can result in significant morbidity and mortality.
Lorazepam is first-line treatment for pediatric catatonia; however, some patients demonstrate incomplete response and require adjunctive medications or electroconvulsive therapy (ECT). Evidence guiding these treatment decisions in pediatric populations remains limited and is largely adapted from adult studies. Characterizing patterns of pharmacologic response and ECT utilization in pediatric catatonia is essential to improving clinical management in this population.

Objective: Our objective is to examine treatment trends in pediatric patients with catatonia, with focus on assessing how often children require adjunctive pharmacotherapy beyond lorazepam and the frequency of ECT use during both initial and recurrent hospitalizations. By analyzing these trends, we aim to provide practical insights that can guide the management of both acute and recurrent episodes of catatonia in pediatric patients.

Design/Methods: The data collected for this poster are derived from a larger IRB-approved retrospective chart review examining pediatric catatonia at a tertiary care academic medical center. We included patients aged 17 years or younger who were admitted to the inpatient psychiatry unit, pediatric unit, pediatric intensive care unit, or emergency department between January 1, 2011, and September 1, 2025, with a confirmed diagnosis of catatonia. A total of 25 patients met these criteria. Data were collected through electronic health record review and included demographic information, psychiatric and non-psychiatric comorbidities, details of treatment interventions, and discharge outcomes. Treatment variables specifically examined included lorazepam dosing and response, use of additional medications, and ECT utilization. Descriptive analyses were performed to identify trends in treatment approaches and outcomes, such as the proportion of patients requiring adjunctive pharmacotherapy or ECT during initial and subsequent hospitalizations. Data collection for the full cohort is ongoing, with completion expected by late 2025.

Trends in Pediatric Catatonia Admissions
This chart illustrates the annual number of pediatric admissions with a diagnosis of catatonia.