What Internists and Neurologists Know and Think About Catatonia

Abstract

Objective: To design and conduct a survey-based study to understand what internists and neurologists know and think about catatonia, with the goal of raising catatonia awareness among these practitioners and informing future educational campaigns. Methods: The authors disseminated an online catatonia survey and educational module of the Bush-Francis Catatonia Rating Scale (BFCRS) via X/Twitter, professional listservs, and newsletters, from September 5, 2023, to January 15, 2024. Attendings, fellows, residents, and advanced-practice providers in internal medicine or neurology were eligible. Results on catatonia knowledge and attitudes are described and evaluated for associations with self-reported demographics. BFCRS scoring accuracy of this study’s cohort is compared with a prior cohort of psychiatric practitioners. Results: Of the 64 eligible respondents, 58 completed the questionnaire, and 38 scored the test patient video. Most participants correctly identified medical sequelae of catatonia and benzodiazepines as the first-line treatment. However, whereas most agreed that practitioners in their specialty should know about catatonia and that it would be beneficial for them to receive catatonia training, only 16 (18%) completed the educational modules. Overall performance in this sample did not differ based on specialty, stage of training, or years of practice. The mean correct score on the BFCRS was 14 of 23, which was statistically lower than that of a historical psychiatry cohort (P < .001). Conclusions: Although participants correctly identified medical sequelae and first-line treatment of catatonia, large gaps in catatonia-related knowledge were identified. The low participation rate and high attrition, despite widespread affirmation of catatonia’s importance to their specialty, may reflect attitudes about catatonia. These results call for education on catatonia recognition and greater awareness of catatonia among internists and neurologists.