Faculty mentor/PI email address
jvarrell@cfgpc.com
Keywords
schizoaffective, catatonia, ECT, schizophrenia, depression, refractory
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background: Catatonia is a neuropsychiatric syndrome
associated with mood and psychotic disorders and may
become life-threatening if untreated. While benzodiazepines
are first-line therapy, some cases are refractory and require
electroconvulsive therapy (ECT).
Hypothesis: Early use of ECT in refractory catatonia leads to
improved clinical and functional outcomes.
Methods: We present a retrospective case analysis of a 62-
year-old female with schizoaffective disorder, bipolar type,
who developed severe catatonia during inpatient psychiatric
hospitalization. Clinical course, Bush–Francis Catatonia Rating
Scale scores, and response to treatment were reviewed.
Results: The patient presented with severe catatonia (Bush–
Francis score 19) and elevated creatine kinase consistent with
catatonia-related muscle activity. She failed multiple
pharmacologic interventions, including benzodiazepines and
antipsychotic therapy. ECT was initiated using bitemporal
placement at three times weekly, resulting in progressive
improvement in speech, engagement, and functional status.
Treatment was tapered to monthly maintenance therapy, with
significant improvement in catatonia severity (19 → 5 → 2).
Conclusions: ECT is a highly effective treatment for refractory
catatonia and should be considered early when pharmacologic
therapy fails to prevent prolonged morbidity and functional
decline.
Disciplines
Medicine and Health Sciences | Mental Disorders | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment
Included in
Mental Disorders Commons, Other Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons
Refractory Catatonia in Schizoaffective Disorder (Bipolar Type) Successfully Treated With Electroconvulsive Therapy
Background: Catatonia is a neuropsychiatric syndrome
associated with mood and psychotic disorders and may
become life-threatening if untreated. While benzodiazepines
are first-line therapy, some cases are refractory and require
electroconvulsive therapy (ECT).
Hypothesis: Early use of ECT in refractory catatonia leads to
improved clinical and functional outcomes.
Methods: We present a retrospective case analysis of a 62-
year-old female with schizoaffective disorder, bipolar type,
who developed severe catatonia during inpatient psychiatric
hospitalization. Clinical course, Bush–Francis Catatonia Rating
Scale scores, and response to treatment were reviewed.
Results: The patient presented with severe catatonia (Bush–
Francis score 19) and elevated creatine kinase consistent with
catatonia-related muscle activity. She failed multiple
pharmacologic interventions, including benzodiazepines and
antipsychotic therapy. ECT was initiated using bitemporal
placement at three times weekly, resulting in progressive
improvement in speech, engagement, and functional status.
Treatment was tapered to monthly maintenance therapy, with
significant improvement in catatonia severity (19 → 5 → 2).
Conclusions: ECT is a highly effective treatment for refractory
catatonia and should be considered early when pharmacologic
therapy fails to prevent prolonged morbidity and functional
decline.