Catatonia-asossicated urinary retention in geriatric patients: a case series report
Notice bibliographique
Résumé
BACKGROUND: Catatonia is an underdiagnosed neuropsychiatric condition, with only a few studies focusing on medical sequalae among elderly populations. Delayed treatment results in complications with high morbidity and mortality. Among elderly individuals, one such complication is urinary retention. Urinary retention can result in prolonged catheter use. In geriatric populations, prolonged use of catheters become particularly concerning and problematic as it can limit patient mobility, are potential sources for infection, and increase the risk for delirium. Catheter use has been independently associated with increased mortality in nursing home settings. Given the above risks and implications of catheter use, this case series describes clinical cases of catatonia-associated urinary retention specifically in older populations, whereby the use of electroconvulsive therapy (ECT) resulted in resolution of urinary retention concurrent with resolution of depressive and catatonic symptoms using validated scales. CASE PRESENTATION: This study involved four patients ranging from 66-84 years old who met criteria for major depressive disorder and catatonia. At admission, Montgomery-Asberg Depression Rating Scale (MADRS) scores ranged from 40-56, indicating severe illness in all patients. All patients also met criteria for catatonia as measured by the Bush Francis Catatonia Rating Scale (BFCRS). During the admission, each patient experienced urinary retention as evidenced by post-void residual (PVR) bladder volumes ranging from 569-1400 mL. Medical workup was completed to exclude alternative causes for urinary retention. Each patient completed ECT treatment, ranging from 14-19 sessions which resulted in resolution of catatonia. All four patients were also noted to have PVR volumes ranging from 6-75 mL, thereby suggesting concurrent resolution of urinary retention. Posttreatment, the MADRS scores ranged from 3-16, indicating a mild or subthreshold index of illness. There was no recurrence of elevated post-void residual volumes, and therefore, all patients were discharged from hospital without the requirements of urinary catheter insertion. CONCLUSIONS: To our knowledge, there are no case reports that describe the concurrent resolution of catatonia, depressive symptoms and urinary retention simultaneously using validated scales throughout the ECT treatment course. Furthermore, there are no prior reports describing catatonia-related urinary retention specifically among a group of geriatric populations. Identifying and treating catatonia in a timely manner can reduce the complications associated with prolonged catheter use. There remains a gap in current research to describe if there exists any overlapping mechanisms and pathways to explain how ECT can treat catatonia, depression, and catatonia-associated urinary retention.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
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| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
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