{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T12:37:44Z","timestamp":1790512664407,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,12,8]],"date-time":"2015-12-08T00:00:00Z","timestamp":1449532800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We describe the clinical characteristics and short\u2010term outcomes of a sample of inpatients with bipolar disorder with severe catatonic features resistant to pharmacological treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study involved 26 catatonic patients, resistant to a trial of benzodiazepines, and then treated with electroconvulsive therapy (<jats:styled-content style=\"fixed-case\">ECT<\/jats:styled-content>). All patients were evaluated prior to and one week following the<jats:styled-content style=\"fixed-case\">ECT<\/jats:styled-content>course using the Bush\u2013Francis Catatonia Rating Scale (<jats:styled-content style=\"fixed-case\">BFCRS<\/jats:styled-content>) and the Clinical Global Impression (<jats:styled-content style=\"fixed-case\">CGI<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In our sample, women were over\u2010represented (n = 23, 88.5%), the mean (\u00b1 standard deviation) age was 49.5 \u00b1 12.5 years, the mean age at onset was 28.1 \u00b1 12.8 years, and the mean number of previous mood episodes was 5.3 \u00b1 2.9. The mean duration of catatonic symptoms was 16.7 \u00b1 11.8 (range: 3\u201350) weeks, and personal history of previous catatonic episodes was present in 10 patients (38.5%). Seventeen (65.4%) patients showed abnormalities at cerebral computerized tomography and\/or magnetic resonance imaging and neurological comorbidities were observed in 15.4% of the sample.<jats:italic>Stupor, rigidity, staring, negativism, withdrawal,<\/jats:italic>and<jats:italic>mutism<\/jats:italic>were observed in more than 90% of patients. At the end of the<jats:styled-content style=\"fixed-case\">ECT<\/jats:styled-content>course, 21 patients (80.8%) were classified as responders. The<jats:styled-content style=\"fixed-case\">BFCRS<\/jats:styled-content>showed the largest percentage of improvement, with an 82% reduction of the initial score. The number of previous mood episodes was significantly lower and the use of anticholinergic and dopamine\u2010agonist medications was significantly more frequent in non\u2010responders than in responders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our patients with bipolar disorder had predominantly retarded catatonia, frequent previous catatonic episodes, indicating a recurrent course, and high rates of concomitant brain structure alterations. However,<jats:styled-content style=\"fixed-case\">ECT<\/jats:styled-content>was a very effective treatment for catatonia in this patient group that was resistant to benzodiazepines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12348","type":"journal-article","created":{"date-parts":[[2015,12,9]],"date-time":"2015-12-09T06:59:21Z","timestamp":1449644361000},"page":"892-901","source":"Crossref","is-referenced-by-count":57,"title":["Catatonia in 26 patients with bipolar disorder: clinical features and response to electroconvulsive therapy"],"prefix":"10.1111","volume":"17","author":[{"given":"Pierpaolo","family":"Medda","sequence":"first","affiliation":[{"name":"Department of Experimental and Clinic Medicine Section of Psychiatry University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Toni","sequence":"additional","affiliation":[{"name":"Institute of Behavioural Science, \u201cG. 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