Table 2.
Meta-analysis of Prevalence of Catatonia in Psychiatric and Medical Patients
| Subgroup/Moderator | Number of Samples | Number of Participants | Prevalence (%) | 95% Confidence Interval (CI) | I 2 (%) | |
|---|---|---|---|---|---|---|
| Lower 95% CI | Upper 95% CI | |||||
| Catatonia (main analysis) | 80 | 110774 | 9.0 | 6.9 | 11.7 | 98 |
| Catatonia (low heterogeneity subgroup) | 19 | 7612 | 7.8 | 7.0 | 8.7 | 39 |
| Catatonia (ECT/elevated CPK subgroup) | 8 | 1168 | 23.9 | 10.0 | 46.9 | 96 |
| Catatonia (no ECT/elevated CPK subgroup) | 72 | 109606 | 8.1 | 6.1 | 10.5 | 98 |
| Sensitivity analyses excluding patients undergoing ECT (based on 92 of 100 samples, from 72 of 80 studies) | ||||||
| Continent (between continent P value = .30) | ||||||
| North America | 8 | 50130 | 11.1 | 5.0 | 22.7 | 99 |
| Asia | 22 | 14113 | 10.0 | 6.3 | 15.4 | 98 |
| Europe | 52 | 37303 | 8.3 | 6.0 | 11.2 | 97 |
| Oceania | 4 | 2410 | 7.1 | 5.8 | 8.8 | 32 |
| Africa | 4 | 28173 | 5.9 | 0.1 | 31.7 | 99 |
| South America | 2 | 2212 | 1.9 | 0.4 | 8.8 | 67 |
| Countrya (between country P value P < .001) | ||||||
| Uganda | 1 | 33 | 48.5 | NA | NA | NA |
| China | 1 | 225 | 32.0 | NA | NA | NA |
| Switzerland | 1 | 140 | 27.1 | NA | NA | NA |
| UK | 6 | 1326 | 19.9 | 8.8 | 38.9 | 96 |
| Hungary | 1 | 276 | 19.6 | 15.3 | 24.7 | NA |
| Singapore | 1 | 423 | 16.8 | NA | NA | NA |
| Austria | 5 | 1370 | 12.1 | 8.1 | 17.6 | 86 |
| India | 12 | 10129 | 11.2 | 5.2 | 22.6 | 98 |
| USA | 8 | 50130 | 11.1 | 5.0 | 22.7 | 99 |
| Spain | 9 | 1631 | 10.7 | 8.2 | 13.8 | 69 |
| Germany | 11 | 5522 | 8.2 | 4.5 | 14.5 | 97 |
| Israel | 1 | 568 | 7.6 | 5.7 | 10.1 | NA |
| Japan | 5 | 1909 | 7.6 | 4.5 | 12.6 | 87 |
| Australia | 4 | 2410 | 7.1 | 5.8 | 8.8 | 32 |
| Netherlands | 4 | 2805 | 6.9 | 3.0 | 15.0 | 96 |
| Norway | 1 | 72 | 5.6 | NA | NA | NA |
| Kuwait | 2 | 859 | 4.9 | 3.2 | 7.6 | 22 |
| Greece | 2 | 494 | 3.9 | 2.5 | 6. | NA |
| France | 12 | 23667 | 3.6 | 2.1 | 6.2 | 95 |
| Nigeria | 3 | 28140 | 2.5 | 0.3 | 17.7 | 99 |
| Mexico | 2 | 2212 | 1.9 | 0.4 | 8.8 | 67 |
| Rating scale/criteria used to diagnose catatonia (between group P value = .13) | ||||||
| Other | 23 | 9430 | 11.9 | 8.7 | 16.1 | 96 |
| ICD | 10 | 4466 | 10.6 | 7.6 | 14.5 | 92 |
| Study-defined | 10 | 48781 | 10.2 | 5.0 | 19.6 | 99 |
| BFCSI | 8 | 1968 | 9,7 | 7.0 | 13.3 | 77 |
| BFCRS | 16 | 25648 | 7.4 | 3.2 | 16.1 | 99 |
| DSM | 25 | 44048 | 5.4 | 3.3 | 8.6 | 98 |
| Period of study conduct (between group P value = .13) | ||||||
| Before 1970 | 5 | 48382 | 5.4 | 2.0 | 13.6 | 99 |
| 1970–1980 | 7 | 3465 | 13.6 | 9.2 | 19.6 | 93 |
| 1980–1990 | 2 | 14880 | 2.4 | 0.2 | 21.7 | 99 |
| 1990–2000 | 26 | 22537 | 6.9 | 4.6 | 10.3 | 98 |
| 2001–2010 | 29 | 39087 | 10.4 | 6.3 | 16.7 | 98 |
| After 2010 | 23 | 5990 | 9.0 | 5.9 | 13.3 | 95 |
| Age group (between group P value = .38) | ||||||
| Adults (>18 years old) | 78 | 106006 | 9.0 | 7.0 | 11.4 | 98 |
| Elderly (>65 years old) | 5 | 552 | 8.5 | 6.4 | 11. | 0 |
| Children/adolescents | 9 | 22883 | 4.9 | 2.1 | 11.0 | 98 |
| Risk of bias (between group P value = .85) | ||||||
| NOS ≤ 5 | 45 | 42202 | 8.6 | 5.9 | 12.3 | 98 |
| NOS > 5 | 47 | 92139 | 8.2 | 6.0 | 11.2 | 99 |
| Main conditiona (between group P value < .001) | ||||||
| Medical or neurological illness | 10 | 1480 | 20.6 | 11.5 | 34.2 | 95 |
| Bipolar disorder | 3 | 226 | 20.1 | 9.6 | 37.3 | 94 |
| Postpartum psychosis | 1 | 200 | 20.0 | NA | NA | NA |
| Autism | 2 | 564 | 11.1 | 3.0 | 33.5 | 93 |
| Schizophrenia | 33 | 20276 | 9.8 | 8.0 | 12.0 | 95 |
| Mixed | 43 | 111595 | 5.7 | 4.2 | 7.7 | 98 |
| Treatment settinga (between group P value = .003) | ||||||
| Nonpsychiatric out- or inpatient units | 15 | 4412 | 15.8 | 8.1 | 28.4 | 97 |
| Psychiatric inpatients units | 74 | 129302 | 7.7 | 6.0 | 9.9 | 99 |
| Psychiatric outpatients services | 3 | 627 | 3.2 | 1.7 | 6.1 | 50 |
| Sample sizea (between group P value < .001) | ||||||
| <100 | 17 | 1069 | 20.7 | 12.8 | 31.6 | 90 |
| ≥100 | 19 | 2324 | 10.9 | 8.2 | 14.3 | 80 |
| ≥200 | 21 | 4766 | 12.9 | 9.7 | 17 | 93 |
| ≥300 | 4 | 1437 | 4.4 | 1.3 | 13.7 | 95 |
| ≥400 | 3 | 1326 | 11.1 | 7.0 | 17.3 | 88 |
| ≥500 | 12 | 8424 | 6.1 | 4.2 | 9.0 | 96 |
| ≥1000 | 16 | 114995 | 2.3 | 1.3 | 3.9 | 99 |
Note: Bold values indicates maini analyses.
aCountry, treatment setting, main underlying condition, and sample size influenced results.