Contributor Information. Corresponding author. Abstract Catatonia is a complex neuropsychiatric syndrome that occurs with primary psychiatric disorders or secondary to general medical conditions. Catatonia is often neglected when screening and examining psychiatric patients. Undiagnosed catatonia can increase morbidity and mortality, illustrating the need to effectively screen patients for presence of catatonia as well as their response to treatment.
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For screening, items are marked as absent 0 or present 3. The presence of two or more of the screening items for 24 hours or longer meets the diagnosis for catatonia proposed by Bush et al. For severity, items are rated using a scale of The rating scale is accompanied by a standardised examination procedure consisting of nine steps.
Sample procedures are: To assess for Echopraxia, the examiner scratches his head in an exaggerated way. I want to stick a pin in it. No information on gender is available Wong, Ungvari, Leung and Tang, Test re-test reliability was not studied because of the fluctuating course of the catatonic syndrome. Validity was harder to assess because of the lack of established diagnostic criteria.
Validity of the scale was also examined by comparison with the sources from which it was derived. The only language the BFCRS has been translated into is Portuguese and the scale remained as reliable and valid as in the original instrument Santos Nunes et al.
The BFCRS is currently the preferred rating scale for the detection of catatonia due to its five minute administration time and reliability and validity.
Wilson, Niu, Nicolson, Levine and Heckers also found it to have low reliability at the low severity level but good reliability at the moderate to severe level. Rating scale and standardized examination. Acta Psychiatrica Scandinavica, 93, References American Psychiatric Association.
Bush, G. Santos Nunes, A. Arq Neuropsiquiatr, 75, Sienaert, P. Journal of Affective Disorders, , Catatonia in DSM Schizophrenia Research, , Wong, E. International Journal of Methods in Psychiatric Research, 16,
Bush-Francis Catatonia Rating Scale (BFCRS)
Catatonia associated with schizoaffective disorder Catatonia associated with substance-induced psychotic disorder Catatonia associated with bipolar and related disorders Catatonia associated with major depressive disorder Catatonic disorder due to another medical condition If catatonic symptoms are present but they do not form the catatonic syndrome , a medication- or substance-induced aetiology should first be considered. Motor activity is nearly non-existent. Individuals in this state make little or no eye contact with others and may be mute and rigid. One might remain in one position for a long period of time, and then go directly to another position immediately after the first position. Catatonic excitement is a state of constant purposeless agitation and excitation. Individuals in this state are extremely hyperactive, although, as aforementioned, the activity seems to lack purpose. The individual may also experience delusions or hallucinations.
The Detection and Measurement of Catatonia