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The Catatonia Quick Screen (CQS): A Rapid Screening Tool for Catatonia in Adult and Pediatric Populations

Luccarelli, James; Kalinich, Mark; Wilson, Jo Ellen; Rogers, Jonathan P; Liu, Jinyuan; Fuchs, D Catherine; Francis, Andrew; ... Ryan Smith, Joshua; + view all (2025) The Catatonia Quick Screen (CQS): A Rapid Screening Tool for Catatonia in Adult and Pediatric Populations. Acta Psychiatrica Scandinavica 10.1111/acps.13820. (In press).

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Abstract

INTRODUCTION: Catatonia is a potentially lethal and frequently underdiagnosed neuropsychiatric disorder marked by significant disturbances in motor, cognitive, and affective functioning. To enhance clinical detection of catatonia, this study aimed to develop and independently validate a rapid, sensitive Catatonia Quick Screen (CQS) using a reduced set of catatonic signs to facilitate screening in both adult and pediatric patients. METHODS: Training data were derived from two retrospective cohorts totaling 446 patients (254 adults, 192 children) who screened positive for catatonia using the Bush Francis Catatonia Screening Instrument (BFCSI). The sensitivity of every potential combination of BFCSI signs was calculated from these data, with sensitivity defined as the proportion of patients identified by each combination of signs relative to the full BFCSI. The CQS was developed by selecting the combination of signs from the BFCSI that offered high sensitivity, ease of assessment by non‐expert providers, and relevance to diverse catatonia presentations. The CQS was then validated in an independent 1456 patient cohort. RESULTS: Using only four of the full BFCSI's 14 signs—excitement, mutism, staring, and posturing—yielded a sensitivity of 97% (95% CI: 95%–98%) relative to the BFCSI across both pediatric and adult patients within the training data. The CQS showed only a modest decrease in sensitivity (91%; 95% CI: 90%–93%) relative to the BFCSI when tested on the independent 1456 patient validation cohort. CONCLUSION: The CQS provides an independently validated, high sensitivity, rapid, and easy to use screening alternative to the BFCSI, potentially improving early detection of catatonia in clinical settings. A positive CQS should lead to a more detailed and definitive assessment for catatonia. Future prospective studies are necessary to determine the specificity of the CQS in diverse clinical populations.

Type: Article
Title: The Catatonia Quick Screen (CQS): A Rapid Screening Tool for Catatonia in Adult and Pediatric Populations
DOI: 10.1111/acps.13820
Publisher version: https://doi.org/10.1111/acps.13820
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Catatonia, diagnosis, screening, psychiatric status rating scales, retrospective studies
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Institute of Mental Health
URI: https://discovery.ucl.ac.uk/id/eprint/10209354
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