Introduction:
Catatonia is regarded as a diverse type of motor dysregulation syndrome that includes mutism, immobility, catalepsy, negativism, stereotypies, and echo phenomena (Rasmussen et al., 2016). More than 10% of patients with acute psychiatric conditions have been found to experience this psychomotor condition (Rasmussen et al., 2016). The syndrome has been divided into two subtypes. Retarded-type catatonia is marked by rigidity, immobility, staring, mutism, and a variety of other clinical symptoms. In a less frequent condition known as excited catatonia, patients experience protracted episodes of psychomotor agitation. Catatonia once believed to be a subset of schizophrenia, is now known to coexist with a wide range of physical and mental health conditions, including affective disorders like depression, bipolar disorder, and schizophrenia and medical conditions like encephalitis, autoimmune disorders, strokes, intracranial mass lesions, Vitamin B12 deficiency, Wilson disease, and as a consequence of other drugs like psychotropic drugs, including fluphenazine, haloperidol, risperidone, and clozapine, non-psychotropic drugs such as steroids, disulfiram, ciprofloxacin, and several benzodiazepines (McKeown et al., 2010).
In many cases, catatonia must be treated before a precise diagnosis of any underlying issues can be made (Gross et al., 2008). There are however many unanswered questions regarding the connection between OCD and catatonia, which makes it difficult to diagnose and treat patients who suffer from both diseases (Fontenelle et al., 2007).
The fact that catatonic syndrome is linked to other illnesses highlights the urgency of a prompt diagnosis and course of action. For instance, the development of neuroleptic malignant syndrome, which has a mortality rate of about 10% and may be clinically indistinguishable from malignant catatonia, appears to be a risk factor for catatonia. Catatonia itself can make it difficult, if not impossible, to conduct patient interviews and physical tests, making it harder to identify underlying diseases. These side effects of catatonia emphasize how critical it is to identify the condition and start treatment as soon as possible (Rasmussen et al., 2016).
The cornerstone of curing disease is proper diagnosis. Unlike medical or surgical diseases, mental disorders are substantially symptom-based diagnoses. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10), in the process of evaluating, syndromes are invariably associated with certain diagnoses. Hence, although rare, catatonia may be associated with obsessive-compulsive disorder (OCD) (Psychiatry.Org - DSM , n.d.; World Health Organization, 1993).
Benzodiazepines are considered first-line treatments for catatonia. However, only 70% and 79% of cases remit with benzodiazepines and lorazepam respectively (Hawkins et al., 1995). In refractory cases with medical therapy, the use and efficacy of electroconvulsive therapy (ECT) are bolstered by limited case studies (Duarte-Batista et al., 2020; D’Urso et al., 2012). In this paper, we present a case of 36 years old woman who developed episodes of catatonia during the course of her obsessive-compulsive disorder (OCD). Success rates have been recorded with both Benzodiazepines and Electroconvulsive therapy (ECT). Gauging the severity of her symptoms and poor drug compliance, the patient was opted for and successfully treated with ECT. This report has been drafted in accordance with CARE guidelines (Gagnier et al., 2013).