Prevalence of catatonic signs and symptoms in an acute psychiatric unit from a tertiary psychiatric center in India

•Prevalence of catatonic syndrome varies from 5.3% to 19% based on diagnostic cut-off/criteria used.•Staring and withdrawal, though frequently noted, are not listed as catatonic signs in the ICD-10 or DSM V.•Significantly higher rates of catatonic syndrome were present in psychotic spectrum disorders. The prevalence of catatonia varies with the setting and type of rating scale used to measure catatonia. Catatonia, initially subsumed under schizophrenia, now is increasingly recognized in association with affective disorders. We aimed to examine the prevalence of catatonia in an acute psychiatric inpatient unit in a tertiary center in India. Study subjects (n = 300) were randomly selected from amongst the inpatients over one year and evaluated within 24 h of admission using BFCRS and NCS, besides a sociodemographic and clinical proforma. During the inpatient stay MINI PLUS 5.0 was applied. Among 300 inpatients recruited, 88 (29.3%) demonstrated at least one catatonic sign in either of the rating scales. As per the diagnostic cut-offs defined by BFCRS and NCS, the prevalence of catatonia syndrome was 49 (16.3%) and 32 (10.6%) respectively. The prevalence rates as per ICD-10 criteria and DSM-5 criteria were 19% and 5.3% respectively. The two most frequently noted signs - staring and withdrawal, were not listed as signs in either the ICD-10 or DSM V. The prevalence of catatonic symptoms was different in psychotic disorders in contrast to affective disorders. Severity of catatonia was associated with younger age, lesser duration of primary illness and prior episodes of catatonia. The prevalence of catatonia varies from 5.3% to 19% based on the criteria used. Identification warrants use of structured instruments. Catatonia is more severe in the initial years of illness, those with prior episodes of catatonia and in the younger age group.