Addressing the underdiagnosis of catatonia and barriers to its treatment with ECT is vital to improving outcomes for patients. Even when all of these conditions are met, and despite well-established data on the safety and efficacy of ECT, stigma surrounding ECT and legal restrictions for its use in catatonia are additional critical barriers. Definitive catatonia care requires recognition of the syndrome, workup to identify and treat the underlying cause, and effective management including appropriate referral for ECT. Current understanding of catatonia’s pathophysiology links it to the current understanding of ECT’s mechanism of action. Catatonia is observable, detectable, and relevant to various medical specialties, but underdiagnosis impedes the delivery of appropriate treatment and heightens risk of serious complications including iatrogenesis. Electroconvulsive therapy (ECT) is the definitive treatment for catatonia, but access to ECT for the treatment of catatonia remains inappropriately limited. Catatonia is a serious, common syndrome of motoric and behavioral dysfunction, which carries high morbidity and mortality.
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