Diagnosis and Management of Catatonia via Telepsychiatry: A Clinical Practice Guide

Background: The uneven distribution of psychiatrists across the United States has led to a significant deficiency in psychiatric care, particularly in rural and remote areas. Telepsychiatry has emerged as an effective solution to bridge this gap, providing comparable outcomes to in-person services. Objective: This case series aims to highlight the effectiveness of telepsychiatry in diagnosing and managing catatonia, a complex neuropsychiatric condition whose diagnosis often requires physical examination, through consultation-liaison (CL) psychiatry services. Methods: We describe three cases of catatonia managed via telepsychiatry by the CL psychiatry service at The University of Pittsburgh Medical Center. CL psychiatrists located in the university hospital diagnosed and managed catatonia via telepsychiatry in patients medically hospitalized in non-urban hospitals with assistance from an in-person clinician. Each case was assessed for diagnostic accuracy and treatment outcomes using the Bush Francis Catatonia Rating Scale. Results: The use of telepsychiatry facilitated timely diagnosis and treatment of catatonia. All patients showed significant improvement, demonstrating the viability of CL telepsychiatry in managing complex conditions like catatonia in the medical setting. Conclusion: CL Telepsychiatry is a critical tool in addressing the shortage of psychiatric care in underserved areas. It may be effective in facilitating the diagnosis and treatment of catatonia in medical hospitals, ensuring patients receive timely and appropriate care.