Major Depressive Disorder with Catatonia: A Phenotype Related to Autistic Traits and High Suicidality
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample and Procedures
- Significant Catatonia (SC) group, exhibiting a CS score of ≥30;
- Non-Significant Catatonia (NSC) group, defined by a CS score <30.
2.2. Measures
2.2.1. Catatonia Spectrum (CS)
2.2.2. Adult Autism Subthreshold Spectrum (AdAS Spectrum)
2.2.3. Mood Spectrum Self-Report (MOOD-SR)
2.2.4. Statistical Analyses
3. Results
3.1. Sample Composition
3.2. Comparisons between CS Total and Domain Scores among the CS Groups
3.3. Comparisons between AdAS Spectrum Total and Domain Scores among the CS Groups
3.4. Distribution of Autistic Traits within Groups
- Participants with possible clinical symptoms of ASD (ASD group), composed of 40 subjects (27.2%);
- Participants with subthreshold autistic traits (AT group), composed of 57 subjects (38.8%);
- Participants without autistic traits (non-AT group), composed of 50 subjects (34.0%).
- NSC group: 60.0% in the non-AT group, 34.7% in the AT group, and 5.3% in the ASD group;
- SC group: 6.9 % in the non-AT group, 43.1% in the AT group, and 50.0% in the ASD group.
- The non-AT group consisted of 90.0% of subjects from the NSC group and 10.0% of individuals from the SC group.
- The AT group consisted of 45.6% of participants of the NSC group and 54.4% of the SC group.
- The ASD group consisted of 10.0% of subjects belonging to the NSC group and 90.0% to the SC group.
3.5. Comparisons between MOODS-SR Total and Domain Scores among the Groups
3.6. Suicidality among the Two CS Groups
3.7. Regression Analyses
3.8. Decision Tree Model
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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CS Groups | Frequency (Percent) | Mean Age (Standard Deviation) | Sex (Percent, %) |
---|---|---|---|
Non-Significant Catatonia (NSC) | 75 (51.0%) | 46.00 (12.351) |
|
Significant Catatonia (SC) | 72 (49.0%) | 41.00 (12.69) |
|
CS Domains | NSC Group Mean ± sd (Mean Rank) | SC Group Mean ± sd (Mean Rank) | p | U | W |
---|---|---|---|---|---|
Psychomotor activity (Stupor) | 5.48 ± 3.31 (42.31) | 11.51 ± 2.17 (107.01) | <0.01 | 5076.500 | 7704.500 |
Verbal response (Mutism) | 2.29 ± 2.13 (46.43) | 6.07 ± 2.06 (102.72) | <0.01 | 4768.00 | 7396.00 |
Repetitive movements (Stereotypes) | 0.97 ± 1.85 (48.01) | 3.22 ± 1.71 (101.08) | <0.01 | 4649.50 | 7277.500 |
Artificial expressions and actions (Mannerisms) | 0.28 ± 0.69 (48.84) | 2.29 ± 2.03 (100.21) | <0.01 | 4587.00 | 7215.00 |
Oppositivity or poor response to stimuli (Negativism) | 1.47 ± 1.57 (45.47) | 4.59 ± 1.76 (103.72) | <0.01 | 4839.500 | 7467.500 |
Response to instructions given from outside (Automatic obedience) | 1.96 ± 1.55 (52.58) | 3.93 ± 1.67 (69.63) | <0.01 | 4329.00 | 6957.00 |
Automatisms | 2.06 ± 1.76 (46.31) | 6.09 ± 2.61 (102.85) | <0.01 | 4777.00 | 7405.00 |
Impulsivity | 2.19 ± 1.85 (48.11) | 6.44 ± 3.36 (100.97) | <0.01 | 4642.00 | 7270.00 |
Total Score | 16.70 ± 8.16 (38.00) | 16.70 ± 8.16 (111.50) | <0.01 | 5400.00 | 8028.00 |
AdAS Spectrum Domains | NSC Group Mean ± sd (Mean Rank) | SC Group Mean ± sd (Mean Rank) | p | U | W |
---|---|---|---|---|---|
Childhood/adolescence | 5.28 ± 3.94 (54.79) | 9.75 ± 4.93 (94.01) | <0.01 | 4140.500 | 6768.500 |
Verbal Communication | 3.95 ± 3.41 (50.85) | 8.01 ± 3.21 (98.11) | <0.01 | 4436.00 | 7064.00 |
Non-Verbal Communication | 6.48 ± 4.83 (51.05) | 12.50 ± 4.97 (97.91) | <0.01 | 4421.50 | 7049.500 |
Empathy | 2.71 ± 2.63 (59.44) | 4.90 ± 3.19 (89.17) | <0.01 | 3792.00 | 6420.00 |
Inflexibility and adherence to routine | 9.43 ± 6.89 (49.49) | 19.60 ± 8.42 (99.53) | <0.01 | 4538.500 | 7166.500 |
Restricted interests and rumination | 5.97 ± 4.51 (51.04) | 11.64 ± 4.26 (97.92) | <0.01 | 4422.00 | 7050.00 |
Hyper-hypo reactivity to sensory input | 2.73 ± 2.94 (48.47) | 7.62 ± 4.04 (99.56) | <0.01 | 4540.00 | 7168.00 |
Total score | 35.54 ± 24.30 (47.72) | 74.03 ± 27.01 (101.38) | <0.01 | 4671.00 | 7299.00 |
AdAS Groups | Non-AT (n, %) | AT (n, %) | ASD (n, %) | Total (n, %) |
---|---|---|---|---|
NSC | ||||
n * | 45a * | 26b * | 4c * | 75 |
% within diagnosis | 60.0% | 34.7% | 5.3% | 100.0% |
% within AdAS group | 90.0% | 45.6% | 10.0% | 51.0% |
SC | ||||
n * | 5a * | 31b * | 36c * | 72 |
% within diagnosis | 6.9% | 43.1% | 50.0% | 100.0% |
% within AdAS group | 10.0% | 54.4% | 90.0% | 51.0% |
MOOD-SR Domains | NSC Group Mean ± sd (Mean Rank) | SC Group Mean ± sd (Mean Rank) | p | U | W |
---|---|---|---|---|---|
Mood Depressive | 12.28 ± 6.54 (59.62) | 17.72 ± 5.34 (91.79) | <0.01 | 3981.00 | 6609.00 |
Mood Manic | 7.17 ± 5.36 (56.85) | 11.90 ± 5.91 (91.87) | <0.01 | 3986.500 | 6614.500 |
Energy Depressive | 3.44 ± 2.72 (55.28) | 6.08 ± 2.70 (93.50) | <0.01 | 4104.00 | 6732.00 |
Energy Manic | 3.32 ± 2.76 (58.35) | 5.57 ± 3.16 (90.11) | <0.01 | 3860.00 | 6488.00 |
Cognition Depressive | 8.64 ± 5.74 (52.61) | 15.78 ± 6.15 (96.28) | <0.01 | 4304.00 | 6932.00 |
Cognition Manic | 4.17 ± 4.18 (59.99) | 7.85 ± 5.83 (88.59) | <0.01 | 3750.00 | 6378.500 |
Rhythmicity and vegetative functions | 10.21 ± 6.00 (55.07) | 15.72 ± 5.22 (93.72) | <0.01 | 4120.00 | 6748.00 |
Mood total | 49.24 ± 25.96 (50.52) | 80.62 ± 25.13 (98.46) | <0.01 | 4461.00 | 7089.00 |
Mood total—Depressive | 24.36 ± 13.15 (52.05) | 39.58 ± 12.00 (69.90) | <0.01 | 4348.500 | 6976.500 |
Mood total—Manic | 14.67 ± 11.06 (55.35) | 25.32 ± 12.56 (93.42) | <0.01 | 4089.500 | 6726.500 |
Rhythmicity | 2.36 ± 1.56 (55.34) | 3.86 ± 1.47 (93.44) | <0.01 | 4099.500 | 6272.500 |
Sleep | 4.20 ± 2.96 (59.98) | 6.19 ± 2.66 (88.60) | <0.01 | 3751.500 | 6379.500 |
Weight and appetite | 1.25 ± 1.28 (59.07) | 2.24 ± 1.23 (89.55) | <0.01 | 3819.500 | 6447.500 |
Sexual functions | 1.49 ± 1.45 (67.25) | 1.99 ± 1.51 (81.03) | <0.01 | 3206.500 | 5834.500 |
Physical Symptoms | 1.11 ± 0.00 (59.20) | 1.90 ± 1.04 (89.42) | <0.01 | 3810.00 | 6438.00 |
Suicidality | 1.52 ± 1.96 (58.04) | 3.18 ± 2.05 (90.63) | <0.01 | 3897.00 | 6525.00 |
Suicidal Ideation | 1.16 ± 1.49 (58.31) | 2.37 ± 1.49 (90.35) | <0.01 | 3877.00 | 6505.00 |
Suicidal Attempts | 0.36 ± 0.71 (63.4) | 0.81 ± 0.85 (85.01) | <0.01 | 3493.00 | 6121.00 |
CS Groups | Non-Suicidality (n, %) | Suicidality (n, %) | Total (n, %) |
---|---|---|---|
NSC | |||
n * | 39a | 36b | 75 |
% within diagnosis | 52.0% | 48.0% | 100.0% |
% within CS group | 76.5% | 37.5% | 51.0% |
SC | |||
n * | 12a | 60b | 72 |
% within diagnosis | 16.7% | 83.3% | 100.0% |
% within CS group | 23.5% | 62.5% | 49.0% |
CS Groups | Non-Suicidal Ideation (n, %) | Suicidal Ideation (n, %) | Total (n, %) |
---|---|---|---|
NSC | |||
n * | 41a | 34b | 75 |
% within diagnosis | 54.7% | 45.3% | 100.0% |
% within CS group | 77.4% | 36.2% | 51.0% |
SC | |||
n * | 12a | 60b | 72 |
% within diagnosis | 16.7% | 83.3% | 100.0% |
% within CS group | 22.6% | 63.8% | 49.0% |
Independent Variables | B(SE) | OR | p | CI (95%) |
---|---|---|---|---|
Constant | −4.154 (0.720) | 0.016 | <0.001 | - |
AdAS Spectrum total score | 0.047 (0.011) | 1.048 | <0.001 | 1.026; 1.070 |
MOOD-SR total score | 0.024 (0.009) | 1.025 | 0.007 | 1.007; 1.043 |
B | OR | p | ||
---|---|---|---|---|
Independent Variables | B(SE) | OR | p | CI (95%) |
Constant | −3.016 (0.595) | 0.049 | <0.001 | - |
Hyper-hypo reactivity to sensory input | 0.183 (0.088) | 1.201 | 0.038 | 1.010; 1.427 |
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Carpita, B.; Amatori, G.; Cremone, I.M.; Bonelli, C.; Nardi, B.; Massimetti, G.; Pini, S.; Dell’Osso, L. Major Depressive Disorder with Catatonia: A Phenotype Related to Autistic Traits and High Suicidality. J. Clin. Med. 2024, 13, 4796. https://doi.org/10.3390/jcm13164796
Carpita B, Amatori G, Cremone IM, Bonelli C, Nardi B, Massimetti G, Pini S, Dell’Osso L. Major Depressive Disorder with Catatonia: A Phenotype Related to Autistic Traits and High Suicidality. Journal of Clinical Medicine. 2024; 13(16):4796. https://doi.org/10.3390/jcm13164796
Chicago/Turabian StyleCarpita, Barbara, Giulia Amatori, Ivan Mirko Cremone, Chiara Bonelli, Benedetta Nardi, Gabriele Massimetti, Stefano Pini, and Liliana Dell’Osso. 2024. "Major Depressive Disorder with Catatonia: A Phenotype Related to Autistic Traits and High Suicidality" Journal of Clinical Medicine 13, no. 16: 4796. https://doi.org/10.3390/jcm13164796