Annor Emmanuel, Lokireddy Venkata S, Ramasamy Dhanalakshmi
Child and Adolescent Psychiatry, Lehigh Valley Health Network, Allentown, USA.
Cureus. 2025 May 3;17(5):e83415. doi: 10.7759/cureus.83415. eCollection 2025 May.
Catatonia is a complex neuropsychiatric syndrome characterized by motor, behavioral, and affective disturbances. Though traditionally associated with schizophrenia, it is now recognized across a range of psychiatric and medical conditions. Catatonia is often underrecognized in the pediatric population, and bullying-induced psychological trauma is a largely overlooked trigger. This case report presents two adolescents who developed prolonged catatonia and severe malnutrition following intense bullying-triggered stress. The first case involves a 17-year-old female with developmental delay who developed severe catatonia and malnutrition following a school bullying incident. Despite initial treatment with benzodiazepines and antidepressants, her condition necessitated electroconvulsive therapy (ECT) after recurrent episodes and prolonged functional decline. The second case involves a 13-year-old female with DiGeorge syndrome who developed catatonia following emotional and physical bullying. Her symptoms partially responded to benzodiazepines, antipsychotics, and supportive care. Both patients exhibited classic catatonic features, including mutism, rigidity, and refusal to eat, and required multidisciplinary interventions. Pharmacological management with lorazepam was central, with ECT proving critical in the first case due to poor response to medication. Nutritional rehabilitation and trauma-informed psychosocial support were also essential to recovery. These cases emphasize the role of bullying-related trauma as a significant yet underrecognized trigger for pediatric catatonia. Early recognition and intervention, including using ECT, are vital to recovery. Increasing awareness, implementing preventive strategies, and conducting future research on school bullying, its effects, and its connection to catatonia may help decrease the occurrence of severe psychiatric outcomes.
紧张症是一种复杂的神经精神综合征，其特征为运动、行为和情感障碍。尽管传统上与精神分裂症相关，但现在已在一系列精神和医学病症中得到认识。紧张症在儿科人群中常常未得到充分认识，而欺凌导致的心理创伤是一个很大程度上被忽视的触发因素。本病例报告介绍了两名青少年，他们在遭受强烈的欺凌引发的压力后出现了持续性紧张症和严重营养不良。第一个病例是一名17岁发育迟缓的女性，在学校欺凌事件后出现了严重的紧张症和营养不良。尽管最初使用苯二氮䓬类药物和抗抑郁药进行治疗，但在复发发作和长期功能衰退后，她的病情需要进行电休克治疗（ECT）。第二个病例是一名患有22q11.2缺失综合征的13岁女性，在遭受情感和身体欺凌后出现了紧张症。她的症状对苯二氮䓬类药物、抗精神病药物和支持性护理有部分反应。两名患者均表现出典型的紧张症特征，包括缄默、僵硬和拒食，并且需要多学科干预。使用劳拉西泮进行药物管理是核心，由于对药物反应不佳，ECT在第一个病例中被证明至关重要。营养康复和创伤知情的心理社会支持对康复也至关重要。这些病例强调了欺凌相关创伤作为儿科紧张症的一个重要但未得到充分认识的触发因素的作用。早期识别和干预，包括使用ECT，对康复至关重要。提高认识、实施预防策略以及对学校欺凌及其影响以及与紧张症的联系进行未来研究，可能有助于减少严重精神后果的发生。
