Silverstein Elena, Basiru Tajudeen O, Aulakh Maninder, Verzura Melissa, Suarez Rogelio
Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.
Developmental Behavioral Pediatrics, Dell Children's Medical Center, Austin, USA.
Cureus. 2025 May 19;17(5):e84392. doi: 10.7759/cureus.84392. eCollection 2025 May.
Catatonia is a rare but potentially life-threatening neuropsychiatric syndrome characterized by a range of motor, behavioral, and affective abnormalities. Catatonia is broadly categorized into three clinical presentations: associated with a psychiatric disorder, secondary to a medical condition, or of unspecified origin. Postpartum catatonia remains poorly understood, particularly in cases where there is no active psychiatric or medical illness at the time of onset. Most documented cases occur in the context of severe peripartum mood or psychotic episodes, highlighting the unique nature of catatonia emerging independently in the postpartum period. In this case report, we present a 33-year-old woman with a known history of major depressive disorder with psychotic features who developed catatonia within 24 hours following childbirth. Notably, the patient exhibited no signs or symptoms of depression or psychosis during the pregnancy or at the time of catatonic onset. She denied experiencing any mood or psychotic symptoms leading up to delivery, and her presentation was not consistent with a relapse of her previous psychiatric condition. This case is notable for its unique context: catatonia emerging in the immediate postpartum period without concurrent psychiatric decompensation or identifiable medical triggers. It raises important clinical questions about whether postpartum physiological or hormonal changes alone may precipitate catatonia in vulnerable individuals, even in the absence of overt psychiatric illness. Our report underscores the importance of maintaining a high index of suspicion for catatonia in postpartum patients, including those without active psychiatric symptoms. Early recognition and treatment are critical for optimal outcomes. Furthermore, this case highlights the need for more research to better understand the spectrum of postpartum catatonia and to determine whether it may, in some instances, represent a distinct clinical entity separate from traditional psychiatric or medical frameworks.
紧张症是一种罕见但可能危及生命的神经精神综合征，其特征为一系列运动、行为和情感异常。紧张症大致分为三种临床表现：与精神障碍相关、继发于躯体疾病或病因不明。产后紧张症仍未得到充分理解，尤其是在发病时没有活动性精神或躯体疾病的情况下。大多数已记录的病例发生在严重的围产期情绪或精神病发作的背景下，突出了产后独立出现的紧张症的独特性质。在本病例报告中，我们介绍了一名33岁有伴精神病性特征的重度抑郁症病史的女性，她在分娩后24小时内出现了紧张症。值得注意的是，该患者在怀孕期间或紧张症发作时没有抑郁或精神病的迹象或症状。她否认在分娩前有任何情绪或精神病症状，并且她的表现与之前精神疾病的复发不一致。该病例因其独特的背景而值得关注：产后即刻出现紧张症，没有并发精神失代偿或可识别的医学诱因。它引发了重要的临床问题，即即使在没有明显精神疾病的情况下，产后生理或激素变化本身是否可能在易感个体中诱发紧张症。我们的报告强调了对产后患者，包括那些没有活动性精神症状的患者保持高度紧张症怀疑指数的重要性。早期识别和治疗对于获得最佳结果至关重要。此外，该病例突出了需要更多研究以更好地理解产后紧张症的范围，并确定它在某些情况下是否可能代表一种与传统精神或医学框架不同的独特临床实体。
