Cannabis Was the Most Common Substance Linked to Catatonic Episodes in a Large London Study | Research

The takeaway

Among 2,130 catatonic episodes in London psychiatric records, 5.1% were substance-related, with cannabis being the most frequently implicated substance in both acute intoxication and chronic use contexts.

Clinicians treating psychiatric emergencies and people interested in serious psychiatric effects of cannabis

2,130 catatonic episodes analyzed

What the researchers found

Of 108 substance-related catatonic episodes, cannabis was linked to 31 of 54 intoxication-related episodes and 37 of 50 chronic use-related episodes. Substance-related catatonia occurred in younger patients (mean age 31.3 vs 35.7) and more often in men (74% vs 54.3%). The number of substance-related episodes increased between 2007 and 2016.

Why it matters

Catatonia is a serious psychiatric emergency that can be life-threatening. Identifying cannabis as the most commonly implicated substance helps clinicians consider substance-related causes and adjust treatment accordingly.

The numbers in context

2,130 total catatonic episodes; 108 (5.1%) substance-related; cannabis linked to 31/54 intoxication episodes and 37/50 chronic use episodes; substance-related episodes increased from 2007-2016 (r=0.72, p=0.02); mean age 31.3 vs 35.7 years

How the study worked

Retrospective cross-sectional study using electronic health records from a large London secondary mental health trust. Identified all catatonic episodes and categorized them as substance-related based on positive urine drug screens, ICD-10 substance use diagnoses, or documented use within two weeks of the episode.

What this study cannot tell us

Retrospective study relying on clinical documentation, which likely underestimates true substance involvement. Cannot establish causation between substance use and catatonia. Single-site study in London limits generalizability. Concurrent substance use made attribution to specific substances difficult in some cases.

How to read the evidence

Large electronic health records study providing real-world data, but retrospective design and documentation limitations affect precision

When this study was published

2022 study

The bigger picture

As cannabis use increases globally, understanding its connection to serious psychiatric emergencies like catatonia becomes more important. The rising trend in substance-related catatonic episodes over a decade suggests this is a growing clinical concern.

Questions still open

Is the increase in substance-related catatonia driven by higher-potency cannabis products? Does cannabis trigger catatonia in vulnerable individuals or can it occur in anyone? What is the optimal treatment for cannabis-associated catatonia?

Common questions

What is catatonia?

Catatonia is a psychiatric condition characterized by unresponsiveness, immobility, unusual postures, or agitation. It can be life-threatening and requires prompt medical treatment.

Does cannabis cause catatonia?

This study found cannabis was the most frequently associated substance with catatonic episodes, but the retrospective design cannot prove causation. The temporal association suggests cannabis may trigger catatonia in susceptible individuals.

Read the original research

Catatonic Episodes Related to Substance Use: A Cross-Sectional Study Using Electronic Healthcare Records.

Journal of dual diagnosis, 18(1), 52-58

View on PubMed ↗Publisher’s paper ↗

Citation

Yeoh, Su Ying; Roberts, Emmert; Scott, Fraser; Nicholson, Timothy R; David, Anthony S; Rogers, Jonathan P. (2022). Catatonic Episodes Related to Substance Use: A Cross-Sectional Study Using Electronic Healthcare Records.. Journal of dual diagnosis, 18(1), 52-58. https://doi.org/10.1080/15504263.2021.2016342