Catatonia and Elevated Mortality: A Population-Wide Cohort Study With Healthy, Sibling, and Schizophrenia Spectrum Controls

Authors

• Chih-Wei Hsu
• Yang-Chieh Brian Chen
• Marco Solmi
• Chih-Sung Liang
• Mu-Hong Chen
• Yao-Hsu Yang
• Liang-Jen Wang
• Edward Chia-Cheng Lai

Language

English

Publication Date

2-1-2026

Journal

Psychiatry and Clinical Neurosciences

DOI

10.1111/pcn.13915

PMID

41230727

PMCID

PMC12866368

PubMedCentral® Posted Date

11-13-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Aim: To determine whether catatonia is associated with increased long-term all-cause and cause-specific mortality.

Methods: Using Taiwan's National Health Insurance Database (2000-2022), we assembled a population-based cohort of all adults (≥18 years) with catatonia and matched each to four controls without catatonia on sex and birthdate. Mortality was compared between (1) individuals with catatonia and their unaffected siblings and (2) individuals with schizophrenia spectrum disorders with catatonia and those with schizophrenia spectrum disorders without catatonia. The primary outcome was all-cause mortality; secondary outcomes were natural- and unnatural-cause deaths. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated with Cox models controlling for age, sex, socioeconomic status, urbanization level, and comorbidities.

Results: We included 6642 individuals with catatonia and 26,568 matched controls. Over mean follow-ups of 11.4 and 13.1 years, respectively, 2150 versus 3459 deaths occurred (adjusted HR 2.60, 95% CI 2.46-2.75). Risks were higher for natural causes (2.42, 2.28-2.57) and unnatural causes (5.57, 4.59-6.77). Compared with unaffected siblings, catatonia remained associated with excess all-cause (1.82, 1.34-2.49), natural (1.57, 1.07-2.30), and unnatural mortality (2.73, 1.56-4.77). Within schizophrenia spectrum disorders, catatonia conferred higher all-cause (1.20, 1.12-1.28) and natural mortality (1.27, 1.18-1.36), whereas unnatural mortality was similar (1.01, 0.87-1.17).

Conclusions: Catatonia conferred a substantial, independent risk of premature mortality across multiple causes. Clinicians should recognize that catatonia is a serious disorder with long-term consequences and should remain vigilant to prevent and manage complications beyond the acute episode.

Keywords

Humans, Catatonia, Male, Female, Adult, Schizophrenia, Taiwan, Middle Aged, Siblings, Young Adult, Cohort Studies, Cause of Death, Aged, catatonic, death, natural causes, suicide, unnatural causes

Published Open-Access

yes

Recommended Citation

Hsu, Chih-Wei; Chen, Yang-Chieh Brian; Solmi, Marco; et al., "Catatonia and Elevated Mortality: A Population-Wide Cohort Study With Healthy, Sibling, and Schizophrenia Spectrum Controls" (2026). Children’s Nutrition Research Center Staff Publications. 408.
https://digitalcommons.library.tmc.edu/staff_pub/408