Periodic Catatonia Marked by Hypercortisolemia and Exacerbated by the Menses: A Case Report and Literature Review

Table 1

Adrenal abnormalities in 8 published patients with periodic catatonia¹.

First author; Year	Country	Case	Age; & sex	Retrospective; diagnosis^2	Endocrine measure
Ashby [30]; 1952	England		38♀	Schizophrenia	Patient improved with ECT but urinary 17-ketosteroids unchanged
Gornall [31]; 1953	Canada	2	36♂	Schizophrenia	↓ urinary 17-ketosteroids during excited phase, normal in interval
		3	33♀	Schizophrenia	↑ urinary steroids during stupor phase, normal in interval
Cookson [32]; 1966	Canada		22♀	Schizophrenia	No relationship between ↑urinary 17-ketosteroids and stupor
Vesterggard [33]; 1969	USA	1	47♂	Schizophrenia	↓ urinary steroids during stupor
		2	40♂	Schizophrenia	↑ urinary steroids during stupor
		3	29♂	Schizophrenia	No relationship between urinary steroids and stupor
McCall [34]; 1989	USA		60♂	Idiopathic; recurrent catatonia^3	Lack of DST suppression during stupor, normalized with recovery

Eight patients were excluded as they did not have clearly distinct episodes of periodic catatonia, including two patients described by Gunne and Gemzell [35] and six patients (Cases 1, 2, 3, 4, 9, and 10) described by Hatotani et al. [36]. Case 1 by Gornall et al. [31] and Cases 5, 6, 7, and 8 by Hatotani et al. [36] are not included among the 16 patients with measures of adrenal function, due to lack of these measures.
²Retrospective DSM-5 diagnoses by agreement between two of the authors.
³There is no family history of catatonia but the patient’s symptoms appeared similar to our patient. As a matter of fact, the patient had some “preoccupation with guilt and punishment” as did our patient.