The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry. Prim Care Companion CNS Disord 2026;28(5):26f04222. Author affiliations are listed at the end of this article.
Importance: Catatonia is a neuropsychiatric syndrome characterized by abnormalities in motor behavior, speech, volition, and affect. Although historically associated with schizophrenia, contemporary diagnostic frameworks recognize catatonia as a transdiagnostic condition occurring across psychiatric, medical, and neurological disorders. Despite its potential for serious complications (including dehydration, autonomic instability, and malignant catatonia), the syndrome remains underrecognized in many clinical settings. Observations: A focused PubMed/MEDLINE search was conducted using combinations of keywords related to catatonia, diagnosis, and treatment. Publications from the past decade were prioritized, with foundational studies included when necessary for diagnostic instruments. Thirty PubMed-indexed studies were selected as the core evidence set and synthesized narratively due to heterogeneity in study design and outcome reporting. Across the literature, diagnosis consistently requires the presence of 3 or more characteristic psychomotor signs, with the Bush-Francis Catatonia Rating Scale representing the most widely used structured assessment tool. Epidemiologic studies estimate an annual incidence of approximately 5.15 cases per 100,000 persons, while prevalence may exceed 10% in psychiatric inpatient populations. Benzodiazepines, particularly lorazepam, remain first-line therapy with response rates ranging from 66 to 100%. Electroconvulsive therapy demonstrates response rates approaching 80-100% in severe or refractory cases. Conclusions: Catatonia is a highly treatable yet frequently missed syndrome. Improved recognition, systematic screening, and timely treatment remain essential to reducing morbidity and improving patient outcomes. Prim Care Companion CNS Disord 2026;28(5):26nr04231. Author affiliations are listed at the end of this article.
Objective: Greater severity of posttraumatic stress disorder (PTSD) symptoms has been linked to elevated C-reactive protein (CRP), a marker of systemic inflammation. The association between PTSD symptoms and CRP levels has been difficult to interpret due to confounding associations between CRP levels and medical comorbidities associated with PTSD and heterogeneity of trauma exposures and PTSD symptoms. The objective of this study was to characterize the relation between clinician-rated PTSD symptom dimensions, medical conditions, and CRP levels among individuals exposed to the World Trade Center (WTC) attacks. WTC rescue, recovery, and clean-up workers were recruited from the WTC Health Program General Responder Cohort. Methods: Participants were assessed using the Clinician-Administered PTSD Scale, completed a questionnaire about medical conditions, and underwent a morning fasting blood draw. Two multivariable binary logistic regression analyses were conducted to identify correlates of elevated CRP levels (>3 mg/dL) and associations between specific PTSD symptom dimensions and elevated CRP levels. Results: After adjusting for demographics, trauma exposure, and medical comorbidities, obesity (odds ratio [OR]=2.96; 95% CI [1.68, 5.21]), lower high-density lipoprotein cholesterol (OR=0.97; 95% CI [0.95, 0.99]), and greater severity of intrusive PTSD symptoms (OR=1.38; 95% CI [1.08, 1.75]) were associated with elevated CRP levels. Post hoc analyses revealed that, among intrusive symptoms, emotional reactivity to trauma cues was independently associated with elevated CRP levels (OR=1.50; 95% CI [1.15, 1.96]). Conclusions: The results suggest that intrusive PTSD symptoms may contribute to systemic inflammation in WTC responders. This finding suggests that targeting both PTSD symptoms and obesity/dyslipidemia may help mitigate risk for elevated systemic inflammation. Prim Care Companion CNS Disord 2026;28(5):25m04177. Author affiliations are listed at the end of this article.
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry. Prim Care Companion CNS Disord 2026;28(4):26f04201. Author affiliations are listed at the end of this article.
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry. Prim Care Companion CNS Disord 2026;28(4):26f04189. Author affiliations are listed at the end of this article.
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry. Prim Care Companion CNS Disord 2026;28(4):26f04188. Author affiliations are listed at the end of this article.
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry. Prim Care Companion CNS Disord 2026;28(4):26f04213. Author affiliations are listed at the end of this article.
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry. Prim Care Companion CNS Disord 2026;28(4):26f04194. Author affiliations are listed at the end of this article.
