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Published online by Cambridge University Press: 31 July 2009
von Baer made the rueful remark that all new and truly important ideas must pass through three stages: first dismissed as nonsense, then rejected as against religion, and finally acknowledged as true, with the proviso from initial opponents that they knew it all along.
Gould, 2001We define and describe catatonia from a clinician's perspective. We detail how to identify it reliably, to seek its causes, and to best treat it, regardless of the severity or the variations in its presentation. If it seems that most of the patients with catatonia that we discuss had miraculous relief and resolution of the underlying disease process, it is not a misperception, nor a misleading selection of clinical vignettes. The majority of patients with catatonia we have treated get “all better.” “All better” is a phrase rarely used in discussions of patients with behavior syndromes. But, if quickly identified and properly treated, “all better” is the frequent response for catatonia. We have presented 51 patient vignettes. Of these, 15 were treated with barbiturates or benzodiazepines, nine successfully; 23 with ECT, 20 successfully; and seven successfully with lithium or anticonvulsants. With that favorable experience in mind, what do we know about this remarkable condition that supports our ability to treat it so well, and what does its study teach us?
Catatonia is a stable syndrome
We know that catatonia is a psychopathological syndrome similar to delirium and delusions. Delirium results from altered arousal and is a feature of many disorders.
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