Published online by Cambridge University Press: 31 July 2009
Few phenomena in psychiatry or neurology are as enigmatic as catatonia. This is a fact in large part due to the many contradictions surrounding the concept. Catatonia has been described as a disease, but also as a syndrome. It has been considered to be a subtype of schizophrenia, and yet has been claimed to be more common in affective disorders. It has been reported to be both caused and ameliorated by neuroleptic drugs. It has been reported to represent a state of stupor so profound that its sufferers die from medical complications, and has also been reported to represent a state of excitement so marked that physical restraints are necessary.
(Lohr and Wisniewski, 1987: 201)Catatonia is a cluster of motor features that appears in many recognized psychiatric illnesses. The classic signs are mutism, a rigid posture, fixed staring, stereotypic movements, and stupor. Catatonia was initially described in the first half of the 19th Century, but its name and our ideas about it are credited to the German psychopathologist Karl Ludwig Kahlbaum. In psychiatric disease classifications (such as the American Psychiatric Association's Diagnostic Statistical Manual and the World Health Organization's International Classification of Diseases), catatonia is traditionally linked to schizophrenia (American Psychiatric Association, 1952, 1980, 1987, 1994; World Health Organization, 1992). Today, however, we recognize that catatonia consists of identifiable and quantifiable motor signs that are part of a broad psychopathology that includes most of the major diagnostic classes.
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