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Catatonia in a woman who is profoundly deaf-mute: case report

  • Gbolagade Sunmaila Akintomide (a1), Stuart Williams Porter (a1) and Anita Pierce (a1)

Catatonia is a common but underrecognised complication of bipolar disorder, with a quarter of in-patients with bipolar disorder developing catatonia. Almost 9 million people in the UK are deaf or have a significant hearing problem and British Sign Language is the preferred language of 50 000–70 000 people within the UK. Between 1 and 2% of these individuals (i.e. the same as in the rest of the population) will experience bipolar disorder in their lifetime and therefore the accurate diagnosis of catatonia is important. We report a case of catatonia presenting with dysphagia in a woman who is profoundly deaf–mute and who has bipolar disorder. This report highlights some modifications of presentation and difficulties of accurate diagnosis and management of catatonia in this patient. To the best of our knowledge, this is the first case report of catatonia in someone who is profoundly deaf–mute.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Gbolagade Sunmaila Akintomide (
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Catatonia in a woman who is profoundly deaf-mute: case report

  • Gbolagade Sunmaila Akintomide (a1), Stuart Williams Porter (a1) and Anita Pierce (a1)
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"Deaf-mute" - time to abandon stigmatisation of the deaf community.

Sara L. Adshead, Consultant Psychiatrist, Leamington Spa
15 November 2012

I was dismayed to read Akintomide et al's reference to the subject oftheir case review as being 'profoundly deaf-mute'

'Deaf-mute' is an out-dated term originating in the 18/19th century. It carries very derogatory connotations, and is no longer used in reference to individuals with profound deafness.

The term 'mute' implies a lack of ability to make noise. Such a labelis technically inaccurate when applied to Deaf individuals, since they generally have functioning vocal chords and therefore retain the ability to make vocalisations.(1)

Those who are profoundly Deaf from early life struggle to develop an oral language, given that hearing is required to facilitate a modulation of one's voice into speech. Many will therefore employ non-verbal communication in the form of sign language instead. This is a complex combination of hand signals, with its own regional dialects and international differences.

Over 75 000 people in Britain currently possess British Sign Language(BSL) as their first or preferred language. The majority of these sign language users consider themselves as members of a distinct cultural community with a strong social identity.(2)

To this day the social image of deafness remains impaired on an international scale. This manifests itself in the form of a deeply rooted pathological stigma, negative stereotypes and prejudiced attitudes towardsthe Deaf.(3)

It would seem that such ignorance also persists among health professionals. In a study conducted by Ralston et al the attitudes of 165 Physicians were surveyed, and a significant difference in attitudes towards hearing patients as compared to their Deaf counterparts was identified.(4)

Munoz-Baell and Ruiz suggest that much of the stigma relating to the Deaf community arises from an extensive social lack of appreciation of both their communication mechanisms and their culture.(3) Unfortunately, in spite of more recent advances in healthcare legislation,(5) it would appear that there is still some way to go before members of the Deaf community achieve the equality of health and social standing to which theyare entitled.

The summary for this paper states that it is the first published casereport of catatonia in someone who is profoundly Deaf. It is a shame therefore that, rather than taking the opportunity to present a positive reflection of managing patients with profound deafness, the authors have merely succeeded in perpetuating existing negative stereotypes about this sector of the population.

Sara L. Adshead, Consultant Psychiatrist, Leamington Spa (formerly Locum Consultant Psychiatrist National Deaf Mental Health Service, Birmingham) References:

1. World Federation of the Deaf

2. Adshead S, du Feu M. Mental health service provision for the Deaf community. Progress in Neurology and Psychiatry 2005; 9(7) 26-30

3. Munoz-Baell I M, Ruiz M T. Empowering the deaf. Let the deaf be deaf. Journal of Epidemiology and Community Health 2000;54:40-44

4. Ralston E, Zazove P, Gorenflo DW. Physicians' attitudes and beliefs about deaf patients. The Journal of the American Board of Family Practice 1996 9(3): 167-173

5. Department of Health. Towards equity and access. Crown Copyright, 1999

NB Deaf is used in reference to those born Deaf whose first language is BSL.deaf is used as a generic term, and for those with acquired deafness whoseprimary form of communication is oral.

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Conflict of interest: None declared

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