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Spysschaert Y, Dhossche D, Sienaert P. [Catatonia in childhood and adolescence: obstacles to diagnosis and treatment]. Tijdschr Psychiatr 2016; 58:371-379. [PMID: 27213636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Catatonia in children and adolescents is the same as it is for adults; in other words it is a recognisable psychomotor syndrome that follows a characteristic course and responds favourably to treatment with benzodiazepines and/or ect. Therefore, one would not expect to encumber many obstacles to diagnosis and treatment. In fact, the obstacles are fairly numerous. AIM To explore the obstacles that can hinder a simple approach to diagnosis and treatment and to provide support for the clinicians involved. METHOD We studied the literature systematically using Limo and keywords. RESULTS For several decades, particularly in the literature, catatonia was defined as a subtype of schizophrenia. This exclusive link to schizophrenia led to the under-diagnosis of catatonia in patients with other psychiatric conditions and to delays in the administration of the correct treatment. Not only this historical error but also other important problems are complicating the approach to catatonia even today. Among other factors hindering diagnosis and treatment are the belief that catatonia is a rare illness, often denied by family members and some clinicians, the use of neuroleptics and the stigmatisation of benzodiazepines and/or ect. CONCLUSION Controversy about catatonia continues. Although diagnosis and treatment are clearly defined, catatonia is still putting professionals to the test. In our essay we offer some practical guidance and advice.
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Abstract
Catatonia is a motor dysregulation syndrome described by Karl Kahlbaum in 1874. He understood catatonia as a disease of its own. Others quickly recognized it among diverse disorders, but Emil Kraepelin made it a linchpin of his concept of dementia praecox. Eugen Bleuler endorsed this singular association. During the 20th century, catatonia has been considered a type of schizophrenia. In the 1970s, American authors identified catatonia in patients with mania and depression, as a toxic response, and in general medical and neurologic illnesses. It was only occasionally found in patients with schizophrenia. When looked for, catatonia is found in 10% or more of acute psychiatric admissions. It is readily diagnosable, verifiable by a lorazepam challenge test, and rapidly treatable. Even in its most lethal forms, it responds to high doses of lorazepam or to electroconvulsive therapy. These treatments are not accepted for patients with schizophrenia. Prompt recognition and treatment saves lives. It is time to place catatonia into its own home in the psychiatric classification.
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Affiliation(s)
- Max Fink
- Department of Psychiatry and Neurology, Stony Brook University, Long Island, NY 11780, USA.
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Abstract
To provide a rational basis for reconceptualizing catatonia in Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), we briefly review historical sources, the psychopathology of catatonia, and the relevance of catatonic schizophrenia in contemporary practice and research. In contrast to Kahlbaum, Kraepelin and others (Jaspers, Kleist, and Schneider) recognized the prevalence of motor symptoms in diverse psychiatric disorders but concluded that the unique pattern and persistence of certain psychomotor phenomena defined a "catatonic" subtype of schizophrenia, based on intensive long-term studies. The enduring controversy and confusion that ensued underscores the fact that the main problem with catatonia is not just its place in Diagnostic and Statistical Manual of Mental Disorders but rather its lack of conceptual clarity. There still are no accepted principles on what makes a symptom catatonic and no consensus on which signs and symptoms constitute a catatonic syndrome. The resulting heterogeneity is reflected in treatment studies that show that stuporous catatonia in any acute disorder responds to benzodiazepines or electroconvulsive therapy, whereas catatonia in the context of chronic schizophrenia is phenomenologically different and less responsive to either modality. Although psychomotor phenomena are an intrinsic feature of acute and especially chronic schizophrenia, they are insufficiently recognized in practice and research but may have significant implications for treatment outcome and neurobiological studies. While devising a separate category of catatonia as a nonspecific syndrome has heuristic value, it may be equally if not more important to re-examine the psychopathological basis for defining psychomotor symptoms as catatonic and to re-establish psychomotor phenomena as a fundamental symptom dimension or criterion for both psychotic and mood disorders.
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Affiliation(s)
- Gabor S Ungvari
- Department of Psychiatry, Chinese University of Hong Kong,Hong Kong SAR, China.
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Affiliation(s)
| | - Rajiv Tandon
- Department of Psychiatry, University of Florida College of Medicine
| | - Juan Bustillo
- Department of Psychiatry, University of New Mexico
- Department of Neurosciences, University of New Mexico
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Stöber G, Kohlmann B, Siekiera M, Rubie C, Gawlik M, Möller-Ehrlich K, Meitinger T, Bettecken T. Systematic mutation analysis of KIAA0767 and KIAA1646 in chromosome 22q-linked periodic catatonia. BMC Psychiatry 2005; 5:36. [PMID: 16225677 PMCID: PMC1274336 DOI: 10.1186/1471-244x-5-36] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Accepted: 10/14/2005] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Periodic catatonia is a familial subtype of schizophrenia characterized by hyperkinetic and akinetic episodes, followed by a catatonic residual syndrome. The phenotype has been evaluated in two independent genome-wide linkage scans with evidence for a major locus on chromosome 15q15, and a second independent locus on chromosome 22qtel. METHODS In the positional and brain-expressed candidate genes KIAA0767 and KIAA1646, we searched for variants in the complete exons and adjacent splice-junctions as well as in parts of the 5'- and 3'-untranslated regions by means of a systematic mutation screening in individuals from chromosome 22q-linked pedigrees. RESULTS The mutation scan revealed 24 single nucleotide polymorphisms, among them two rare codon variants (KIAA0767: S159I; KIAA1646: V338G). However, both were neither found segregating with the disease in the respective pedigree nor found at a significant frequency in a case-control association sample. CONCLUSION Starting from linkage signals at chromosome22qtel in periodic catatonia, we screened two positional brain-expressed candidate genes for genetic variation. Our study excludes genetic variations in the coding and putative promoter regions of KIAA0767 and KIAA1646 as causative factors for periodic catatonia.
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Affiliation(s)
- Gerald Stöber
- Department of Psychiatry and Psychotherapy, University of Würzburg, Füchsleinstraße 15, 97080 Würzburg, Germany
| | - Bernd Kohlmann
- Department of Psychiatry and Psychotherapy, University of Würzburg, Füchsleinstraße 15, 97080 Würzburg, Germany
- Department of Child and Youth Psychiatry and Psychotherapy, University of Würzburg, Füchsleinstraße 15, 97080 Würzburg, Germany
| | - Markus Siekiera
- Department of Psychiatry and Psychotherapy, University of Würzburg, Füchsleinstraße 15, 97080 Würzburg, Germany
| | - Claudia Rubie
- Department of Psychiatry and Psychotherapy, University of Würzburg, Füchsleinstraße 15, 97080 Würzburg, Germany
- Department of General, Vascular and Paediatric Surgery, University of the Saarland, Homburg/Saar 66421, Germany
| | - Micha Gawlik
- Department of Psychiatry and Psychotherapy, University of Würzburg, Füchsleinstraße 15, 97080 Würzburg, Germany
| | - Kerstin Möller-Ehrlich
- Department of Psychiatry and Psychotherapy, University of Würzburg, Füchsleinstraße 15, 97080 Würzburg, Germany
| | - Thomas Meitinger
- Institute of Human Genetics, Technical University of Munich & GSF Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
| | - Thomas Bettecken
- Institute of Human Genetics, Technical University of Munich & GSF Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
- Max-Planck Institute of Psychiatry, Kraepelinstr. 2–10, 80804 Munich, Germany
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Abstract
Two views of catatonia influence clinical practice. In the classical European view, adopted by DSM classifications, the signs of catatonia indicate a form of schizophrenia. In the syndromal view, the signs of catatonia are motor signs that are readily identified in many psychiatric disorders. Catatonia is a parallel behavior phenomenon to delusions (in thought) and delirium (in cognition). The syndromic view includes the neuroleptic malignant syndrome. It encourages a different treatment algorithm, the use of benzodiazepines and electroconvulsive therapy, to replace the customary use of antipsychotic drugs alone. The benefits of such treatment warrant the recommended change in concept and classification.
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Affiliation(s)
- M Fink
- SUNY at Stony Brook, New York, USA.
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Abstract
OBJECTIVE To evaluate the relationships of symptoms of catatonic schizophrenia to 77 symptoms relevant for diagnosing schizophrenia and to socioanamnestic variables. METHOD Data from a sample of 112 Canadian patients diagnosed with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) were evaluated via phi correlation coefficients. RESULTS Forty-five (40.2%) of our 112 patients had catatonic symptoms, either at the time of this study or in the past. However, only weak correlations (phi < 0.31) to other symptoms relevant for diagnosing schizophrenia were found, and no significant correlations to socioanamnestic variables were found. CONCLUSION Symptoms of catatonia appear to be independent of the key symptoms of schizophrenia.
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Affiliation(s)
- Z Z Cernovsky
- Department of Psychiatry, University of Western Ontario, London.
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Bengel D, Balling U, Stöber G, Heils A, Li SH, Ross CA, Jungkunz G, Franzek E, Beckmann H, Riederer P, Lesch KP. Distribution of the B33 CTG repeat polymorphism in a subtype of schizophrenia. Eur Arch Psychiatry Clin Neurosci 1998; 248:78-81. [PMID: 9684916 DOI: 10.1007/s004060050021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Clinical evidence for a dominant mode of inheritance and anticipation in periodic catatonia, a distinct subtype of schizophrenia, suggests that trinucleotide repeat expansions may be involved in the aetiology of this disorder. Since genes with triplet repeats are putative canditates for causing schizophrenia, we have analysed the polymorphic B33 CTG repeat locus on chromosome 3 in 45 patients with periodic catatonia and 43 control subjects. The B33 CTG repeat locus was highly polymorphic, but all alleles in both the patient and control groups had repeat lengths within the normal range. We conclude that susceptibility to periodic catatonia is not influenced by variation at the B33 CTG repeat locus. Nevertheless, that periodic catatonia displays dominant inheritance and anticipation, characteristic of genetic disorders involving trinucleotide repeats, justifies further screening for triplet repeat expansions in this illness.
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Affiliation(s)
- D Bengel
- Department of Psychiatry, University of Würzburg, Germany
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Abstract
BACKGROUND To determine the motor characteristics of chronic catatonia, catatonia and other motor disorders were systematically rated in a long-term hospitalized sample. METHOD Chronically hospitalized psychiatric inpatients (N = 42) with a clinical diagnosis of catatonic schizophrenia (295.2X) were rated for catatonia with a novel 23-item catatonia rating scale, and for parkinsonism, dyskinesia and akathisia using standard rating scales with scale-based criteria for case definition. RESULTS Catatonia was the sole motor syndrome in nine cases (21%), co-existed with parkinsonism in five (12%), tardive dyskinesia in four (10%), and both parkinsonism and tardive dyskinesia in 10 (24%). There was no correlation between total scores across the four rating scales. 'Rigidity' was the sole catatonic sign which overlapped with other scales. The symptom profile of catatonia in this chronic sample was similar to previous reports based on acutely ill patients. CONCLUSION Catatonia is distinguishable from other motor disorders in chronic psychiatric patients using the 23-item catatonia rating scale. The features of chronic catatonia are described, and the distribution of catatonic signs is similar for chronic and acute catatonia.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Akathisia, Drug-Induced/classification
- Akathisia, Drug-Induced/diagnosis
- Akathisia, Drug-Induced/psychology
- Antipsychotic Agents/adverse effects
- Antipsychotic Agents/therapeutic use
- Chronic Disease
- Diagnosis, Differential
- Dyskinesia, Drug-Induced/classification
- Dyskinesia, Drug-Induced/diagnosis
- Dyskinesia, Drug-Induced/psychology
- Female
- Humans
- Long-Term Care
- Male
- Middle Aged
- Muscle Rigidity/chemically induced
- Muscle Rigidity/classification
- Muscle Rigidity/diagnosis
- Muscle Rigidity/psychology
- Neurologic Examination
- Parkinson Disease, Secondary/chemically induced
- Parkinson Disease, Secondary/classification
- Parkinson Disease, Secondary/diagnosis
- Parkinson Disease, Secondary/psychology
- Patient Admission
- Psychomotor Disorders/chemically induced
- Psychomotor Disorders/classification
- Psychomotor Disorders/diagnosis
- Psychomotor Disorders/psychology
- Schizophrenia, Catatonic/classification
- Schizophrenia, Catatonic/diagnosis
- Schizophrenia, Catatonic/psychology
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Affiliation(s)
- G Bush
- Department of Psychiatry and Behavioral Science, SUNY at Stony Brook 11794, USA
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Stöber G, Jungkunz G, Franzek E, Beckmann H. [Manneristic catatonia. A psychotropic drug refractory chronic progressive course]. Fortschr Neurol Psychiatr 1996; 64:250-60. [PMID: 8765891 DOI: 10.1055/s-2007-996393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Manneristic catatonia, one form of Leonhard's systematic schizophrenias, is illustrated in nine case notes. The essential syndrome of this rare disorder (described by Leonhard in the preneuroleptic era) consisted in mannerisms and progressive stiffness of psychomotor activity. Mannerisms often developed from obsessive and compulsive ideas; whereas distress disappeared, repetitive behavior developed into a stereotype. Complex movements (e.g. not to shake hands; mutism) became mannerisms. With disease progression stiffness of facial expression and gestures and an impairment of voluntary motor activity became increasingly prominent. There were no signs of (neuroleptic-induced) parkinsonism. Manneristic catatonia affects preponderantly men and exhibits an early age of onset (median: 23 years). In none of the cases a family history of psychiatric illness was noted. Severe obstetric and birth complications as well as the high prevalence of supratentorial and cerebellar CT/MR abnormalities in this patient group point to deviations of prenatal brain maturation. The median yearly dose of neuroleptics was 83.1 g chlorpromazin equivalents. The characteristic psychopathology was not essentially influenced by modern psychopharmacological treatment neither in the beginning nor in the long run irrespective of the time of onset of the disease. Continuous high-dose neuroleptic treatment is not efficacious in this distinct group of systematic schizophrenias. Behavioural training in a rehabilitation unit is the treatment of choice from the early beginning.
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Affiliation(s)
- G Stöber
- Psychiatrische Klinik mit Poliklinik, Universität Würzburg
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Northoff G, Krill W, Wenke J, Travers H, Pflug B. [The subjective experience in catatonia: systematic study of 24 catatonic patients]. Psychiatr Prax 1996; 23:69-73. [PMID: 8657812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Catatonic patients are often not able to communicate their subjective experiences behind their "fassade of immobility." Therefore was retrospectively (3 weeks later) investigated subjective experiences in 24 catatonic patients with a self-assessment-scale especially for catatonia developed by us. Our results showed that catatonic patients subjectively experience less their altered movements but rather cognitive, i.e. ambivalence, or affective, i.e. intense emotions which couldn't be controlled, alterations. According to our results we were able to distinguish an emotive (intense anxiety) from a non-emotive, i.e. cognitive (predominating ambivalence), subtype in catatonia with regard to subjective experience.
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Affiliation(s)
- G Northoff
- Universität Frankfurt, Abteilung für Klinische Psychiatrie II, Frankfurt am Main
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Lee JW. Catatonia and ECT. Aust N Z J Psychiatry 1994; 28:690-1. [PMID: 7794213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Abstract
OBJECTIVE The authors sought to clarify differences in outcome and familial psychopathology among the classical subtypes of schizophrenia. METHOD In the epidemiologically based Roscommon Family Study, personal interviews were conducted with 88% of traceable living probands (N = 415) an average of 16 years after illness onset and with 86% of traceable living first-degree relatives (N = 1,753). Probands meeting the DSM-III-R criteria for schizophrenia were subtyped by DSM-III-R and ICD-9. RESULTS By both diagnostic systems, age at onset differed significantly across subtypes, being earliest in the subjects with the hebephrenic and catatonic subtypes and latest in the paranoid subjects. The probands with the paranoid subtype had substantially better outcome, especially in occupational functioning and capacity for self-care. The DSM-III-R criteria for paranoid schizophrenia were considerably more successful than the ICD-9 criteria in selecting good-outcome cases. Neither the risk for schizophrenia nor the risk for schizophrenia spectrum disorders significantly differed in relatives as a function of the proband subtype. The subtypes of schizophrenia did not "breed true" within families. CONCLUSIONS Paranoid schizophrenia, especially when narrowly defined, as in DSM-III-R, has a substantially better outcome than other subtypes. From a familial perspective, 1) paranoid schizophrenia is not a milder form of schizophrenia and 2) catatonic schizophrenia is probably closely related to typical schizophrenia. The subtypes of schizophrenia are not, from a familial perspective, etiologically distinct syndromes.
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MESH Headings
- Adult
- Age of Onset
- Comorbidity
- Family
- Female
- Follow-Up Studies
- Humans
- Ireland/epidemiology
- Male
- Mental Disorders/diagnosis
- Mental Disorders/epidemiology
- Outcome Assessment, Health Care
- Prevalence
- Probability
- Psychiatric Status Rating Scales
- Schizophrenia/classification
- Schizophrenia/diagnosis
- Schizophrenia/epidemiology
- Schizophrenia, Catatonic/classification
- Schizophrenia, Catatonic/diagnosis
- Schizophrenia, Catatonic/epidemiology
- Schizophrenia, Disorganized/classification
- Schizophrenia, Disorganized/diagnosis
- Schizophrenia, Disorganized/epidemiology
- Schizophrenia, Paranoid/classification
- Schizophrenia, Paranoid/diagnosis
- Schizophrenia, Paranoid/epidemiology
- Sex Factors
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Affiliation(s)
- K S Kendler
- Department of Psychiatry and Human Genetics, Medical College of Virginia, Richmond 23298-0710
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Abstract
Age at onset and sex differences in the age at onset were investigated in the schizophrenic subtypes of 200 patients. Significant differences in the age at onset were observed among these subtypes; the disorganized subtype demonstrated the earliest and the paranoid the latest onset. The mean age at onset of all female patients was significantly greater than that of the male. Specifically, in the paranoid subtype the onset for men occurred earlier than for women. Conversely, in the disorganized subtype the disorder appeared earlier in women. There was no significant sex difference in the age at onset in the undifferentiated and the residual subtypes. In the paranoid subtype most men developed the disease before age 30 (72%), whereas women had an even distribution of the onset before and after 30. Ninety-six patients admitted for the first time demonstrated findings similar to those of the total sample. The data provide additional information on the phenotypic expression of the subtypes of schizophrenic disorders and indicate the necessity for further demographic and genetic studies to delineate the underlying defect.
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Affiliation(s)
- S Beratis
- Dept. of Psychiatry, University of Patras Medical School, Greece
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Inoue S. Hebephrenia as the most prevalent subtype of schizophrenia in Japan. Jpn J Psychiatry Neurol 1993; 47:505-14. [PMID: 8301863 DOI: 10.1111/j.1440-1819.1993.tb01792.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The author reviewed the frequency of the hebephrenic subtype compared to the paranoid subtype diagnosis of schizophrenia in Japan, using research papers and statistical reports that have been published during this century. It was found that the reported rates for the hebephrenic subtype ranged from a low of 23% to a high of 68% with the majority falling between 30% and 50%. These rates had not varied significantly over a long period of time or across wide geographical areas. It was discussed that Japanese psychiatrists were so sensitive to the negative symptoms of schizophrenia that they had a broader concept of hebephrenia as compared to other Kraepelian subtypes in schizophrenia.
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Affiliation(s)
- S Inoue
- Department of Neuropsychiatry, Kochi Medical School, Nankoku, Japan
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Abstract
Although catatonic features can be seen in various psychiatric and organic disorders, some patients with catatonia cannot be fitted into existing classification systems. In the current study various sociodemographic and clinical variables were compared between patients who presented with catatonia only (idiopathic catatonia), or with catatonia as a symptom of an identifiable underlying functional disorder. Patients seen over one year (1988) were classified into idiopathic catatonia (n = 30) and according to diagnosis (n = 35; schizophrenia n = 19, depression n = 16). There was an excess of females in the idiopathic group and the illness was of a shorter duration. There were no other differences between the groups. All subjects showed good response to ECTs and required almost the same mean number of ECTs. No clusters were observed using the average method. The current study suggests that catatonic symptoms can occur in the absence of any other identifiable psychiatric syndrome, although they cannot be otherwise differentiated from other psychiatric syndromes in which catatonia can present.
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Affiliation(s)
- V Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
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Abstract
In a recent article, Andreasen and Flaum (Schizophrenia Bulletin, Vol. 17, No. 1, 1991) argued that greater emphasis should be placed on negative symptoms in the diagnosis of schizophrenia, leading to a less important role for positive symptoms. This article presents a counter-argument to this view. Positive symptoms are common and reliable and therefore highly useful diagnostically. First-rank symptoms, although not specific to schizophrenia, show good discriminability. No other type of symptom or investigative method can make such claims to usefulness. Although positive symptoms do not predict outcome, this is not a necessary function of diagnostic criteria. The predictive power of negative symptoms is, in any case, based largely on studies of patients with chronic disorder. Premorbidly impaired social development may interact with schizophrenia, worsening the prognosis. We believe positive symptoms have always been the essence of psychiatric disorder and should remain so. Increasing the diagnostic weight given to negative symptoms risks restricting the definition of schizophrenia excessively.
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Affiliation(s)
- A S David
- Dept. of Psychological Medicine, King's College Hospital, London, United Kingdom
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Abstract
The classification 'psychomotor psychoses' goes back to Wernicke, Kleist and Leonhard. The incidence of psychomotor deficiencies is a typical trait. The motility psychoses (a form of the cycloid psychosis), the periodical catatonia (a form of unsystematic schizophrenias) and the catatonic forms of systematic schizophrenias belong to the group of 'psychomotor psychoses'. To some extent they correspond with the 'catatonic type' according to DSM-III (295.2). The number of children and adolescents with psychomotor psychoses, who were examined by Leonhard and Neumärker have shown beside different clinical-psychopathological features a significant difference as regards the age-related manifestation of each psychomotor psychosis.
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Affiliation(s)
- K J Neumärker
- Klinik und Poliklinik für Neurologie und Psychiatrie, Medizinische Fakultät (Charité), Humboldt-Universität zu Berlin, Germany
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Abstract
The validity of the current systems of classification of endogenous psychoses has not yet been unambiguously demonstrated using the criterion of prognosis. An alternative to these systems may be seen in the Leonhard classification of endogenous psychoses. In a catamnestic study, 93% of the initial diagnoses and prognoses made between 1969 and 1973 could be confirmed in 1986.
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Affiliation(s)
- S von Trostorff
- Psychiatric and Neurological Clinic, Humboldt University, Berlin, Germany
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Amore M. [The catatonic dilemma]. Minerva Psichiatr 1989; 30:233-50. [PMID: 2695729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In discussing some clinical cases the paper suggests an interpretation of catatonic syndrome based on the original and main characteristics of this psychopathological condition. Kahlbaum described this disease underlining the "affective" symptoms, but since then, catatonia has been considered a schizophrenic syndrome. The paper proposes a definition of catatonia based on Kahlbaum's earlier view in which the complex of psychomotor disturbances can be seen as the expression of schizophrenia, bipolar psychoses or of a specific cyclic disease.
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Abstract
A classification of chronic psychoses including nonparanoid schizophrenia, paranoid schizophrenia, paranoid state and paranoia (delusional disorder) is presented. This classification is dependent on a systematic increase in number of symptoms with each group. In particular, delusional disorder is examined with regard to family history. It is clear from the data which are presented that delusional disorder is more likely to be associated with a family history of such traits as suspiciousness, jealousy, secretiveness, and the presence of paranoid behavior or delusions. There is evidence that such familial traits are not seen in schizophrenia, only in delusional disorder.
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Abstract
The authors examined the reliability, frequency, concordance, and demographic characteristics of subtypes of schizophrenia in patients from the Iowa 500 study as defined by four major diagnostic systems: DSM-III, Research Diagnostic Criteria (RDC), ICD-9, and the Tsuang-Winokur criteria. Reliability was higher in diagnostic systems with operationalized than in those with unoperationalized criteria and consistently higher for the paranoid subtype. The frequency of individual subtypes varied widely for the different systems. Concordance for subtype diagnoses between systems ranged from quite high to quite low. Demographic characteristics of the individual subtypes were similar according to all systems.
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Peters UH. [Laing's negative model of dementia (author's transl)]. Nervenarzt 1977; 48:478-82. [PMID: 917158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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