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Abstract Various definitions have been applied to catatonia in medicine in general and clinical psychiatry in particular. The word catatonia is of Greek origin for tension insanity, a concept developed by Kahlbaum to describe a new illness. His concept of catatonia was later marginalized by Kraepelian psychiatry to a subtype of schizophrenia. Also, three subtypes have been described: Retarded, excited and malignant. Risk factors for catatonia may include both predisposing and precipitating factors. The precipitating factors may interplay with the predisposing factors to lead to the catatonia phenotype. Moreover, the presentation of a patient with catatonia is not fixed and may vary from interview to another and the patients are often cachectic and disheveled. The characteristic motor signs of catatonia include mannerisms, stereotypy, festination, athetotic movements, dyskinesia, posturing, catalepsy, waxy flexibility (flexibilitas cerea), rigidity, sudden muscular tone alterations, gegenhalten and akinesia. The characteristic affective features include compulsive emotions, emotional lability, anxiety, impulsivity, aggression, excitement, agitation, flat affect, affective latency, ambivalence and staring. The cognitive-behavioral catatonic features include grimacing, verbigeration, perseveration, abnormal speech, automatic obedience, echolalia or echopraxia, Mitgehen or Mitmachen, compulsive behavior, negativism, autism or withdrawal, mutism, stupor, loss of vegetative abnormalities. Furthermore, the first line of treatment for catatonia is generally benzodiazepines and BST sessions. |