Organic catatonic disorder is a disorder of diminished (stupor) or increased (excitement) psychomotor activity associated with catatonic symptoms. Additionally; The extremes of psychomotor disturbance may alternate. [2]
According to the ICD-10 (F06.1) disorder of either diminished (stupor) or increased (excitement) psycho-motor activity associated with catatonic symptoms.
Generally; The extremes of psycho-motor disturbance may alternate. [2] In detail; The presence of other catatonic symptoms and signs increases the confidence in the diagnosis. [1]
In brief; Complete absence of speech.
Maintenance of a rigid posture against efforts to be moved.
An apparently motiveless resistance to all commands and attempts either to be moved, or doing just the opposite.
Voluntary assumption of an inappropriate also often bizarre posture for long periods of time.
Akinesis (no movement) with mutism but with evidence of relative preservation of conscious awareness.
Repetition, echo or mimic king of either phrases or words heard.
Repetition, echo or mimic king of actions observed.
In detail; Parts of body can be placed in positions that will be maintained for long periods of time, even if very uncomfortable; flexible like wax.
Due to ambivalence, conflicting impulses and tentative actions are made, but no goal directed action occurs, e.g. on asking to take out tongue, tongue is slightly protruded but taken back again
Such as mannerisms, stereotypies (verbal also behavioural), automatic obedience (commands are followed automatically, irrespective of their nature) and verbigeration (incomprehensible speech). [1]
According to the ICD-10(F06.1), the following features are required for the diagnosis of organic catatonic disorder, additionally to the general guidelines for the diagnosis of other organic mental disorders, described earlier:
1. Stupor (diminution or complete absence of spontaneous movement with partial or complete mutism, negativism, also rigid posturing).
2. Excitement (gross hyper-motility either with or without a tendency to assaultiveness).
3. Mixed (shifting rapidly also unpredictably from hypo- to hyperactivity). [1]
1. Treatment of the underlying cause, if amenable to treatment.
2. Symptomatic treatment with low dose of a short acting benzodiazepine (e.g. Lorazepam), or electroconvulsive therapy (if needed).
Anti-psychotics should usually be avoided as they can make catatonic features worse; however small doses of atypical anti-psychotics such as Risperidone, Olanzapine, Aripiprazole or Quetiapine can be used with care. [1]
It is a disorder of diminished (stupor) or increased (excitement) psychomotor activity associated with catatonic symptoms.
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