REVIEW The Catatonia Syndrome Forgotten but Not Gone

C atatonia is a motor dysregulation syndrome among psychiatric asylum patients thatwas delineated in 1874. The syndrome was so well characterized that within a fewyears its prevalence among psychiatric populations was reported from 6 % to 38%,averaging 15 % of hospitalized patients in the years since.1 In the mid–20th century, as psychiatric practice shifted from the asylum to the ambulatory clinic with an emphasis on psy-chotherapy and the prescription of psychotropic agents, the role of the medical examination was degraded and the recognition of catatonia languished.2 The perceived tight bond between catato-nia and the diagnosis of schizophrenia led to the widespread assumption that catatonia is mainly a form of psychosis and is not appropriately classified elsewhere.3 Interest in catatonia among clinical neu-rologistswanedwith the recognitionof cata-tonia limited to a classic retarded formwith posturing, rigidity, staring, immobility, and mutism.A recent case report in theNewEn-gland Journal ofMedicine describes a young woman with well-defined catatonia that is neither recognized nor treated except as a passing mention in the case analysis.4 A