Prevalence of catatonic signs in acute psychiatric patients

Kahlbaum characterised catatonia as a specific disturbance in motor functioning which represents a phase in a progressive illness that includes stages of mania, depression and psychosis that typically ends in dementia. Kraepelin incorporated features of catatonia into his concept of dementia praecox and Bleuler, under the heading of catatonic symptoms, gave the fullest account of schizophrenic abnormalities in movement, volition, overall behaviour and speech. Throughout most of the 20th century, clinicians considered catatonia as an exclusive subtype of schizophrenia. Numerous authors argued against this view as catatonic features amid affective symptomatology were not uncommon. Whereas until 1960 the catatonic subtype made up a third of the total number of cases of schizophrenia, the prevalence shrank to 2-10% during the following decades. The decline has been attributed to various causes, and includes early detection and management and a liberal and humane hospital atmosphere. Other reasons include a more restrictive definition of schizophrenia; more reliable exclusion of other cerebral diseases by improved neurological diagnosis; improved capabilities of psychopharmacological treatment; ORIGINAL PAPERS