Editorial
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. May 19, 2023; 13(5): 131-137
Published online May 19, 2023. doi: 10.5498/wjp.v13.i5.131
Catatonia: “Fluctuat nec mergitur”
Gabor S Ungvari, Stanley N Caroff, Levente Csihi, Gábor Gazdag
Gabor S Ungvari, Division of Psychiatry, School of Medicine, University of Western Australia, Crawley 6009, Western Australia, Australia
Gabor S Ungvari, Section of Psychiatry, University of Notre Dame, Fremantle 6160, Western Australia, Australia
Stanley N Caroff, Department of Psychiatric Service, Corporal Michael J Cresencz Veterans Affairs Medical Center, Philadelphia, PA 19104, United States
Stanley N Caroff, Department of Psychiatric Service, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States
Levente Csihi, Gábor Gazdag, Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc South Pest Hospital, Budapest 1204, Hungary
Gábor Gazdag, Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest 1083, Hungary
Author contributions: Gazdag G and Ungvari GS outlined the content of the editorial; Ungvari GS prepared the first draft of the manuscript, Caroff SN, Csihi L and Gazdag G critically reviewed and corrected the manuscript; All authors approved the final version of the text.
Conflict-of-interest statement: Dr. Caroff received research grants for unrelated projects from Neurocrine Biosciences and Eagle Pharmaceuticals and served as consultant for Neurocrine Biosciences and Adamas Pharmaceuticals. The other authors have no declarations of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gábor Gazdag, MD, PhD, Professor, Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc South Pest Hospital, Köves utca 1, Budapest 1204, Hungary. gazdag@lamb.hu
Received: January 21, 2023
Peer-review started: January 21, 2023
First decision: January 31, 2023
Revised: February 2, 2023
Accepted: April 17, 2023
Article in press: April 17, 2023
Published online: May 19, 2023
Processing time: 117 Days and 20.4 Hours
Abstract

In the beginning of the 1900s, the prevalence of catatonia in inpatient samples was reported to be between 19.5% and 50%. From the mid-1900s, most clinicians thought that catatonia was disappearing. Advances in medical sciences, particularly in the field of neurology, may have reduced the incidence of neurological diseases that present with catatonic features or mitigated their severity. More active pharmacological and psychosocial treatment methods may have either eliminated or moderated catatonic phenomena. Moreover, the relatively narrow descriptive features in modern classifications compared with classical texts and ascribing catatonic signs and symptoms to antipsychotic-induced motor symptoms may have contributed to an apparent decline in the incidence of catatonia. The application of catatonia rating scales introduced in the 1990s revealed significantly more symptoms than routine clinical interviews, and within a few years, the notion of the disappearance of catatonia gave way to its un-expected resurgence. Several systematic investigations have found that, on average, 10% of acute psychotic patients present with catatonic features. In this editorial, the changes in the incidence of catatonia and the possible underlying causes are reviewed.

Keywords: Catatonia; Historical overview; Frequency of catatonia; Diagnostic and Statistical Manual of Mental Disorders-5; Wernicke–Kleist-Leonhard school; Bush-Francis Catatonia Rating Scale

Core Tip: Although the prevalence of catatonia was reported to be between 19.5% and 50% in the early 1900s, most clinicians thought that catatonia was disappearing by mid-century, However, more recent systematic investigations have found that catatonia continues to be a common clinical disorder with an average prevalence of 10%. The apparent historical changes in the prevalence of catatonia reflects shifts in the socio-cultural context of psychiatry, the type of service, diagnostic criteria, research methods, and advances in treatment and clinical practice. We propose the establishment of an international society and journal dedicated to the study of catatonia to facilitate understanding and research.