Towards a valid nosography and psychopathology of catatonia in children and adolescents.

Paraphrasing Taylor and Fink (2003), catatonia needs "a home of its own" in child and adolescent psychiatry. Limited but expanding literature supports that catatonia in children and adolescent can be identified reliably among other childhood conditions, is sufficiently common, treatable with the same specific treatments as adult catatonia (e.g., sedative drugs and electroconvulsive therapy), and can be worsened by other treatments (e.g., antipsychotics). Other findings in child and adolescent catatonia suggest that sex ratio and associated disorders may differ, and the proposed classification of Taylor and Fink (2003) needs modification. Adopting a broader diagnostic schedule may accommodate both child, adolescent, and adult catatonia. A psychomotor automatism variant should be included as a diagnosis, as well as specifiers for associated disorders such as acute nonpsychotic anxious state and pervasive developmental disorder. Duration of illness should be specified as acute or chronic. Regardless of associated psychiatric disorders, this chapter describes a new psychopathological model. Three main modalities of movement dysfunction in catatonic subjects are listed: (1) adherence to delusional ideas leading to a psychomotor automatism (De Clérambault, 1927); (2) resistance to delusional thinking or conviction; and finally (3) hyperanxious states. Case-vignettes illustrate the model, and future research directions are identified.