Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. May 19, 2024; 14(5): 600-606
Published online May 19, 2024. doi: 10.5498/wjp.v14.i5.600
First 150 years of catatonia: Looking back at its complicated history and forward to the road ahead
Levente Csihi, Gabor S Ungvari, Stanley N Caroff, Gábor Gazdag
Levente Csihi, Gábor Gazdag, Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc South Pest Hospital, Budapest 1204, Hungary
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, Behavioral Health Service, Corporal Michael J Cresencz, Veterans Affairs Medical Center, Philadelphia, PA 19104, United States
Stanley N Caroff, Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, United States
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; Csihi L prepared the first draft of the manuscript; Ungvari GS, Caroff SN, and Gazdag G critically reviewed and corrected the manuscript; and all authors approved the final version of the text.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
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, 1 Köves utca, Budapest 1204, Hungary. gazdag@lamb.hu
Received: January 27, 2024
Revised: March 27, 2024
Accepted: April 17, 2024
Published online: May 19, 2024
Processing time: 110 Days and 1.1 Hours
Abstract

Karl Ludwig Kahlbaum (1828-1899) was the first to conceptualize and describe the main clinical features of a novel psychiatric illness, which he termed catatonia in his groundbreaking monograph published 150 years ago. Although Kahlbaum postulated catatonia as a separate disease entity characterized by psychomotor symptoms and a cyclical course, a close examination of his 26 cases reveals that most of them presented with motor symptom complexes or syndromes associated with various psychiatric and medical conditions. In his classification system, Kraepelin categorized catatonic motor symptoms that occur in combination with psychotic symptoms and typically have a poor prognosis within his dementia praecox (schizophrenia) disease entity. Because of the substantial influence of Kraepelin’s classification, catatonia was predominantly perceived as a component of schizophrenia for most of the 20th century. However, with the advent of the psychopharmacotherapy era starting from the early 1950s, interest in catatonia in both clinical practice and research subsided until the early 2000s. The past two decades have witnessed a resurgence of interest in catatonia. The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, marked a paradigmatic shift by acknowledging that catatonia can occur secondary to various psychiatric and medical conditions. The introduction of an independent diagnostic category termed “Catatonia Not Otherwise Specified” significantly stimulated research in this field. The authors briefly review the history and findings of recent catatonia research and highlight promising directions for future exploration.

Keywords: Catatonia; Historical overview; Psychopharmacology; Diagnostic and Statistical Manual of Mental Disorders-5; Wernicke-Kleist-Leonhard school

Core Tip: With the advent of the psychopharmacotherapy era starting from the early 1950s, interest in catatonia in both clinical practice and research subsided until the early 2000s. The past two decades have witnessed a resurgence of interest in catatonia. The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, marked a paradigmatic shift by acknowledging that catatonia can occur secondary to various psychiatric and medical conditions. The introduction of an independent diagnostic category termed “Catatonia Not Otherwise Specified” significantly stimulated research in this field.