Cataphasia appears in two forms, the excited and the inhibited. The former is characterized by confused pressure of speech, in which verbalizations become incomprehensible in severe cases. The patients' behavior however remains generally sensible and their activities are well preserved, but their affect is flattened. The inhibited phase in some cases is characterized by mutism, in milder cases by poverty of speech. The thought disorder of cataphasia, its central symptom, is reminiscent of that seen in confusion psychosis, but in the excited phase it goes well beyond simple incoherence, and in the inhibited form, well beyond simple thought inhibition. ln excited cataphasia severe logical blunders are found, as exemplified by the patients' speech with wrong choice of words, neologisms, and lack of grammatical correctness. ln the inhibited form errors in logic also occur but the principal symptom is thought inhibition which as in confusion psychosis may lead to perplexity. ln the patients' facial expression an internal dullness can be recognized. Furthermore, instead of answering patients tend to stare fixedly at the examiner. ln excited cataphasia confabulations occur frequently, in the inhibited form, ideas of reference. Besides the excited and inhibited forms there are patients who display severe thought and speech disorder but who are neither talkative nor taciturn, i.e. they display only the central defect syndrome of the disorder.

As in affective paraphrenia, cataphasia often contains admixtures of other unsystematic schizophrenias or of cycloid psychoses; anxious and ecstatic mood fluctuations occur quite frequently. The course of cataphasia can be insidiously progressive. More often remissions occur, sometimes with a periodic course.