Research criteria for manneristic catatonia
| Contents |
[Edit]1 Instructions for the diagnosis
1 - Evolution criteria are fulfilled
2 - Met clinical criteria
3 - None of the exclusion criteria must be observed
Criteria of rank A are required for diagnosis
Criteria of rank B, are highly suggestive of the diagnosis but inconsistent or too difficult to observe to be mandatory Clinical symptoms compatible with the diagnosis are just informative and are not part of the criteria.
[Edit]2 Evolution criteria
(A) Progressive installation of the cardinal symptoms (> 3 months, usually worsening over 2 to 15 years or more)
(B) Processual symptoms to varying degrees, may be absent
[Edit]3 Clinical criteria
The following symptoms must be permanent :
(A) Mannerism according to WKL, ie rigid behavioral rituals either positive (compulsive aspect) or negative (omission = loss of behavioral register). 3 of the 4 criteria must be present if no processual symptoms, 2 are sufficient if processual symptoms present:
- No egodystonic feeling, symptoms accepted as normal (no insight) even if patients recognize them as meaningless
- No attempt to fight against the compulsions (no conflict)
- No obsessive idea congruent with rituals
- Absence of anxiety in case the ritual can not be performed, simple irritation
(A) Stiff behavior (at least 2 criteria):
- Stiffness of voluntary movements and/or posture
- Reduction motor expression (mimic, prosody ...)
- Reduction in the spectrum of activities
(A) The ending of a ritual, the passage from one action to another, or the conclusion of an action can be promoted by prompting the patient
(B) Slowness
(B) Impulsive actions in the installation phase of mannerism
(B) Difficulty in completing an action or a sentence. Movement or speech are like suspended, the patient can not finish them by himself
(B) With the evolution: mutism, oppositionisme, posturing
Various, compatible with the diagnosis but WITHOUT being indicative for it :
- Anxiety unrelated to the obsessions or the compulsions
[Edit]4 Exclusion criteria
Not secondary to
(A) Drug intoxication or withdrawal
(A) An organic disease
(A) A reactive psychosis (reaction to a severe stressor)
Clinical
(A) Hypochondriacal complaints
(A) Deep affective flattening
(A) Ethical blunting
(A) Persistencies other catatonic symptoms: parakinesia, negativism with ambitendancy, stereotypies or iterations, short-circuit responses.
(A) Persistence of a thought or a language disorder, of a disorganized speech or illogicality
(A) Persistence of psychotic symptoms (delusions, hallucinations)
(A) Persistence of genuine mood disorder