Research criteria for periodic catatonia
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[Edit]1 Instructions for the diagnosis
(A) Evolution criteria has to be fullfilled
(A) Clinical criteria for one or both pole have to be met regarding this episode and ALL the former (if many test >= 3 with one of a different pole)
(A) None of the exclusion criteria can be met
Criteria of rank A are requiered for the diagnosis.
Criteria of rank B are not requiered but if prensent give further confidence in the diagnosis (shifted to the right). Clinical symptoms compatible with the diagnosis are just informative and are not part of the criteria.
[Edit]2 Evolution criteria
(A) Single episode, episodic evolution unipolar or bipolar
(A) Complete recovery after a first episode then gradually with incomplete remission:
- Apathy
- Reduction of expressive motor behavior
- Stiffness, clumsiness or a distortion of psychomotricity
- Discrete catatonic symptoms (staring, parakinesia, minimal negativism ...)
- Lack of insight inconsistent at first, at least partially with evolution
REM: Start non orienting: acute (less then 2 weeks), subacute (1-3 months) or progressive.
[Edit]3 Clinical criteria during the episode
Akinetic phase
(A) Akinesia (with hyperkinesis)
(A) Impassive facial expression
(A) Bizarre postures up waxy flexibility
(B) Stupor
(B) Frequent albeit uncharacteristic depressed mood or anxiety
Hyperkinetic phase
(A) Hyperkinesia (with akinesia)
(A) Uniform psychomotor excitement, stereotypical.
(B) Frequent elation of mood
(B) Impulsive actions or words with possible aggressive behavior
In both phase
- Strict mix: akinetic segments or members while others are hyperkinetic.
- Intermittently the presence of one of these symptoms is sufficient (may only last an hour during an episode of several months):
-> Real negativism (ie with ambitendancy)
-> Parakinesias
-> Grimacing facial expressions (paramimies)
-> Waxy flexibility
-> Less specific but orienting towards the diagnosis: stereotypies, ittérations, perseveration, staring
Micellaneous, compatible with the diagnosis but WITHOUT being indicative for it
- The clouding up the confusion may occur transiently in all bipolar forms (PMD, cycloid psychoses, non systematized schizophrenia)
- Disorganized speech
- Frequent hallucinations
- Frequent delusions
[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) Disordered logic or fuzzy concepts
(A) Language impaired at syntactic or semantic level
(A) Organized paranoia, persecutory delusions with designated persecutor passional delusion as erotomania, jealousy
(A) Uniform evolution
(A) Other mood disorders (mania or melancholia) arising out of the post-episode.