Theme: Catatonia
Select the term used to describe each of the following behaviors
| A. | Verbigeration |
| B. | Mitmachen |
| C. | Obstruction |
| D. | Cerea flexibilitas |
| E. | Stereotypy |
| F. | Echopraxia |
| G. | Mitgehen |
| H. | Mannerisms |
| I. | Logorrhoea |
| J. | Posturing |
Select the term used to describe each of the following behaviors
| NaN. | A patient can be positioned in uncomfortable postures, which are maintained for a considerable period of time despite the original force being removed |
| The correct answer is: Cerea flexibilitas 79% Cerea flexibilitas is another term for waxy flexibility. It is differentiated from forms of automatic obedience by the fact that the limb remains in position once the force applied to move it is removed |
| NaN. | A patient with catatonia is seen rocking in the corner of the room |
| The correct answer is: Stereotypy 84% Rocking is a repetitive, regular movement that is not goal-directed. This type of movement is referred to as stereotypic. |
| NaN. | A patient with schizophrenia is observed to be sat in bed repeatedly saluting |
| The correct answer is: Mannerisms 87% Repetitive saluting is seemingly goal directed and is therefore classed as a mannerism. |
Catatonia
Karl Ludwig Kahlbaum (1828-1899) is credited with the original clinical description of catatonia.
Catatonia is the psychiatric syndrome of disturbed motor functions amid disturbances in mood and thought. Exam questions on this topic are common. Most questions in the paper one exam relate to definitions of the behaviors associated with catatonia.
The following definitions were taken from, Rajagopal, Advances in Psychiatric Treatment (2007), vol. 13, 51-59
Stupor - combination of immobility and mutism
Posturing - maintaining the same posture for long periods. A classic example is the 'crucifix'. An extreme version of posturing is catalepsy
Waxy flexibility (cerea flexibilitas) - patient can be positioned in uncomfortable postures, which are maintained for a considerable period of time.
Negativism (Gegenhalten) - patient resists the attempts of the examiner to move parts of their body and, according to the original definition, the resistance offered is exactly equal to the strength applied
Automatic obedience - exaggerated cooperation, automatically obeying every instruction of the examiner.
Mitmachen - a form of automatic obedience whereby the body of the patient can be put into any posture, even if the patient is given instructions to resist. The body part immediately returns to the original position once the force is removed (unlike in waxy flexibility)
Mitgehen - an extreme form of mitmachen in which the examiner is able to move the patient's body with the slightest touch (anglepoise lamp sign).
Ambitendency - The patient alternates between resistance to and cooperation with the examiner's instructions; for example, when asked to shake hands, the patient repeatedly extends and withdraws the hand
Psychological pillow - The patient assumes a reclining posture, with their head a few inches above the bed surface, and is able to maintain this position for prolonged periods
Forced grasping - The patient forcibly and repeatedly grasps the examiner's hand when offered
Obstruction - The patient stops suddenly in the course of a movement and is generally unable to give a reason. This appears to be the motor counterpart of thought block
Echopraxia - The patient imitates the actions of the interviewer
Aversion - The patient turns away from the examiner when addressed
Mannerisms - These are repetitive, goal-directed movements (e.g. Saluting)
Stereotypies - These are repetitive, regular movements that are not goal-directed (e.g. Rocking)
Motor perseveration - The patient persists with a particular movement that has lost its initial relevance
Echolalia - repetition of the examiners words
Logorrhoea - incoherent talkativeness
Verbigeration - Meaningless, repetition of words or phrases
Taken from: Rajagopal, Advances in Psychiatric Treatment (2007), vol. 13, 51-59
