title: Revisiting the concept of late catatonia.
abstract: OBJECTIVE
  The objective of this paper is to introduce the concept of late catatonia to foreign readers for the first time in English.
  
  
  METHODS
  The original study was conducted about 20 years ago. The subjects were 16 persons who first visited our institutions between 1990 and 1996. They fulfilled the following criteria: 1) late-onset psychosis, with the initial mental changes occurring after 40 years of age; 2) more than one catatonic symptom observed during the clinical course; 3) a total clinical course lasting more than 2 years; and 4) no evidence of apparent organic brain disease. The medical records of individual patients were retrospectively reviewed to summarize the clinical features of this diagnosis.
  
  
  RESULTS
  The crucial feature was the evolution or longitudinal change in the clinical picture over time, with the clinical course being divided into five stages: stage I (prodromal depression), stage II (anxiety and agitation), stage III (hallucination and delusion), stage IV (catatonia syndrome), and residual state. As for treatment, the effect of psychotropic agents was very limited. The electroconvulsive treatment was the most effective treatment option.
  
  
  CONCLUSIONS
  Apart from the current diagnostic dichotomy of schizophrenia and mood disorder, the concept of late catatonia is useful in clinical settings and may provide clinically important knowledge.
authors.affiliation: Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan. Electronic address: kocha@js6.so-net.ne.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kocha
authors.affiliation: Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Moriguchi
authors.affiliation: Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Mimura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002389:Catatonia / Q000175:diagnosis* / Q000523:psychology*; D003937:Diagnosis, Differential; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D016896:Treatment Outcome