title: Recurrent Idiopathic Catatonia: Implications beyond the Diagnostic and Statistical Manual of Mental Disorders 5th Edition.
abstract: We describe a case of recurrent, life-threatening, catatonic stupor, without evidence of any associated medical, toxic or mental disorder. This case provides support for the inclusion of a separate category of "unspecified catatonia" in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) to be used to classify idiopathic cases, which appears to be consistent with Kahlbaum's concept of catatonia as a distinct disease state. But beyond the limited, cross-sectional, syndromal approach adopted in DSM-5, this case more importantly illustrates the prognostic and therapeutic significance of the longitudinal course of illness in differentiating cases of catatonia, which is better defined in the Wernicke-Kleist-Leonhard classification system. The importance of differentiating cases of catatonia is further supported by the efficacy of antipsychotics in treatment of this case, contrary to conventional guidelines.
authors.affiliation: Philadelphia Veterans Affairs Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Stanley N
authors.initials: SN
authors.lastname: Caroff
authors.affiliation: Philadelphia Veterans Affairs Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Hurford
authors.affiliation: Philadelphia Veterans Affairs Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Henry R
authors.initials: HR
authors.lastname: Bleier
authors.affiliation: Philadelphia Veterans Affairs Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Gregg E
authors.initials: GE
authors.lastname: Gorton
authors.affiliation: Philadelphia Veterans Affairs Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: E Cabrina
authors.initials: EC
authors.lastname: Campbell
keywords: Antipsychotic agents; Catatonia; Cycloid psychosis; Neuroleptic malignant syndrome; Periodic catatonia; Schizophrenia