{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T06:21:58Z","timestamp":1791699718990,"version":"4.3.4"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T00:00:00Z","timestamp":1653264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012621","name":"University College London Hospitals Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012621","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015873","name":"National Brain Appeal","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015873","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The external clinical manifestations (psychopathology) and internal subjective experience (phenomenology) of catatonia are of clinical importance but have received little attention. This study aimed to use a large dataset to describe the clinical signs of catatonia; to assess whether these signs are associated with underlying diagnosis and prognosis; and to describe the phenomenology of catatonia, particularly with reference to fear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective descriptive cross-sectional study was conducted using the electronic healthcare records of a large secondary mental health trust in London, United Kingdom. Patients with catatonia were identified in a previous study by screening records using natural language processing followed by manual validation. The presence of items of the Bush-Francis Catatonia Screening Instrument was coded by the investigators. The presence of psychomotor alternation was assessed by examining the frequency of stupor and excitement in the same episode. A cluster analysis and principal component analysis were conducted on catatonic signs. Principal components were tested for their associations with demographic and clinical variables. Where text was available on the phenomenology of catatonia, this was coded by two authors in an iterative process to develop a classification of the subjective experience of catatonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Searching healthcare records provided 1,456 validated diagnoses of catatonia across a wide range of demographic groups, diagnoses and treatment settings. The median number of catatonic signs was 3 (IQR 2\u20135) and the most commonly reported signs were mutism, immobility\/stupor and withdrawal. Stupor was present in 925 patients, of whom 105 (11.4%) also exhibited excitement. Out of 196 patients with excitement, 105 (53.6%) also had immobility\/stupor. Cluster analysis produced two clusters consisting of negative and positive clinical features. From principal component analysis, three components were derived, which may be termed parakinetic, hypokinetic and withdrawal. The parakinetic component was associated with women, neurodevelopmental disorders and longer admission duration; the hypokinetic component was associated with catatonia relapse; the withdrawal component was associated with men and mood disorders. 68 patients had phenomenological data, including 49 contemporaneous and 24 retrospective accounts. 35% of these expressed fear, but a majority (72%) gave a meaningful narrative explanation for the catatonia, which consisted of hallucinations, delusions of several different types and apparently non-psychotic rationales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The clinical signs of catatonia can be considered as parakinetic, hypokinetic and withdrawal components. These components are associated with diagnostic and prognostic variables. Fear appears in a large minority of patients with catatonia, but narrative explanations are varied and possibly more common.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2022.886662","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T01:08:40Z","timestamp":1653268120000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":33,"title":["Catatonia Psychopathology and Phenomenology in a Large Dataset"],"prefix":"10.3389","volume":"13","author":[{"given":"Eleanor","family":"Dawkins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leola","family":"Cruden-Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Carter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Amad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Zandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glyn","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony S.","family":"David","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,23]]},"reference":[{"key":"B1","author":"Kahlbaum","year":"1874","journal-title":"Die Katatonie: Oder das Spannungsirresein, Eine Klinische Form Psychischer Krankheit."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1093\/schbul\/sbx157","article-title":"Prevalence of catatonia and its moderators in clinical samples: results from a meta-analysis and meta-regression analysis.","volume":"44","author":"Solmi","year":"2018","journal-title":"Schizophr Bull."},{"key":"B3","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1176\/appi.neuropsych.17060123","article-title":"Catatonia under-diagnosis in the general hospital.","volume":"30","author":"Llesuy","year":"2018","journal-title":"J Neuropsychiatry Clin Neurosci."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1002\/gps.5382","article-title":"Catatonia in elderly psychiatric inpatients is not always associated with intense anxiety: factor analysis and correlation with psychopathology.","volume":"35","author":"Cuevas\u2212Esteban","year":"2020","journal-title":"Int J Geriatr Psychiatry."},{"key":"B5","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1016\/j.schres.2014.12.036","article-title":"The diagnostic criteria and structure of catatonia.","volume":"164","author":"Wilson","year":"2015","journal-title":"Schizophr Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1016\/j.psychres.2015.07.020","article-title":"Catatonia in inpatients with psychiatric disorders: a comparison of schizophrenia and mood disorders.","volume":"229","author":"Grover","year":"2015","journal-title":"Psychiatry Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.schres.2017.09.013","article-title":"Dissecting the catatonia phenotype in psychotic and mood disorders on the basis of familial-genetic factors.","volume":"200","author":"Peralta","year":"2018","journal-title":"Schizophr Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/S0010-440X(03)00108-1","article-title":"Factor analysis of the catatonia rating scale and catatonic symptom distribution across four diagnostic groups.","volume":"44","author":"Kr\u00fcger","year":"2003","journal-title":"Compr Psychiatry."},{"key":"B9","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1016\/j.pnpbp.2006.11.012","article-title":"Schizophrenia with prominent catatonic features (\u2018catatonic schizophrenia\u2019).II. 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