CATATONIA, a variety of schizophrenia —or dementia praecox, which latter is the most frequent of all mental disorders. The catalonic variety is the most severe and is usually marked by a greatly increased tend ency toward excessive motor reactions, such as negativism, catalepsy, mannerisms and violent tempestuous outbreaks, often ex tremely furious in their character. It is a form of the mental disorder which most fre quently exhausts the patient and leads more often to tuberculosis.
These patients often will stand in one posi tion, often an extremely strained one, for hours at a time, sometimes days, often weeks. Some cases are known, for instance, to lie rigid in bed like a corpse for six months or a year at a time, refusing to pay any attention to the external world. They urinate and defecate in bed and may have to be tube fed all this time. Others will make incessant stereotyped move ments, walking backward and forward like animals in a cage, or go through certain occu pational movements,. sawing, hammering, etc., hour upon hour without interruption. They may stand in a rapt attitude all day long with out so much as winking. Sometimes they talk incessantly, saying the same thing over and over again. Others make wild rushes here and there in their rooms, beating their fists against the walls or a piece of furniture.
Careful study of these cases shows that the movements always have a certain symbolic significance for the individual. They are fre
quently made in response to hallucinatory voices or images and can usually be resolved to certain elementary instinctive desires of the individual, usually connected with sexual taboos of some kind.
The causes are not completely revealed. In some there are obvious endocnnopathic dis turbances. Certain psychiatrists regard these latter as primary; others are disposed to view them as secondary to the disturbances in the emotional fields of activity. Thus these hold the primary defect to lie in patients' incapacity to make social adjustments along the line of the love-life of mankind. This incapacity is revealed in the unconscious strivings which are greatly distorted in the behavior of the indi vidual and hence are uninterpretable, so modi fied are the symbolic expressions of this internal conflict. The catatonic cases occasion ally get well following an acute maniacal period, but when the disease is prolonged 5 to 10 years they usually make up a great mass of the chronic incurable lunatics of our hospi tals for mental diseases. See DEMENTIA PILE cox. Consult Jelliffe and White, 'Diseases of the Nervous System) (2d ed., 1917).