Table 1.
Catatonic Symptoms on the Bush Francis Catatonia Rating Scale.
| Movement category | Symptom | Definition |
|---|---|---|
| Hypokinetic | Immobility/stupor | Decreased activity, minimal response to stimuli |
| Mutism | Decreased verbal output, ranging from only a few words to total silence | |
| Staring | Minimal gaze movement; decreased blinking | |
| Posturing/catalepsy | Maintenance of a posture for a prolonged period | |
| Rigidity (Gegenhalten) | Maintenance of a rigid position, or resistance or stiffness with passive range of motion | |
| Withdrawal | Decreased oral intake; decreased eye contact | |
| Muscle resistance | Resistance to passive movement of limb to repositioning, with increased resistance to increased pressure | |
| Ambitendency | Appearance of being stuck in motor movements | |
| Negativism | Refusal to follow instructions or other oppositional behavior | |
| Hyperkinetic | Excitement | Excessive motor activity |
| Impulsivity | Sudden inappropriate behavior (ie, suddenly running down hallway, taking off clothing) | |
| Combativeness | Sudden aggression or agitation without explanation or provocation | |
| Parakinetic | Grimacing | Contracting the face into odd facial expressions; can be episodic or maintained |
| Echopraxia | Mimicking examiner's movement | |
| Echolalia | Mimicking examiner's speech | |
| Stereotypy | Repetitive non-goal-directed motor activity (ie, fiddling thumbs, patting leg) | |
| Mannerisms | Repetitive purposeful motor activity (ie, waving hand, combing hair); the act is unusual either in its context or its persistence | |
| Verbigeration | Repetition of words or phrases, “like a broken record” | |
| Waxy flexibility | Initial resistance to repositioning, then allowing repositioning (like a wax candle bending) | |
| Automatic obedience | Exaggerated cooperation with examiner (ie, continues shaking hand when told to stop; sticks tongue out if told, “stick your tongue out for me, I'm going to stick a pin in it”) | |
| Passive obedience (Mitgehen) | Raises arm in response to light pressure of finger, even if told not to raise arm | |
| Grasp reflex | Grasps the examiner's fingers when the palm is rubbed | |
| Perseveration | Repetition of the same topic or motor movement | |