Katatonie zwischen schizophrenie und depression: Psychopathologie und pathophysiologie

Catatonia was originally described by Kahlbaum as a psychomotor disease with affective, behavioral and motor symptoms which, according to him, were closely related with affective disorders like, for example, depression. In contrast, Kraeplin and Bleuer subsumed catatonia as a subtype under schizophrenia. We therefore put the focus of the present contribution on this intermediate position of catatonia between schizophrenia and depression. The psychopathological and pathophysiological symptoms of catatonia are presented and related with its affective, behavioral and motor alterations. These are then discussed in relation to psychopathology and pathophysiology in schizophrenia and depression. Psychopathologically, catatonia is characterized as a "psychomotor disorder". Extreme, intense and uncontrollable emotions induce behavioral and motor alterations. The medial orbitofrontal and the ventromedial prefrontal cortex may be of crucial importance in pothophysiology of these psychomotor symptoms. Both regions may be modulated in extreme cases of either paranoid schizophrenia or major depression which consecutively may result in catatonic syndrome.