Catatonia Emerges in a New Book

How can catatonia be a major psychiatric illness when no-one knows what it is? Could it be that psychiatry has lost touch with the real mental disorders? The question is important because catatonia is probably more treatable than anything else in psychiatry. And it affects one patient in every ten with a serious illness — but first it has to be recognized.

It is not a form of “schizophrenia,” and does not respond well to the anti-schizophrenic drugs that many doctors might be inclined to use.  

In his novel, The Winter Soldier, Daniel Mason writes of a World War I soldier's body that is curled up among a pile of roots: "Alive...But it doesn’t move. It doesn’t speak." The fictional soldier's body only twitches when someone touches his shoulder. "The man’s eyes were wide, his nose flared, as he tried to take in breath. But no words, nothing save the flinch, the stare," the novel continues.

That is a fair description of catatonia, a bodily condition. Staring, stupor, mutism, food refusal: these are the watchwords. Patients are cut off from their surroundings. They make also make strange, purposeless movements.

Catatonia is now found in many disorders and  also on its own. It occurs often  among adolescents, the severely depressed and manic, and in toxic conditions. Withdrawal, mutism, stupor, excitement, and febrile states are now recognized as catatonia.

The story of this remarkable medical milestone is highlighted in the new Oxford University Press publication, The Madness of Fear: A History of Catatonia, written by the historian of medicine Edward Shorter and the clinician neuropsychiatrist Max Fink.

This important book will help clinicians and the educated public recognize the disorder and ask for its proper treatment. Clinicians can make patients with catatonia better on a reliable basis. There are not many illnesses in psychiatry that are highly responsive to treatment, but catatonia is one of them.

Patients who are successfully treated can return to their communities. Most of the time, they do not have residual symptoms and do not relapse. "It is a kind of miracle," say Shorter and Fink. "Even patients who have been in long-term catatonic stupors can go on to have new lives." 

So why has there been so little psychiatric interest in catatonia? In The Madness of Fear, Drs. Shorter and Fink seek to understand why this “vast field of ignorance” exists. In the history of catatonia, they see a remarkable story about how medicine flounders, and then seems to find its way. And it will help doctors, and the public recognize and successfully treat this core illness in psychiatry.

The Madness of Fear:

A History of Catatonia

By Edward Shorter and Max Fink

Oxford University Press

2018

ISBN: 978-0-19-088119-1

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Dr. Max Fink, Author of 

The Madness of Fear: A History of Catatonia

Dr. Ned Shorter, The Madness of Fear: A History of Catatonia