Psychiatric specifier

With catatonia

A marked psychomotor syndrome is present and needs structured, time-sensitive assessment.

Episode features

Mood disordersPsychotic disordersMedical conditions

At a glance

Applies to: Mood disorders · Psychotic disorders
Deciding signal: A cluster of psychomotor signs is more informative than immobility or reduced speech alone.
Ask this: Is there a coherent catatonic syndrome after urgent medical, neurological, toxic, and medication causes are considered?
Wording outcome: Bipolar I disorder, current episode depressed, with catatonia

Reduced movement is better explained by sedation, delirium, neurological disease, severe parkinsonism, or negative symptoms.
Only one nonspecific sign is present without a broader syndrome.

Fit and exclusions

Start with the deciding signal, then test chronology, competing explanations, and the effect on diagnostic wording.

Multiple characteristic psychomotor signs are directly observed or reliably described.
The change is substantial from baseline and not explained by ordinary withdrawal or fatigue.
A structured examination and urgent physical assessment are underway.

Treat catatonia as time-sensitive; coordinate urgent medical assessment and syndrome-specific management.

Focus: A clustered psychomotor syndrome
Time course: Acute or subacute change requiring close observation
Look for: Immobility, posturing, negativism, echophenomena, stereotypy, agitation without purpose
Avoid: Do not equate quietness, mutism, or immobility alone with catatonia

Bipolar I disorder, current episode depressed, with catatonia

At a glance

Applies to

Mood disorders · Psychotic disorders

Deciding signal

A cluster of psychomotor signs is more informative than immobility or reduced speech alone.

Ask this

Is there a coherent catatonic syndrome after urgent medical, neurological, toxic, and medication causes are considered?

Wording outcome

Bipolar I disorder, current episode depressed, with catatonia