Sluggish Catatonia

"Classification of Endogenous Psychoses and Their Differentiated Etiology"
Karl Leonhard
Springer Verlag, 2nd Revised edition, 1999
p. 146-153

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Sluggish catatonics give sluggish answers in the early stages and in later stages generally do not give any. Later they look around distractedly and move their lips in whispers. From time to time they become more excited. They talk more loudly to themselves or become so excited that they scream and gesticulate into space, scolding against the voices they hear. In earlier stages patients' verbalizations confirm that they suffer considerably from hallucinations. Moreover they often present fantastic confabulations which probably also play a role in the end state, but which can no longer be demonstrated due to the patients' unapproachability. Not only speech but all other reactions are slowed in the end state. However since the patients speak a lot and move actively during their excitement their sluggish reactions presumably are due to their constant distractibility causing them to be nearly oblivious to external stimuli. Initiative is extinguished, self-motivation is apparent only in their behaviour toward their hallucinations. Affect, too, is only recognizable in their excited arguments with the voices. The thinking of sluggish catatonics cannot be easily judged because of their unapproachability, but it appears to be characterized by incoherence.

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