"Classification of Endogenous Psychoses and Their Differentiated Etiology"
Springer Verlag, 2nd Revised edition, 1999
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The excited pole of motility psychosis is characterized by restlessness composed mainly of expressive and reactive movements. Likewise in the inhibited pole, reactive and expressive movements are affected; voluntary movements only in so far as they contain the psychomotor elements. In milder cases the disorder is recognized in the rigid posture and facial expression despite the continued presence of voluntary movements. In this way mild cases of akinesia can be differentiated from the stupor of confusion psychosis. Beside the core syndromes of motility psychosis there is often other features belonging to other bipolar phenotypes. Incoherent pressure of speech often accompanies hyperkinesia. Incoherence of the kind where disconnected words are blurted out with interruptions is, in fact, typical of motility psychosis. However the presence of pressure of speech points to an element of confusion psychosis. A circular fluctuation of the psychosis between the two poles is quite common; akinesia is rarer than hyperkinesia. On the other hand the duration of akinesia is often longer and may last for months whereas hyperkinesia lasts less long, usually only a few weeks. In terms of physique, without more precise investigations it can only be said that the leptosomic element is considerably more prevalent here than in confusion psychosis. Prepsychotic signs frequently manifest a "temperament of motility" with abundance of expressive movements and at times a dancelike nature (von Trostorff, 1966).