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Catatonia: the tension insanity SIR: Johnson in his lecture article (Journa!, June 1993, 162, 733â€"738)suggests that catatonia should be regarded as a neuropsychiatric syndrome in which an abnormal mental state is associated with ‘¿ cataleptic phenomena'. Cataleptic phenomena, as used by Johnson, essentially refer to features of catatonic stupor, with immobility, maintenance ofposture and mutism constituting a diagnostic triad. Such a view ofcatatonia would virtually exclude those ‘¿ catatonic' conditions in which only the excited state is present. Catatonia is generally regarded as having two phases â€"¿ retardation (stupor) and excitement â€"¿ with sometimes rapid alternation between the two. Although less common, the excited form may be the only state present. Morrison (1973) studied 250 cases ofcatatonia and found that 110 were predominantly retarded, 67 predominantly excited, and the remain der in a mixed state. It is interesting to note that the three-state concept of catatonia â€"¿ retarded, excited and mixed â€"¿ is incorporated into the ICDâ€"lOdiag nostic guidelines (World Health Organization, 1992)

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