BACKGROUND Catatonia was first described by Kahlbaum as a psychomotor disease with motor, behavioral, and affective symptoms. In keeping with this concept, we developed a rating scale for catatonia (Northoff Catatonia Scale [NCS]) with three different categories of symptoms (i.e., motor, behavioral, affective). Furthermore, the question of the relationship among catatonic symptoms, extrapyramidal motor symptoms, and neuroleptics was addressed in the present study. METHOD 34 acute catatonic patients and 68 age‐, sex‐, diagnosis‐, and medication‐matched psychiatric control subjects were investigated on days 0, 1, 3, 7, and 21 with the NCS, with other already validated catatonia rating scales by Rosebush, Bush (BFCRS), and Rogers (MRS), as well as with scales for hypokinetic (SEPS) and dyskinetic (AIMS) extrapyramidal motor features. Validity and reliability of the new scale, factor analysis, correlational analysis, and differences between catatonic patients and psychiatric control subjects were statistically calculated. RESULTS NCS showed high validity (i.e., significant positive correlations [p <0.0001] with the other scales, significant differences between catatonic and control subjects), high intra‐ and interrater reliabilities (r = 0.80–0.96), and high affective subscores. Factor analysis revealed four factors best characterized as affective, hypoactive, hyperactive, and behavioral. Catatonic scores in NCS correlated significantly with AIMS on day 0 and SEPS on days 7 and 21. There were no significant differences in catatonic (i.e., NCS, MRS, BFCRS) and extrapyramidal (i.e., AIMS, SEPS) scores between neuroleptically treated and untreated catatonic subjects. CONCLUSIONS The following conclusions were drawn: (1) the NCS has to be considered as a valid and reliable rating instrument for catatonia; (2) catatonia can be characterized by psychomotor symptoms encompassing motor, affective, and behavioral alterations; and (3) extrapyramidal hyperkinesias like dyskinesias are apparently closely related to catatonic symptoms which, in general, seem to be relatively independent of previous neuroleptic medication.

The antidepressant effect of rolipram, believed to be based on a new mechanism of action, was investigated in an open phase II study in 10 depressive patients, most of whom had been refractory to previous antidepressant therapy. Five patients displayed a good to very good improvement of their depressive condition. Four patients failed to show any substantial improvement, and therapy had to be withdrawn in one case due to deterioration of the condition. In most cases, the antidepressant effect of the trial preparation became noticeable after 2-4 days of treatment only. Basing on the presented cases, the tolerance can be described as excellent compared to other antidepressants. Although, on the whole the trial yielded very encouraging results, only double-blind trials can determine the true antidepressant efficacy of rolipram.

A multicenter randomized 4-week interindividual double-blind study was carried out in 58 hospitalized patients with major depressive disorder (DSM III 296.23,296.22,296.33,296.32,296.53 and 296.52) to test the dose-effect relationship of three different doses of the new cAMP-phosphodiesterase inhibitor rolipram: 3 × 0.25 mg, 3 × 0.50 mg and 3 × 1.00 mg rolipram/day. With respect to the desired effect, the 3 × 0.50 mg dosage stood out from the others in almost all relevant parameters. With respect to the response rate, the efficacy of the 3 × 0.25 mg dosage was about the same as that reported in the literature for placebo. The inferior performance of the 3 × 1.00 mg dosage compared to the 3 × 0.50 mg dosage might indicate a reverse U-shaped dose-effect relationship. There was good tolerance to all three dosages. There were no findings that might cast doubt on the safety of the dosages tested.

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A k in e tic S ta te s in C a ta to n ic a n d P a r k in so n ia n P a tie n ts G . N o rth o ff U niv ersity o f F ra n k fu rt an d U n iv ersity o f M a g de b u rg, G erm a n y W . K rill, J. W e n k e a n d B . G ille U niv ersity o f F ra n k fu rt, G erm a n y M . R us s U n ive rsity o f M a g d eb u rg, G erm a n y J. E c k e rt U niv ersity o f F ra n k fu rt, G erm a n y U . P e ste r a n d B . B o g e rts U n ive rsity o f M a g d eb u rg, G erm a n y B . P flu g U niv ersity o f F ra n k fu rt, G erm a n y B o th c a ta to n ic a n d pa r kins o nian p atie n ts sh ow se v e re m oto r d ef ic its s uc h as co m p le te a kin e s ia . In c o n tra s t to P a rk in so n ' s d is e as e, m ec h an ism s o f a kine tic sta tes in c a ta ton ia re m a in u n cle ar . In an a ttem pt to d e fine c ata to nic a k in e si a in a m or e d eta iled w ay w e in v es tiga ted su b je ctiv e ex p er ie n ce in 2 2 a k in e tic c ata to n ic pa tie nts c o m p ar in g th e m w ith 2 2 m a jor d e p re ss iv e , 2 2 pa r an o id sc h iz o p h re n ic , 22 re si du a l sc h iz o p h r en ic , a n d 2 2 a k in e tic p a rk in so n ia n p a tie nts. C a taton ic p a tien ts w e r e d ia g n o s ed a c co rd ing to s ta n da rd ise d cr ite ria . T he y w er e trea te d e xc lus iv e ly w ith lo ra z e p a m (2 ±4m g) du rin g the firs t 24 h ou rs an d , a cc o rd in g to th eir re s po n se on da y 1 , th e y w e re d iv id ed in to r e sp on d e rs a n d no n re sp o n d e rs . S u b je c tive ex p er ie n ce w a s in v e st ig a te d w ith a se lf-r ate d q u es tion n aire , de v elo pe d by u s, f or R e q u e s ts fo r re p rin ts s h o u ld b e s e n t to D r G . N o rth o ff , D e p a rt m e n t o f P s y c h ia try , U n iv e rs ity o f M a g d e b u rg , L e ip z ig e r S tra s s e 4 4 , 3 9 1 2 0 M a g d e b u rg , G e rm an y .the su b je c tive e x pe rie nc e o f p sy c ho lo g ic a l a n d m oto r fu n ction s in an a cu te a k in e tic st a te . C a ta to n ic p a tie nts d iffe r ed si gn ific a ntly in th e ir s u bjec tiv e e x pe r ie n ce fr o m p ar k in so n ia n , d e p r es si ve , a nd s c hizo p h r e nic p a tie n ts. U n lik e pa rk ins on ian p a tien ts, c ata to n ic s w e re no t fu lly a w a re of th e ir se ve r e d ef ic its in m o to r e xe c u tion . I n c on tra st to c a ta to n ic n on r es po n de r s to lo ra z ep a m , lor az e p am -re s po n de r s w e r e c ha r ac ter is ed by in ten se a nd ov e rw h e lm in g e m otio n a l e xp e rien c e s. S ub jec tiv e e xp e rie nc e o f ak in e si a s ee m s to d iff e r f u nd a m e ntally be tw ee n c ata to n ic a n d p ar k in so n ia n p atie n ts a s w e ll a s b e tw e e n c ata to nic r es p o n de r s an d no n re sp o nd e rs to lo ra z ep a m .