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Patients with psychiatric catatonias vs those with medical catatonias may differ in catatonic phenomenology. To determine if these could be distinguished, the following methods were used: 1) a review of the literature; 2) a chart review; and 3) a prospective series. The literature review of 467 report of medical catatonias yielded 240 cases that met research criteria. A chart review of 47 episodes of catatonia revealed a higher frequency of negativism in patients with medical catatonias. Prospective data obtained from rating scales revealed an increased frequency of echophenomena in patients with medical catatonias; however, no discriminate pattern of catatonic signs for medical catatonias arose. Overall, catatonic signs appear to share a similar distribution. These findings suggest that psychiatric and medical catatonias are indistinguishable based upon catatonic signs.

Catatonia is a neuropsychiatric syndrome that may present a difficult diagnostic dilemma. Catatonic disorder due to general medical conditions must be considered in every patient with catatonic signs. Four patients with this disorder are presented. In these patients, general medical conditions associated with catatonic disorder included dystonia, HIV encephalopathy, progressive multifocal leukoencephalopathy, encephalitis, and renal failure. Three of these patients had multifactorial presentations of medical conditions or prior psychiatric disorders. A critical literature review concerning catatonia and associated nonpsychiatric medical conditions only infrequently supported causal relationships between organic factors and the development of catatonia. The majority of patients have multifactorial etiologies.

A series of poly(a,o-alkyldiynes) and copoly(a,w-alkyldiynes) were synthesized by catalytic Glaser coupling reactions. Two routes were investigated and developed. These routes were chosen in anticipation that high molar mass, linear and polydisperse, polymers would be achieved. GPC (gel permeation chromatography) curves revealed that this was possible for the majority of polymers synthesized by the first route. However, a wide range of molar masses were obtained by the second route with a significant low molar mass tail present in almost all GPC curves. Very low M, (number average molar mass) values by GPC gave correspondingly very high M, values by end-group analysis (EGA). Hence, it was proposed that the low molar mass tail was a consequence of cyclic structures. From these results and observations a mechanism for the polymerization of the a,o-alkyldiynes was proposed.Key words: poly(a,o-alkyldiynes), Glaser coupling, molar mass.Resume : On a synthCtisC une sCrie de poly(a,w-alkyldiynes) et de copoly(a,o-alkyldiynes) par les rkactions de couplage catalytique de Glaser. On a CtudiC et dCveloppC deux voies. Ces voies ont Ct C choisies dans le but d'obtenir des polymkres lintaires et polydispersks de poids molCculaires ClevCs. Des courbes de chromatographie par permtation de gel (GPC) ont rCvklk que ceci est possible pour la majoritt des polymkres synthCtisCs par la premikre voie. Toutefois, la seconde voie a conduit 21 de grandes variations dans les poids molCculaires et, dans chaque cas, les courbes de GPC ont toutes prCsentCes des trainCes avec des quantitCs importantes de produits de faibles poids molCculaires. Des valeurs trks faibles de M,, (valeur moyenne de la masse molaire) par GPC fournissent des valeurs correspondantes ClevCes de M,, par l'analyse des groupes terminaux (EGA). On suggkre donc que les trainees de faible poids molCculaire sont une constquence de structures cycliques. Sur la base de ces rksultats et de I'ensemble des observations, on propose un mtcanisme pour la polymtrisation des a,o-alkyldiynes.