Catatonia in the DSM--shall we move or not?

The current issue ofSchizophreniaBulletin includes 2 opinion pieces on the nosology of catatonia and 1 on the treatment of catatonia. Fink and colleagues argue that the original concept of catatonia, introduced by Karl Kahlbaum in 1874, was inappropriately subsumed under dementia praecox and, subsequently, schizophrenia. They ask for a divorce of catatonia from schizophrenia and the recognition of catatonia as an independent diagnostic class in the next edition of theDiagnostic and Statistical Manual of Mental Disorder (DSM). Ungvari and colleagues argue that chronically abnormal psychomotor behavior is a core feature of schizophrenia. They ask for clarification of which psychomotor symptoms are part and parcel of psychotic and mood disorders and consider a divorce of catatonia from schizophrenia premature. Rosebush and Mazurek summarize treatment observations, which provide support for both perspectives: catatonic symptoms uniquely respond to treatment with benzodiazepines and electroconvulsive therapy (ECT) (supporting Fink et al), but catatonic patients with schizophrenia do not derive as much benefit as patients with an affective disorder (supporting Ungvari et al).