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Edward Shorter

and Max Fink

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date: 01 March 2021

The long history of catatonia is presently resolved into a systemic syndrome, identified by symptoms and signs, verified by tests, and fully resolved by defined means. Our skills in relieving catatonia are as successful as our treatment for neurosyphilis. Catatonia is best seen as a systemic medical, not a psychiatric disorder. Unresolved fear is a core feature in its pathophysiology. There are difficulties distinguishing catatonia from melancholia; the prompt resolution of both with induced seizures presents a challenge in understanding them. Are they related? Melancholia’s neuroendocrine abnormalities offer direction to neuroscience studies of catatonia and of the mechanism of electroconvulsive therapy (ECT).

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