Catatonia in ICD-11.

Area of Science:

• Psychiatry
• Neurology
• Clinical Psychology

Background:

• Catatonia was historically linked solely to schizophrenia in earlier ICD versions.
• ICD-10 allowed for organic catatonia but overlooked its presence in mood and autism spectrum disorders.
• Previous classifications failed to capture the full spectrum of catatonia's presentation and associations.

Purpose of the Study:

• To provide context for the revised catatonia diagnostic criteria in ICD-11.
• To compare ICD-11 criteria with the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR).
• To explore the clinical implications and future research directions for catatonia diagnosis.

Main Methods:

• Historical review of catatonia conceptualization across ICD versions.
• Comparative analysis of ICD-11 and DSM-5-TR diagnostic criteria for catatonia.
• Examination of ICD-11's approach to psychomotor activity and diagnostic categories.

Main Results:

• ICD-11 classifies catatonia as an independent disorder with a common phenotype, irrespective of the associated condition.
• Diagnosis in ICD-11 requires at least three features from decreased, increased, or abnormal psychomotor activity categories.
• ICD-11 includes four diagnoses: catatonia associated with another mental disorder, substance/medication-induced, secondary catatonia syndrome, and unspecified catatonia.
• The ICD-11 framework aligns more closely with DSM-5-TR's broader recognition of catatonia's associations.

Conclusions:

• The revised ICD-11 criteria enhance the recognition of catatonia as a distinct syndrome.
• This expanded classification facilitates better understanding and tailored treatment for catatonia and its associated conditions.
• Further research is needed to refine conceptual areas and improve clinical outcomes for catatonia.