4 topics with concise reviews: definitions, key facts, and class questions.
Motor disorders in psychiatry are not just a neurological deficit, but an external manifestation of severe mental disorders or a direct consequence of psychopharmacotherapy. In this chapter, we analyze the pathology of the psychomotor sphere, where every gesture or complete lack of movement has crucial diagnostic significance.
This section covers four key blocks: emergency conditions (psychomotor agitation and stupor), catatonic syndrome specific to endogenous psychoses, as well as neuroleptic extrapyramidal syndrome, and various tics and hyperkinesias.
During clinical case reviews and exams, professors most frequently ask about the differential diagnosis of catatonic stupor and severe extrapyramidal syndrome. Pay special attention to algorithms for the pharmacological management of psychomotor agitation and the principles of prescribing correctors during antipsychotic therapy. A clear understanding of these topics is essential for safe practice in a psychiatric inpatient facility.
How does catatonic agitation differ from psychomotor agitation?
Psychomotor agitation reflects the patient's emotions (e.g., an attempt to escape from an imaginary threat). Catatonic agitation is senseless, chaotic, and has no connection to internal psychological experiences.
What is the difference between catatonic agitation and manic agitation?
In manic syndrome, speech and actions are always purposeful (the patient wants to help, interferes in affairs) and are never stereotyped. In catatonia, agitation is senseless, chaotic, and full of stereotypies.
Why are disinhibiting drugs contraindicated in depressive stupor?
Relieving motor inhibition against the background of preserved melancholic affect allows the patient to immediately carry out suicidal intentions.
What is the main danger for a patient in catatonic stupor?
The primary threat to the patient's life comes from prolonged refusal of food, which requires immediate medical intervention. This danger outweighs the risks of suicide or infections.
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