[Stability and variability of catatonic symptoms in the longitudinal course of illness. Videotape documentation in catatonic schizophrenia].

The symptomatology of a female patient with catatonic schizophrenia is presented with respect to its longitudinal course. The stability and variability of catatonic symptoms are investigated using videotape technique. It is demonstrated that catatonic symptoms are stable in the longitudinal course but due to unsteady arousal the severity of the catatonic symptoms varies markedly. There are fluctuating symptom patterns that dominate the clinical picture: a hyperkinetic form with prevailing restlessness or excitement, with abnormal involuntary movements, stereotypies, and parakinetic movements, and a hypokinetic form with various inhibition phenomena, mutism and stupor. The clinical impression of the catatonic syndrome changes according to the dominating symptom patterns at different times, whereas the less severe symptoms recede into the background and thus, may be overlooked. Considering this finding the problem of a 'diagnostic threshold' is discussed. The authors intend to emphasize videotape documentation of catatonic motor disturbances as most useful. This technique may contribute to differentiating illness related from neuroleptic induced movement disorders.