Catatonia in ICD-11
Abstract In the International Statistical Classification of Diseases and Related Health Problems Version 11 (ICD-11), the diagnostic criteria for catatonia have been extensively revised. We provide context for these changes beginning with a brief history of how catatonia has been conceptualized and...
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BMC
2025-04-01
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| Online Access: | https://doi.org/10.1186/s12888-025-06857-6 |
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| author | Jonathan P. Rogers Jo Ellen Wilson Mark A. Oldham |
| author_facet | Jonathan P. Rogers Jo Ellen Wilson Mark A. Oldham |
| author_sort | Jonathan P. Rogers |
| collection | DOAJ |
| description | Abstract In the International Statistical Classification of Diseases and Related Health Problems Version 11 (ICD-11), the diagnostic criteria for catatonia have been extensively revised. We provide context for these changes beginning with a brief history of how catatonia has been conceptualized and a description of how the criteria for catatonia have changed across ICD versions. We also compare ICD-11 with the criteria in the latest Diagnostic and Statistical Manual of Mental Disorders (i.e., DSM-5-TR), consider clinical implications of the changes in ICD-11, and highlight conceptual areas in need of further development. Described in 1874 by Karl Kahlbaum, catatonia was subsequently subsumed into the Kraepelinian concept of dementia praecox. This was reflected in versions of ICD up to ICD-9, which considered catatonia exclusively as a form of schizophrenia. ICD-10 introduced the diagnosis of organic catatonic disorder but did not incorporate the growing evidence that catatonia can occur in psychiatric conditions such as mood and autism-spectrum disorders. ICD-11 conceptualizes catatonia as an independent disorder with a common clinical phenotype regardless of associated condition, if present. In ICD-11, catatonia diagnosis requires at least three clinical features from the following categories: decreased, increased or abnormal psychomotor activity. These features may come from any combination of the categories, but only one from the increased psychomotor activity category should be counted. The four catatonia diagnoses in ICD-11 are catatonia associated with another mental disorder, catatonia induced by substances or medications, secondary catatonia syndrome and catatonia, unspecified. This expanded view of catatonia more closely resembles DSM-5-TR, which also recognizes catatonia associated with several psychiatric and general medical conditions. ICD-11 also offers guidance on distinguishing catatonia from similar behavioural features of other conditions, such as psychomotor retardation in depression, delirium, and factitious disorder. This new classification stands to improve recognition of catatonia and our hope is that it may lead to a growing awareness of the wide range of conditions associated with it. Ultimately, a better understanding of catatonia should contribute to improved outcomes as clinicians offer treatments both for catatonia itself as well as tailored treatments for its broad range of associated conditions. |
| format | Article |
| id | doaj-art-4c97c8f1bd954389aa0aae62fcec769b |
| institution | DOAJ |
| issn | 1471-244X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj-art-4c97c8f1bd954389aa0aae62fcec769b2025-08-20T03:18:34ZengBMCBMC Psychiatry1471-244X2025-04-0125111010.1186/s12888-025-06857-6Catatonia in ICD-11Jonathan P. Rogers0Jo Ellen Wilson1Mark A. Oldham2Division of Psychiatry, University College LondonVeterans Affairs, Geriatric Research, Education and Clinical Center, Tennessee Valley Healthcare SystemDepartment of Psychiatry, University of Rochester Medical CenterAbstract In the International Statistical Classification of Diseases and Related Health Problems Version 11 (ICD-11), the diagnostic criteria for catatonia have been extensively revised. We provide context for these changes beginning with a brief history of how catatonia has been conceptualized and a description of how the criteria for catatonia have changed across ICD versions. We also compare ICD-11 with the criteria in the latest Diagnostic and Statistical Manual of Mental Disorders (i.e., DSM-5-TR), consider clinical implications of the changes in ICD-11, and highlight conceptual areas in need of further development. Described in 1874 by Karl Kahlbaum, catatonia was subsequently subsumed into the Kraepelinian concept of dementia praecox. This was reflected in versions of ICD up to ICD-9, which considered catatonia exclusively as a form of schizophrenia. ICD-10 introduced the diagnosis of organic catatonic disorder but did not incorporate the growing evidence that catatonia can occur in psychiatric conditions such as mood and autism-spectrum disorders. ICD-11 conceptualizes catatonia as an independent disorder with a common clinical phenotype regardless of associated condition, if present. In ICD-11, catatonia diagnosis requires at least three clinical features from the following categories: decreased, increased or abnormal psychomotor activity. These features may come from any combination of the categories, but only one from the increased psychomotor activity category should be counted. The four catatonia diagnoses in ICD-11 are catatonia associated with another mental disorder, catatonia induced by substances or medications, secondary catatonia syndrome and catatonia, unspecified. This expanded view of catatonia more closely resembles DSM-5-TR, which also recognizes catatonia associated with several psychiatric and general medical conditions. ICD-11 also offers guidance on distinguishing catatonia from similar behavioural features of other conditions, such as psychomotor retardation in depression, delirium, and factitious disorder. This new classification stands to improve recognition of catatonia and our hope is that it may lead to a growing awareness of the wide range of conditions associated with it. Ultimately, a better understanding of catatonia should contribute to improved outcomes as clinicians offer treatments both for catatonia itself as well as tailored treatments for its broad range of associated conditions.https://doi.org/10.1186/s12888-025-06857-6CatatoniaCatatonic schizophreniaICD-11Classification |
| spellingShingle | Jonathan P. Rogers Jo Ellen Wilson Mark A. Oldham Catatonia in ICD-11 BMC Psychiatry Catatonia Catatonic schizophrenia ICD-11 Classification |
| title | Catatonia in ICD-11 |
| title_full | Catatonia in ICD-11 |
| title_fullStr | Catatonia in ICD-11 |
| title_full_unstemmed | Catatonia in ICD-11 |
| title_short | Catatonia in ICD-11 |
| title_sort | catatonia in icd 11 |
| topic | Catatonia Catatonic schizophrenia ICD-11 Classification |
| url | https://doi.org/10.1186/s12888-025-06857-6 |
| work_keys_str_mv | AT jonathanprogers catatoniainicd11 AT joellenwilson catatoniainicd11 AT markaoldham catatoniainicd11 |