Psychiatric specifier

With catatonia

A marked psychomotor syndrome is present and needs structured, time-sensitive assessment.

Episode features

Mood disordersPsychotic disordersMedical conditions

What matters now

Applies toMood disorders · Psychotic disorders

Deciding signalA cluster of psychomotor signs is more informative than immobility or reduced speech alone.

Ask thisIs there a coherent catatonic syndrome after urgent medical, neurological, toxic, and medication causes are considered?

Wording outcomeBipolar I disorder, current episode depressed, with catatonia

Fit and exclusions

Make the specifier earn its place

Start with the deciding signal, then test chronology, competing explanations, and the effect on diagnostic wording.

When this fits

Multiple characteristic psychomotor signs are directly observed or reliably described.
The change is substantial from baseline and not explained by ordinary withdrawal or fatigue.
A structured examination and urgent physical assessment are underway.

When this may not fit

Reduced movement is better explained by sedation, delirium, neurological disease, severe parkinsonism, or negative symptoms.
Only one nonspecific sign is present without a broader syndrome.

Focused checks

Patient language

Clinical implication

Treat catatonia as time-sensitive; coordinate urgent medical assessment and syndrome-specific management.