The polysemous concepts of psychomotricity and catatonia: A European multi-consensus perspective

Current classification systems use the terms catatonia and psychomotor phenomena as mere a-theoretical descriptors, forgetting about their theoretical embedment. This was the source of misunderstandings among clinicians and researchers of the European collaboration on movement and sensorimotor/psychomotor functioning in schizophrenia and other psychoses or ECSP. Here, we review the different perspectives, their historical roots and highlight discrepancies. In 1844, Wilhelm Griesinger coined the term psychic-motor to name the physiological process accounting for volition. While deriving from this idea, the term psychomotor actually refers to systems that receive miscellaneous intrapsychic inputs, convert them into coherent behavioral outputs send to the motor systems. More recently, the sensorimotor approach has drawn on neuroscience to redefine the motor signs and symptoms observed in psychoses. In 1874, Karl Kahlbaum conceived catatonia as a brain disease emphasizing its somatic - particularly motor - features. In conceptualizing dementia praecox Emil Kraepelin rephrased catatonic phenomena in purely mental terms, putting aside motor signs which could not be explained in this way. Conversely, the Wernicke-Kleist-Leonhard school pursued Kahlbaum's neuropsychiatric approach and described many new psychomotor signs, e.g. parakinesias, Gegenhalten. They distinguished 8 psychomotor phenotypes of which only 7 are catatonias. These barely overlap with consensus classifications, raising the risk of misunderstanding. Although coming from different traditions, the authors agreed that their differences could be a source of mutual enrichment, but that an important effort of conceptual clarification remained to be made. This narrative review is a first step in this direction. (C) 2021 Published by Elsevier B.V.

Automated summary

The current classification systems use terms catatonia and psychomotor phenomena as a-theoretical descriptors, leading to misunderstandings among clinicians and researchers. Historical perspectives and terms have been reviewed, highlighting discrepancies and the need for conceptual clarification. Different schools of thought have contributed to the understanding of psychomotor functioning in schizophrenia and psychoses.