There is not yet a definitive consensus regarding diagnostic criteria of<unk> . In the American Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the World Health Organization's eleventh edition of the International Classification of Disease (ICD-11) the classification is more homogeneous than in earlier editions. Prominent researchers in the field have other suggesions for diagnostic criteria. DSM-5 classification The DSM-5 does not classify<unk>  as an independent disorder, but rather it classifies it as<unk>  associated with another mental disorder, due to another medical condition, or as unspecified<unk> .<unk>  is diagnosed by the presence of three or more of the following 12 psychomotor symptoms in association with a mental disorder, medical condition, or unspecified: * stupor: no psycho-motor activity; not actively relating to the environment * catalepsy: passive induction of a posture held against gravity * waxy flexibility: allowing positioning by an examiner and maintaining that position * mutism: no, or very little, verbal response (exclude if known aphasia) * negativism: opposition or no response to instructions or external stimuli * posturing: spontaneous and active maintenance of a posture against gravity * mannerisms that are odd, circumstantial caricatures of normal actions * stereotypy: repetitive, abnormally frequent, non-goal-directed movements * agitation, not influenced by external stimuli * grimacing: keeping a fixed facial expression * echolalia: mimicking another's speech * echopraxia: mimicking another's movements. Other disorders (additional code 293.89 F06.1 to indicate the presence of the co-morbid<unk> : *<unk>  associated with autism spectrum disorder *<unk>  associated with schizophrenia spectrum and other psychotic disorders *<unk>  associated with brief psychotic disorder *<unk>  associated with schizophreniform disorder *<unk>  associated with schizoaffective disorder *<unk>  associated with a substance-induced psychotic disorder *<unk>  associated with bipolar and related disorders *<unk>  associated with major depressive disorder *<unk>  disorder due to another medical condition If<unk>  symptoms are present but do not form the<unk>  syndrome, a medication- or substance-induced aetiology should first be considered. ICD-11 classification In ICD-11<unk>  is defined as a syndrome of primarily psychomotor disturbances that is characterized by the simultaneous occurrence of several symptoms such as stupor; catalepsy; waxy flexibility; mutism; negativism; posturing; mannerisms; stereotypies; psychomotor agitation; grimacing; echolalia and echopraxia.<unk>  may occur in the context of specific mental disorders, including mood disorders, schizophrenia or other primary psychotic disorders, and Neurodevelopmental disorders, and may be induced by psychoactive substances, including medications.<unk>  may also be caused by a medical condition not classified under mental, behavioral, or neurodevelopmental disorders. Assessment/Physical<unk>  is often overlooked and under-diagnosed. Patients with<unk>  most commonly have an underlying psychiatric disorder, for this reason, physicians may overlook signs of<unk>  due to the severity of the psychosis the patient is presenting with. Furthermore, the patient may not be presenting with the common signs of<unk>  such as mutism and posturing. Additionally, the motor abnormalities seen in<unk>  are also present in psychiatric disorders. For example, a patient with mania will show increased motor activity that may progress to exciting<unk> . One way in which physicians can differentiate between the two is to observe the motor abnormality. Patients with mania present with increased goal-directed activity. On the other hand, the increased activity in<unk>  is not goal-directed and often repetitive.<unk>  is a clinical diagnosis and there is no specific laboratory test to diagnose it. However, certain testing can help determine what is causing the<unk> . An EEG will likely show diffuse slowing. If seizure activity is driving the syndrome, then an EEG would also be helpful in detecting this. CT or MRI will not show<unk> ; however, they might reveal abnormalities that might be leading to the syndrome. Metabolic screens, inflammatory markers, or autoantibodies may reveal reversible medical causes of<unk> . Vital signs should be frequently monitored as<unk>  can progress to malignant<unk>  which is life-threatening. Malignant<unk>  is characterized by fever, hypertension, tachycardia, and tachypnea. Rating scale Various rating scales for<unk>  have been developed, however, their utility for clinical care has not been well established. The most commonly used scale is the Bush-Francis<unk>  Rating Scale (BFCRS) (external link is provided below). The scale is composed of 23 items with the first 14 items being used as the screening tool. If 2 of the 14 are positive, this prompts for further evaluation and completion of the remaining 9 items. A diagnosis can be supported by the lorazepam challenge or the zolpidem challenge. While proven useful in the past, barbiturates are no longer commonly used in psychiatry; thus the option of either benzodiazepines or ECT.
Catatonia
Neuroleptic malignant syndrome
Paratonia
Childhood schizophrenia
Cataplexy
Clonus
Catalepsy
Psychomotor agitation