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The Madness of Fear - A History of Catatonia (Paperback)
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The Madness of Fear - A History of Catatonia (Paperback)
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What are the real disease entities in psychiatry? This is a
question that has bedeviled the study of the mind for more than a
century yet it is low on the research agenda of psychiatry. Basic
science issues such as neuroimaging, neurochemistry, and genetics
carry the day instead. There is nothing wrong with basic science
research, but before studying the role of brain circuits or
cerebral chemistry, shouldn't we be able to specify how the various
diseases present clinically? Catatonia is a human behavioral
syndrome that for almost a century was buried in the poorly
designated psychiatric concept of schizophrenia. Its symptoms are
well-know, and some of them are serious. Catatonic patients may die
as their temperatures accelerate; they become dehydrated because
they refuse to drink; they risk inanition because they refuse to
eat or move. Autistic children with catatonia may hit themselves
repeatedly in the head. We don't really know what catatonia is, in
the sense that we know what pneumonia is. But we can identify it,
and it is eminently treatable. Clinicians can make these patients
better on a reliable basis. There are few other disease entities in
psychiatry of which this is true. So why has there been so little
psychiatric interest in catatonia? Why is it simply not on the
radar of most clinicians? Catatonia actually occurs in a number of
other medical illnesses as well, but it is certainly not on the
radar of most internists or emergency physicians. In The Madness of
Fear, Drs. Shorter and Fink seek to understand why this "vast field
of ignorance" exists. In the history of catatonia, they see a
remarkable story about how medicine flounders, and then seems to
find its way. And it may help doctors, and the public, to recognize
catatonia as one of the core illnesses in psychiatry.
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