Chapter 36 covers the topic of catatonia and electroconvulsive therapy . Through a case vignette with topical MCQs for consolidation of learning, readers are brought through the management of a patient with catatonia from first presentation to subsequent complications of the conditions and its treatment with electroconvulsive therapy (ECT) and other medications. Things covered include the symptoms, diagnosis, differential diagnoses, investigations, the evidence-based use and indications of pharmacological treatment such as benzodiazpines and ECT, adverse effects of ECT, management of adverse cognitive effects from ECT and use of ECT in pregnancy.

Psychiatric illness may be associated with objective or subjective motor disorders. This chapter is chie?y devoted to objective motor disorders, but subjective motor disorders may also occur. It is difficult to classify motor disorders because although clear-cut individual motor signs (such as stereotypies) can be treated as if they were neurological symptoms, it is much more difficult to classify more complicated patterns of behaviour. Nonetheless, motor disorders can be broadly grouped into the following categories: (a) disorders of adaptive movements; (b) disorders of non-adaptive movements; (c) motor speech disturbances; (d) disorders of posture; (e) abnormal complex patterns of behaviour; and (f) movement disorders associated with antipsychotic medication. This chapter explores and explains these different categories of motor disorder in the context of psychiatric illness. The chapter concludes with suggested questions for eliciting specific symptoms in clinical practice, in addition to standard history-taking, mental state examination and physical examination.