Where psychiatric diagnosis is dominated by subjective report, psychosomatic medicine fosters unique opportunities for clinical assessment that is rooted firmly in the physical examination. Catatonia presents a prime example. By rendering patients unable to describe their internal experiences, catatonia demands from psychiatrists a confident comfort with its variable presentations and diagnostic challenges. This proves especially true in the general hospital. Despite a common tendency to confine the syndrome to psychiatric disease, catatonia is precipitated by general medical conditions in up to 25% of cases1 and can, itself, trigger serious physical complications.2"4 As a result, consultation psychiatrists find themselves routinely at the forefront in providing care for the catatonic patient.
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