Year: 2026
Type: preprint
Study design: Observational Study
Abstract: When benzodiazepines fail in catatonia, clinicians know what to escalate to but not what to stabilize first. We asked a narrower question that clinical records can address: does recovery follow a fixed order? We defined five capacities in plain clinical terms and mapped them onto precision domains of hierarchical inference. The domains are theory-derived clinical abstractions, not latent variables estimated from these data. In 25 consecutive inpatients managed without electroconvulsive therapy, an order fixed before coding held without inversion in every patient, and held again when a hypothesis-blind co-author re-rated all milestones according to a pre-registered protocol. In five patients the sequence was completed while hallucinations and delusions persisted, so the order does not follow the resolution of psychotic symptoms. Bush–Francis scores fell from 26.3 to 2.0. This retrospective study shows that the order held, not why. Prospective studies, preferably with blinded daily rating, are needed to corroborate the order.
Source: medRxiv
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7203627183