Which of the following is a sign of catatonia?

• A. Waxy flexibility
• B. Pressured speech
• C. Delusions of persecution
• D. Tremor

Answer: (A)

Catatonia presents with marked psychomotor disturbance, and a hallmark sign is waxy flexibility. In this finding, a examiner can move a patient’s limb into a new position and the limb will stay in that position for a while, as if it were made of wax. This passive maintenance of posture differentiates catatonia from normal movement or voluntary resistance, and it often appears alongside other motor symptoms like stupor, mutism, rigidity, negativism, echolalia, or echopraxia. By contrast, pressed speech signals a rapid, loud flow of ideas typical of mania or high arousal, not catatonia; delusions of persecution are beliefs about outside threats, a thought content issue rather than a motor disturbance; tremor is a rhythmic movement more common in neurological conditions or medication side effects.