Stupor is a neglected syndrome. This may be due to its low incidence, intrinsic complexity and good response to ECT. Paucity of clinical material has not allowed for adequate statistical and scientific analysis and therefore its phenomenology and neurophysiology remain unclear. Important questions are whether: (1) stupor constitutes a stable form of behavior amounting to a "symptom complex"; (2) it represents a preprogrammed or vestigial behavior which may be triggered off by severe noxae, whether psychogenic or organic; (3) personality and underlying cause play a modulating role and; (4) organic and functional stupors share similar underlying mechanisms or, alternatively, refer to unrelated clinical states. An evolutionary view should integrate neurological and organic stupors and justify the use of the "freezing" or cataleptic response to stress in animals as a research model. This should in turn suggest pharmacological predictions of interest for the management of human stupor.
Stupor; disorders of consciousness; disorders of consciousness; organic mental disorders