Catatonia as a disorder of agency: Commentary on Wang et al.

Abstract

Catatonia is conventionally understood as a disorder of motor output, yet many defining signs preserve that output, and in several signs the examiner supplies the initiation. This commentary proposes that catatonia is better described as a disorder of agency, and that criteria organized by the form the signs take rather than by the disturbance they express may account for the unstable factor structure Wang et al. (2026) report. It predicts that patients will later report blocked intention during immobility, and will not report the elicited signs. Catatonia research should assess dissociation directly, by observation during the episode and self-report after it.