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These diagnostic criteria significantly advance the field because they represent the consensus of an international multispecialty expert panel, include critical values, provide guidance regarding the relative importance of individual elements, and are less influenced by particular theoretical biases than most previously published criteria. They require validation before being applied in clinical settings.

Catatonia is a common neuropsychiatric syndrome which may arise from GABA-A hypoactivity, dopamine (D2) hypoactivity,and possibly glutamate NMDA hyperactivity. Amantadine and memantine have been reported as effective treatments for catatonia in selected cases, and probably mediate the presence of catatonic signs and symptoms through complex pathways involving glutamate antagonism. The authors identified 25 cases of catatonia treated with either agent. This article provides indirect evidence that glutamate antagonists may improve catatonic signs in some patients who fail to respond to established treatment, including lorazepam or electroconvulsive therapy. Further study of glutamate antagonists in the treatment of catatonia is needed.

European states responded to the rapid spread of the COVID-19 pandemic in 2020 with a variety of public policy measures. Governments across the continent acted more or less swiftly to close down schools, restrict arrival into their countries and travel within their territories, ban public meetings, impose local and national lockdowns, declare states of emergency and pass other emergency measures. Importantly, both the mix of policy tools as well as the speed with which they were enacted differed significantly even within the member states of the European Union. In this article we ask what can account for this variation in policy responses, and we identify a number of factors related to institutions, general governance and specific health-sector related capacities, societal trust, government type, and party preferences as possible determinants. Using multivariate regression and survival analysis, we model the speed with which school closures, national lockdowns and states of emergency were announced. The models suggest a number of significant and often counterintuitive relationships: we find that more centralized countries with lower government effectiveness, freedom and societal trust, but with separate ministries of health and health ministers with medical background acted faster and more decisively. These results are important in light of the large positive effects early policy responses likely had on managing the impact of the pandemic.

Catatonia and neuroleptic malignant syndrome (NMS) are uncommon disorders that can be life-threatening. Many researchers consider them as clinically divergent entities; however, they share similar and overlapping literature on causative agents, phenomenology, and treatment response. This hypothesis considers both disorders as a single entity that result from variable combinations of the following: 1) γ-aminobutyric acid (GABA) hypoactivity at the GABAA receptor; 2) dopamine hypoactivity at the D2 receptor; 3) serotonin hyperactivity at the 5-HT1A receptor and hypoactivity at the 5-HT2A receptor; and 4) glutamate hypoactivity at the N-methyl-D-aspartate (NDMA) receptor. In this paper, evidence to support this hypothesis is limited to retrospective human studies of catatonia and NMS. The four components of the hypothesis are: 1) GABAA agonists have been shown to alleviate catatonia and NMS; 2) D2 antagonism is proportional to the relative likelihood of NMS and catatonia; 3) 5-HT1A agonism with 5-HT2A antagonism is implicated in catatonia and NMS; 4) NMDA receptor antagonists, such as phencyclidine and ketamine, reduce glutamate transmission. This hypothesis proposes that it is the interaction of these systems that prediposes, initiates, and maintains the twin syndromes of catatonia and NMS.

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