Am J Psychiatry 1986; 143:1409-1414
Copyright © 1986 by American Psychiatric Association
Mutism: review, differential diagnosis, and report of 22 cases [published erratum appears in Am J Psychiatry 1987 Apr;144(4):542]
LL Altshuler, JL Cummings and MJ Mills
Mutism is a common manifestation of both psychiatric and neurologic
illness. Psychiatric disturbances associated with mutism include
schizophrenia, affective disorders, conversion reactions, dissociative
states, and dementias. Neurologic disorders producing mutism involve the
basal ganglia, frontal lobes, or limbic system structures. In psychiatric
and neurologic conditions, mutism is often associated with other signs of
catatonia. The authors review the literature on mutism, including
psychiatric, neurologic, toxic-metabolic, and drug-induced causes. Methods
to discriminate among the many causes of mutism in the clinical setting are
discussed, and 22 new cases of mutism are reported to emphasize the wide
differential diagnosis.
