Fade into you: catatonia and disorders of diminished motivation in two cases

Catatonia is a complex neuropsychiatric syndrome often associated with psychiatric or medical conditions, requiring careful evaluation to identify underlying causes. Disorders of diminished motivation (DDM), such as Abulia and Akinetic Mutism, can mimic catatonia and demand alternative treatment approaches. This case series describes two patients, one diagnosed with Abulia secondary to Wernicke’s encephalopathy and the other with lorazepam-responsive catatonia due to medication mismanagement. These cases highlight the utility of validated tools such as the Bush-Francis Catatonia Rating Scale (BFCRS) and KANNER scale in diagnostic assessment. They also emphasize the importance of individualized treatment strategies tailored to the underlying etiology. The discussion incorporates evidence-based guidelines from Spiegel and Denysenko et al., emphasizing systematic diagnostic frameworks for catatonia and its mimics.