Obsessive slowness mimicking catatonia in an adolescent - A case report

Obsessive Slowness (OS) is an extremely rare clinical syndrome characterised by debilitating slowness of all voluntary adaptive movements and activities. It is a diagnosis of exclusion with management difficulties. We report a case of adolescent male presented with extreme slowness of all voluntary activities and associated catatonic signs like mutism, posturing, immobility, metgehen and ambitendency. Diagnosis of Obsessive Compulsive Disorder (OCD) with OS was made after systematic neurological examination, extensive investigations and detailed psychiatric assessment. He has shown remarkable improvement with escitalopram 40 mg/day, clonazepam 2 mg/day, Intensive family-based Cognitive Behavioural Therapy (CBT) and individualised psychosocial rehabilitation interventions. After 15 months of discharge, his improvement is sustained and is currently practicing home based Exposure Response Prevention (ERP) and has returned to school.