{"id":"https://openalex.org/W7203627183","doi":"https://doi.org/10.64898/2026.08.13.26360194","title":"Recovery from catatonia follows a hierarchical precision order","display_name":"Recovery from catatonia follows a hierarchical precision order","publication_year":2026,"publication_date":"2026-08-17","ids":{"openalex":"https://openalex.org/W7203627183","doi":"https://doi.org/10.64898/2026.08.13.26360194"},"language":"en","primary_location":{"id":"doi:10.64898/2026.08.13.26360194","doi":"https://doi.org/10.64898/2026.08.13.26360194","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.13.26360194","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/17/2026.08.13.26360194.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/17/2026.08.13.26360194.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5140534844","display_name":"Hiroki Saito","orcid":"https://orcid.org/0000-0002-4964-8559","observed_orcids":["https://orcid.org/0000-0002-4964-8559"]},"institutions":[{"id":"https://openalex.org/I80188885","display_name":"Nippon Medical School","ror":"https://ror.org/00krab219","country_code":"JP","type":"education","lineage":["https://openalex.org/I80188885"]}],"countries":["JP"],"is_corresponding":true,"raw_author_name":"Hiroki Saito","raw_affiliation_strings":["Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8602, Japan","Onda-daini Hospital, Matsudo-shi, Chiba, Japan"],"raw_orcid":"https://orcid.org/0000-0002-4964-8559","affiliations":[{"raw_affiliation_string":"Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8602, Japan","institution_ids":["https://openalex.org/I80188885"]},{"raw_affiliation_string":"Onda-daini Hospital, Matsudo-shi, Chiba, Japan","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5108255260","display_name":"Yuichi Takizawa","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I80188885","display_name":"Nippon Medical School","ror":"https://ror.org/00krab219","country_code":"JP","type":"education","lineage":["https://openalex.org/I80188885"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Yuichi Takizawa","raw_affiliation_strings":["Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8602, Japan","Onda-daini Hospital, Matsudo-shi, Chiba, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8602, Japan","institution_ids":["https://openalex.org/I80188885"]},{"raw_affiliation_string":"Onda-daini Hospital, Matsudo-shi, Chiba, Japan","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5036432593","display_name":"Issei Murata","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Issei Murata","raw_affiliation_strings":["Onda-daini Hospital, Matsudo-shi, Chiba, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Onda-daini Hospital, Matsudo-shi, Chiba, Japan","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5089350264","display_name":"Amane Tateno","orcid":"https://orcid.org/0000-0002-4590-0120","observed_orcids":["https://orcid.org/0000-0002-4590-0120"]},"institutions":[{"id":"https://openalex.org/I80188885","display_name":"Nippon Medical School","ror":"https://ror.org/00krab219","country_code":"JP","type":"education","lineage":["https://openalex.org/I80188885"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Amane Tateno","raw_affiliation_strings":["Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8602, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8602, Japan","institution_ids":["https://openalex.org/I80188885"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037624542","display_name":"Jakob Theorell","orcid":"https://orcid.org/0000-0001-8752-3151","observed_orcids":["https://orcid.org/0000-0001-8752-3151"]},"institutions":[{"id":"https://openalex.org/I1335113835","display_name":"Karolinska University Hospital","ror":"https://ror.org/00m8d6786","country_code":"SE","type":"healthcare","lineage":["https://openalex.org/I1335113835"]},{"id":"https://openalex.org/I28166907","display_name":"Karolinska Institutet","ror":"https://ror.org/056d84691","country_code":"SE","type":"education","lineage":["https://openalex.org/I28166907"]}],"countries":["SE"],"is_corresponding":false,"raw_author_name":"Jakob Theorell","raw_affiliation_strings":["Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden","Unit of Neurology, Karolinska University Hospital, Stockholm, Sweden"],"raw_orcid":"https://orcid.org/0000-0001-8752-3151","affiliations":[{"raw_affiliation_string":"Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden","institution_ids":["https://openalex.org/I28166907"]},{"raw_affiliation_string":"Unit of Neurology, Karolinska University Hospital, Stockholm, Sweden","institution_ids":["https://openalex.org/I1335113835"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5026948578","display_name":"Ryosuke Arakawa","orcid":"https://orcid.org/0000-0001-5569-1361","observed_orcids":["https://orcid.org/0000-0001-5569-1361"]},"institutions":[{"id":"https://openalex.org/I80188885","display_name":"Nippon Medical School","ror":"https://ror.org/00krab219","country_code":"JP","type":"education","lineage":["https://openalex.org/I80188885"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Ryosuke Arakawa","raw_affiliation_strings":["Department of Pharmacology, Graduate School of Medicine, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8602, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pharmacology, Graduate School of Medicine, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8602, Japan","institution_ids":["https://openalex.org/I80188885"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5063179816","display_name":"Mikael Tiger","orcid":"https://orcid.org/0000-0001-8495-8125","observed_orcids":["https://orcid.org/0000-0001-8495-8125"]},"institutions":[{"id":"https://openalex.org/I2801939835","display_name":"Region Stockholm","ror":"https://ror.org/02zrae794","country_code":"SE","type":"government","lineage":["https://openalex.org/I2801939835"]},{"id":"https://openalex.org/I28166907","display_name":"Karolinska Institutet","ror":"https://ror.org/056d84691","country_code":"SE","type":"education","lineage":["https://openalex.org/I28166907"]},{"id":"https://openalex.org/I4210135665","display_name":"Stockholm Health Care Services","ror":"https://ror.org/04d5f4w73","country_code":"SE","type":"healthcare","lineage":["https://openalex.org/I2801939835","https://openalex.org/I4210135665"]}],"countries":["SE"],"is_corresponding":false,"raw_author_name":"Mikael Tiger","raw_affiliation_strings":["Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden"],"raw_orcid":"https://orcid.org/0000-0001-8495-8125","affiliations":[{"raw_affiliation_string":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden","institution_ids":["https://openalex.org/I2801939835","https://openalex.org/I28166907","https://openalex.org/I4210135665"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5140534844"],"corresponding_institution_ids":["https://openalex.org/I80188885"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11921","display_name":"Electroconvulsive Therapy Studies","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2738","display_name":"Psychiatry and Mental health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11921","display_name":"Electroconvulsive Therapy Studies","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2738","display_name":"Psychiatry and Mental health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10919","display_name":"Deep Brain Stimulation and Movement Disorders","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11071","display_name":"Treatment of Major Depression","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2736","display_name":"Pharmacology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/catatonia","display_name":"catatonia","score":0.9819999933242798},{"id":"https://openalex.org/keywords/recovery-sequences","display_name":"recovery sequences","score":0.6970000267028809},{"id":"https://openalex.org/keywords/hierarchical-inference","display_name":"hierarchical inference","score":0.781000018119812},{"id":"https://openalex.org/keywords/precision-medicine","display_name":"precision medicine","score":0.7480000257492065},{"id":"https://openalex.org/keywords/psychotic-symptoms","display_name":"psychotic symptoms","score":0.6330000162124634},{"id":"https://openalex.org/keywords/hallucinations-and-delusions","display_name":"delusions and hallucinations","score":0.8500000238418579},{"id":"https://openalex.org/keywords/clinical-milestones","display_name":"clinical milestones","score":0.31700000166893005},{"id":"https://openalex.org/keywords/pre-registered-protocol","display_name":"pre-registered protocol","score":0.6129999756813049}],"concepts":[{"id":"https://openalex.org/C2778941822","wikidata":"https://www.wikidata.org/wiki/Q501571","display_name":"Catatonia","level":3,"score":0.6678000092506409},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.5400999784469604},{"id":"https://openalex.org/C1893757","wikidata":"https://www.wikidata.org/wiki/Q3653001","display_name":"Inversion (geology)","level":3,"score":0.5378000140190125},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.461899995803833},{"id":"https://openalex.org/C2777330709","wikidata":"https://www.wikidata.org/wiki/Q131543","display_name":"Electroconvulsive therapy","level":3,"score":0.44110000133514404},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.42500001192092896},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.3400000035762787},{"id":"https://openalex.org/C2780665704","wikidata":"https://www.wikidata.org/wiki/Q959298","display_name":"Intervention (counseling)","level":2,"score":0.31839999556541443},{"id":"https://openalex.org/C180747234","wikidata":"https://www.wikidata.org/wiki/Q23373","display_name":"Cognitive psychology","level":1,"score":0.31690001487731934},{"id":"https://openalex.org/C91602232","wikidata":"https://www.wikidata.org/wiki/Q756115","display_name":"Volatility (finance)","level":2,"score":0.3043000102043152},{"id":"https://openalex.org/C182306322","wikidata":"https://www.wikidata.org/wiki/Q1779371","display_name":"Order (exchange)","level":2,"score":0.2969000041484833},{"id":"https://openalex.org/C2780791683","wikidata":"https://www.wikidata.org/wiki/Q846785","display_name":"Action (physics)","level":2,"score":0.28780001401901245},{"id":"https://openalex.org/C2778755073","wikidata":"https://www.wikidata.org/wiki/Q10858537","display_name":"Scale (ratio)","level":2,"score":0.2793000042438507},{"id":"https://openalex.org/C2779070825","wikidata":"https://www.wikidata.org/wiki/Q760434","display_name":"Augment","level":2,"score":0.2754000127315521},{"id":"https://openalex.org/C94487597","wikidata":"https://www.wikidata.org/wiki/Q11101","display_name":"Sensory system","level":2,"score":0.26980000734329224},{"id":"https://openalex.org/C149782125","wikidata":"https://www.wikidata.org/wiki/Q160039","display_name":"Econometrics","level":1,"score":0.26750001311302185},{"id":"https://openalex.org/C11413529","wikidata":"https://www.wikidata.org/wiki/Q8366","display_name":"Algorithm","level":1,"score":0.2644999921321869},{"id":"https://openalex.org/C83849319","wikidata":"https://www.wikidata.org/wiki/Q7295720","display_name":"Rating scale","level":2,"score":0.26339998841285706}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.08.13.26360194","doi":"https://doi.org/10.64898/2026.08.13.26360194","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.13.26360194","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/17/2026.08.13.26360194.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.08.13.26360194","doi":"https://doi.org/10.64898/2026.08.13.26360194","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.13.26360194","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/17/2026.08.13.26360194.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"score":0.9391000270843506,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7203627183.pdf","grobid_xml":"https://content.openalex.org/works/W7203627183.grobid-xml"},"referenced_works_count":1,"referenced_works":["https://openalex.org/W7202027051"],"related_works":["https://openalex.org/W7202167331","https://openalex.org/W7203544448","https://openalex.org/W2316930304","https://openalex.org/W2398163015","https://openalex.org/W7073898450","https://openalex.org/W2059974927","https://openalex.org/W2057257149","https://openalex.org/W2730769923","https://openalex.org/W4323809933","https://openalex.org/W7160469129"],"abstract_inverted_index":{"Abstract":[0],"When":[1],"benzodiazepines":[2],"fail":[3],"in":[4,38,80],"catatonia,":[5],"clinicians":[6],"know":[7],"what":[8,14],"to":[9,11,15,94,126,147],"escalate":[10],"but":[12],"not":[13,57,114,136],"stabilize":[16],"first.":[17],"We":[18,34],"asked":[19],"a":[20,31,87,95],"narrower":[21],"question":[22],"that":[23,132],"clinical":[24,40,55],"records":[25],"can":[26],"address:":[27],"does":[28,113],"recovery":[29],"follow":[30,115],"fixed":[32,74],"order?":[33],"defined":[35],"five":[36,99],"capacities":[37],"plain":[39],"terms":[41],"and":[42,83,107],"mapped":[43],"them":[44],"onto":[45],"precision":[46],"domains":[47,52],"of":[48,118],"hierarchical":[49],"inference.":[50],"The":[51],"are":[53,145],"theory-derived":[54],"abstractions,":[56],"latent":[58],"variables":[59],"estimated":[60],"from":[61,124],"these":[62],"data.":[63],"In":[64,98],"25":[65],"consecutive":[66],"inpatients":[67],"managed":[68],"without":[69,78],"electroconvulsive":[70],"therapy,":[71],"an":[72],"order":[73,112,134],"before":[75],"coding":[76],"held":[77,84],"inversion":[79],"every":[81],"patient,":[82],"again":[85],"when":[86],"hypothesis-blind":[88],"co-author":[89],"re-rated":[90],"all":[91],"milestones":[92],"according":[93],"pre-registered":[96],"protocol.":[97],"patients":[100],"the":[101,111,116,133,149],"sequence":[102],"was":[103],"completed":[104],"while":[105],"hallucinations":[106],"delusions":[108],"persisted,":[109],"so":[110],"resolution":[117],"psychotic":[119],"symptoms.":[120],"Bush\u2013Francis":[121],"scores":[122],"fell":[123],"26.3":[125],"2.0.":[127],"This":[128],"retrospective":[129],"study":[130],"shows":[131],"held,":[135],"why.":[137],"Prospective":[138],"studies,":[139],"preferably":[140],"with":[141],"blinded":[142],"daily":[143],"rating,":[144],"needed":[146],"corroborate":[148],"order.":[150]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-08-18T00:00:00"}