A catatonic patient allows her arm to be lifted without resistance and holds it wherever the examiner places it. When instructed to raise her arm she refuses, yet the moment the examiner gently guides the limb upward it moves smoothly with his hand. What is this phenomenon called?

• A Mitgehen (automatic obedience) ✓
• B Mitmachen (forced compliance)
• C Gegenhalten (paratonic rigidity)
• D Waxy flexibility

Explanation

Mitgehen is automatic obedience in its extreme form, where the limb moves with the slightest guidance despite verbal refusal of the command. It is scored as a separate item on the Bush-Francis Catatonia Rating Scale. In mitmachen the patient moves in response to pressure but then returns the limb to its original position, which is not described here. Gegenhalten is opposition increasing with applied force.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

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