Dear Editor, Catatonia is an enigmatic neuropsychiatric syndrome that may occur in the context of various psychiatric and medical conditions and is characterized by a range of volitional, motor, behavioral and cognitive symptoms.1 Although catatonia is common among hospitalized patients, its diagnosis may be challenging in the general hospital setting and thus it is likely under-recognized.2,3 Negativism and gegenhalten may be mistaken for wilful refusal by patients to cooperate with hospital staff,4 whereas more serious clinical features such stupor may be misinterpreted as progression of an underlying medical condition potentially resulting in withholding effective interventions.