Recovery from catatonia follows a hierarchical precision order

In 25 consecutive inpatients with catatonia treated without electroconvulsive therapy, recovery followed a pre-specified hierarchical precision order with no inversions in every patient.

• Why it matters: Clinicians can escalate when benzodiazepines fail but lack guidance on which clinical capacities to stabilize first, and whether recovery follows a fixed sequence.
• What they did: Five plain clinical capacities were mapped onto theory-derived hierarchical inference domains, then milestones were coded and re-rated by a hypothesis-blind co-author using a pre-registered protocol.
• The result: Bush–Francis scores dropped from 26.3 to 2.0, the sequence completed even when hallucinations and delusions persisted, implying the order is not tied to psychotic symptom resolution.