Background. There are no modern cross-cultural comparative studies of the frequency and clinical presentation of catatonia in a Western country and India using standardized rating instruments and diagnostic criteria.

Method. A total of 104 consecutively admitted patients in Wales and in India were screened for catatonic features using the same standardized rating instrument by the same psychiatrist to generate DSM-IV and other diagnostic criteria for catatonia, and a profile of signs in catatonia. Inter-rater reliability for the ratings made by the research psychiatrist was established with local psychiatrists at each unit.

Results. The frequency of DSM-IV criteria catatonia was 13·5% in India versus 9·6% in Wales (N.S.). The severity of catatonia did not differ between the two units. However, retarded catatonia was more common in India (12·5%) versus Wales (p<0·05) whereas the frequency of excited catatonia was equally common in both units. Catatonia was found in many different mental disorders not just schizophrenia and affective disorder.

Conclusions. Catatonia is commonly found among psychiatric in-patients with a similar frequency and severity but differing clinical presentations in Wales and India. Some classic signs of catatonia like posturing, catalepsy, staring and stupor were more frequent among psychiatric admissions in India than Wales. The differing clinical presentations may be due to differences in demographic features rather than cultural or aetiological factors.