ABULIA

Loss of the ability to perform voluntary actions and make decisions. The term is usually reserved for extreme cases in which a patient manifests such a profound lack of initiative that he does not carry out the simplest actions such as walking or raising his arm to eat. He may also be unable to make up his mind about the simplest matters such as selecting his clothes or going to the dining room. His will appears to be completely paralyzed, probably by deep internal conflicts or despair. Abulia is a rare condition most frequently found in schizophrenia, but also observed in some cases of profound depression. The more common disturbance of will is hypobulia, a reduction or im-pairment rather than a complete absence of initiative. A group of symptoms known as the akinetic-abulic syndrome sometimes appears in the course of treatment with tranquilizers. These symptoms include decreased mental drive, lack of interest, bradykinesia (slow movement), and tremor. For parabulia, or distortion of volition, see PARERGASIA.