Both catatonic and parkinsonian patients show severe motor deficits such as complete akinesia. In contrast to Parkinson's disease, mechanisms of akinetic states in catatonia remain unclear. In an attempt to define catatonic akinesia in a more detailed way we investigated subjective experience in 22 akinetic catatonic patients comparing them with 22 major depressive, 22 paranoid schizophrenic, 22 residual schizophrenic, and 22 akinetic parkinsonian patients. Catatonic patients were diagnosed according to standardised criteria. They were treated exclusively with lorazepam (2-4mg) during the first 24 hours and, according to their response on day 1, they were divided into responders and nonresponders. Subjective experience was investigated with a self-rated questionnaire, developed by us, for the subjective experience of psychological and motor functions in an acute akinetic state. Catatonic patients differed significantly in their subjective experience from parkinsonian, depressive, and schizophrenic patients. Unlike parkinsonian patients, catatonics were not fully aware of their severe deficits in motor execution. In contrast to catatonic nonresponders to lorazepam, lorazepam-responders were characterised by intense and overwhelming emotional experiences. Subjective experience of akinesia seems to differ fundamentally between catatonic and parkinsonian patients as well as between catatonic responders and nonresponders to lorazepam.