Catatonic Schizophrenia: Causes, Symptoms, and Treatment

Catatonia refers to a set of symptoms that might develop in some patients with schizophrenia. It can include periods where the individual moves very little and does not respond to instructions.

At the other end of the extreme, the individual can demonstrate motor activity that is considered “excessive” and “peculiar,” such as echolalia (mimicking sounds) or Echopraxia (mimicking movements). This is called catatonic excitement.

In this article, we will look at the symptoms of catatonic schizophrenia, its causes, diagnosis, and how it is treated.

Fast facts on catatonic schizophrenia

Here are some key points about catatonic schizophrenia. More detail and supporting information is in the main article.

Catatonia only occurs in some individuals with schizophrenia

Symptoms can involve flipping between hyperactivity and under activity

Risk factors for catatonic schizophrenia are the same as those for schizophrenia in general

There are now a number of effective treatments for the symptoms of catatonic schizophrenia

Symptoms of catatonic schizophrenia

[Woman with schizophrenia]
Modern treatments are effective at managing catatonic schizophrenia.

Catatonic schizophrenia is much rarer than it used to be thanks to improved treatments. Catatonic states are now more likely to be found in types of mental illness other than schizophrenia, such as neurodevelopmental (conditions that affect children during the development of their nervous system), psychotic bipolar, or depressive disorders.

Individuals with catatonia may flip between decreased and excessive motor activity.

With modern treatments, patients with catatonic schizophrenia can manage their symptoms easier, making the likelihood of leading a happier and healthier life much greater.

The clinical picture of catatonia is dominated by at least three of the following symptoms:

Stupor – no psychomotor activity, no interaction with the environment

Catalepsy – includes adopting unusual postures

Waxy flexibility – if an examiner places the patient’s arm in a position, they will maintain this position until it is moved again

Mutism – limited verbal responses

Negativism – little or no response to instructions or external stimuli

Posturing – actively holding a posture against gravity

Mannerism – carrying out odd, exaggerated actions

Stereotypy – repetitive movements without an apparent reason

Agitation – for no known reason

Grimacing

Echolalia – mimicking another person’s speech

Echopraxia – mimicking another person’s movements

Without proper treatment, a catatonic episode can persist for days or even weeks.

Schizophrenia symptoms

Apart from the above, the patient may also have the following symptoms of schizophrenia:

Delusions – The patient may believe they are being persecuted. Alternatively, they may think they have extraordinary powers and gifts.

Hallucinations – particularly hearing voices (auditory hallucination), but hallucinations can include visual (seeing things that aren’t there) or hallucinations involving any other sensory system.

Thought disorder – when speaking, the person can jump from one subject to another for no logical reason. The patient’s speech might be muddled and impossible to understand.

Lack of motivation (avolition) – the patient loses their drive. They give up on everyday activities, such as washing and cooking.

Poor expression of emotions – they may not respond to happy or sad events, or may react inappropriately.

Social withdrawal – when a patient with schizophrenia withdraws socially it is often because they believe somebody is going to harm them.

Unaware of illness (also referred to as “poor insight”) – because the hallucinations and delusions seem so real to the patient, many do not believe they are ill.

Cognitive difficulties – the patient’s ability to concentrate, remember things, plan ahead, and to organize is affected and communication becomes more difficult.

Patients with the symptoms of catatonic schizophrenia are not usually able to get medical help on their own. Often, it is a family member or friend who seeks medical help.

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Risk factors for catatonic schizophrenia

The risk factors for catatonic schizophrenia are the same as those for other schizophrenia subtypes, they include:

Genetics – individuals with a family history of schizophrenia have a higher risk of developing it themselves.

Viral infection – some recent studies suggest that viral infections may predispose the child to development of schizophrenia.

Fetal malnutrition – if the fetus suffers from malnutrition during pregnancy, there is a higher risk of developing schizophrenia.

Stress during early life – severe stress early in life may contribute to the development of schizophrenia. Stressful experiences often occur just before schizophrenia appears.

Childhood abuse or trauma.

Age of parents at birth – older parents have a higher risk of having children who develop schizophrenia.

Drugs – the use of drugs that affect the mind during adolescence may increase the risk of developing schizophrenia.

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