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Catatonic Schizophrenia - Causes, Symptoms, Treatment

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Catatonic schizophrenia is a feature of schizophrenia where the behaviors fluctuate to extremes. For more information, read the article below.

Medically reviewed by

Dr. S. Adithya

Published At December 8, 2022
Reviewed AtDecember 27, 2023

What Is Catatonic Schizophrenia?

Catatonic schizophrenia is a type of one of the most severe mental illnesses called schizophrenia. It is a disorder that makes it difficult for the person to differentiate between the real and the reel.

A subject acquires a state of psychosis and presents extreme behaviors, like suicidal tendencies, seeing things or people that do not exist or hearing a weird, scary voice. These people hallucinate about the higher authorities commanding them and can end up harming themselves or the people around them to follow the commands.

Catatonic schizophrenia presents these extreme behaviors, too; a person is completely quiet for a while and can burst with anger the next moment.

It is important to know what catatonia is to understand catatonia schizophrenia better. Catatonia is a psychiatric syndrome characterized by abnormal behaviors or movements that can be severe and occur in a series of episodes. It usually happens with mood disorders and schizophrenia. It has to be differentiated from neuroleptic malignant syndrome and extrapyramidal side effects, which usually happen with antipsychotics.

What Are the Causes of Catatonic Schizophrenia?

The exact cause of the disorder remains unknown. However, researchers believe that the symptoms are present due to abnormal activity in the brain centers that regulate the movements, like the forebrain and hypothalamus. The disorder also has been found to have hereditary patterns and run in families. Substance abuse, drugs, or alcohol can also cause catatonic symptoms; medications used in the treatment of mental disorders have also been reported to present signs of catatonia.

What Are the Symptoms of Catatonic Schizophrenia?

Catatonic schizophrenia presents with characteristic signs and symptoms. Most common among them are abnormal movements, and gait, even when the person is physically able.

Following are some common symptoms of catatonic schizophrenia.

  • Abnormal movements, or no movement at all.

  • Being quiet, not talking.

  • Sluggish response.

  • Staring gaze.

  • Repeating someone's movement or speech over and over again.

  • Repeated movements like tapping feet or blinking.

How Is Catatonic Schizophrenia Diagnosed?

Catatonic schizophrenia is seldom seen as a disorder, and it is almost always encountered as a symptom of some of the other mental health disorders like:

  • Schizophrenia and catatonia are most commonly associated with schizophrenia.

  • Mood disorders.

  • Autism.

The diagnosis of catatonia is confirmed when a patient presents with any three of the following features:

  • Being quiet or mute.

  • Inappropriate naive reactions to the situations around them, and stupor.

  • Abnormal gestures and movements.

  • Without any reluctance, let others position themselves or their limbs.

  • Ignore instructions and requests.

  • They are hyperactive without any reason.

  • Can have abnormal posture for a long time, like holding up legs in the air.

  • Mimic movements.

  • Mimic speech.

  • Repeated gestures like rocking legs or shrugging.

  • Contour face into a grimace.

How Is Catatonic Schizophrenia Treated?

Catatonic schizophrenia is treated the same as other types of schizophrenia, an individual with schizophrenia requires treatment throughout their life even if the person feels he has overcome the disorder and no symptoms are present. The treatment modalities vary depending on the severity, frequency, and effects caused due to the symptoms present. Treatment mainly aims at controlling and overcoming the symptoms, as the condition can not be cured completely. Different treatment options include medications and various therapies.

Medications:

  • Benzodiazepines: These are the most commonly used group of medications; Benzodiazepines are fast-acting tranquilizers administered intravenously. For best results, the drug is prescribed for a long duration and thus can cause dependency when used for several days or weeks.

  • Barbiturates: These drugs suppress the central nervous system and are referred to as depressants or sedatives; these drugs act as mild sedatives and instantly cure the symptoms of catatonic schizophrenia. Like Benzodiazepines, these drugs also have the risk of dependence, but the risk is comparatively low.

  • Antidepressants: Antidepressants are frequently used along with other medications as these individuals present with other mental health issues like depression. Antidepressants act as mood stabilizers and help the person to stay calm.

Other Treatments:

  • Electroconvulsive Therapy: Electroconvulsive therapy is used to treat patients with catatonic schizophrenia in cases where other treatment options are ineffective. This procedure is performed under general anesthesia, where an electrode pad is placed near the head, and a mild electric current is passed through it; this electrical stimulation creates controlled seizures. However, this treatment method can have specific side effects like short-term memory loss.

  • Hospitalization: It is necessary when a person has uncontrollable severe and frequent uncontrollable episodes; these patients must be monitored at regular intervals and need immediate attention during the attack. These individuals are considered safe in the hospital as they can get timely attention, access to healthcare facilities, and proper nutrition and rest.

  • Psychotherapy: In patients with catatonic schizophrenia, psychotherapy is considered adjuvant therapy, it is not very helpful in treating severe cases where medications are required, but psychotherapy can be used in mild to moderate cases to counsel and calm the patients or prevent episodic damage by advising lifestyle modifications.

  • Social and Vocational Skills Training: Developing these skills promote the patients to live a confident and independent life, the patient is educated about good hygiene and lifestyle habits like healthy diet and exercise, and they are even taught ways for better communication that helps them socialize more comfortably and confidently. Employment, residential and therapy support are encouraged.

  • Compliance (Adherence): Compliance or commitment to medicine means taking the medication correctly and at the proper doses. Unfortunately, lack of compliance is a significant problem for patients with schizophrenia. As a result, patients can stop taking their medication for long periods, significantly interfering with their lives and those around them.

What Are the Complications of Catatonic Schizophrenia?

Catatonic schizophrenia can cause health, financial, behavioral, and legal problems if it is not treated at the right time. The symptoms caused by the condition are so severe that they can affect an individual's life in every possible way.

Some common complications can include the following:

  • Depression, suicidal thoughts; most individuals with catatonic schizophrenia present with suicidal thoughts and depression, which can result in uncontrollable life-threatening events if left untreated.

  • Malnutrition.

  • Hygiene problems.

  • Substance abuse may include alcohol, over-the-counter drugs, and illegal, abusive substances.

  • Difficulty in being employed results in poor quality of life

  • Imprisonment is commonly seen as the symptom that leads to criminal actions and behaviors.

  • Severe family issues.

  • The inability to attend school or college leads to illiteracy.

  • Addicted smoker.

Conclusion:

Catatonic schizophrenia is a mental health disorder or a condition that is found to be associated with other mental health disorders. The person with catatonic schizophrenia presents with abnormal movements and gazes and might also have suicidal thoughts making the condition severe. The treatment includes medications like barbiturates and other psychotherapy therapies.

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Dr. S. Adithya
Dr. S. Adithya

Psychiatry

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