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Catatonic Schizophrenia

Last updated Nov. 15, 2019

Approved by: Maulik P. Purohit MD MPH

Learn about the causes, signs, and management of schizophrenia.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Catatonia
  • Schizophrenia - Catatonic Type

What is Catatonic Schizophrenia? (Definition/Background Information)

  • Schizophrenia is a psychiatric disorder in which an individual perceives ‘reality’ abnormally. The most prominent symptoms of schizophrenia are delusions, hallucinations, disorganized thinking and speech, and disorganized behavior
  • There are many types of schizophrenia and these include:
    • Paranoid type
    • Disorganized type
    • Catatonic type
    • Undifferentiated type
    • Residual type
  • Catatonic Schizophrenia is quiet rare and is predominantly characterized by disturbance in movements
  • The individual either keeps moving continuously, or they do not move at all from one place. Also, they either keep talking continuously without making any sense, or do not talk at all
  • A family history of the disorder is the strongest risk factor for Catatonic Schizophrenia
  • The treatment of Catatonic Schizophrenia may include psychotherapy, medicines, and electroconvulsive therapy. With appropriate and effective treatment, the symptoms can be managed efficiently and the individual can lead a healthier quality of life
  • Presently, there is no effective preventive measures available for Catatonic Schizophrenia

Who gets Catatonic Schizophrenia? (Age and Sex Distribution)

  • Catatonic schizophrenia usually affects adolescents and adults; the condition is rare in children
  • It affects both men and women

What are the Risk Factors for Catatonic Schizophrenia? (Predisposing Factors)

Factors that increase the risk of developing Catatonic Schizophrenia include:

  • Family history of the disorder
  • Exposure of the fetus to viruses in the womb
  • Poor nutritional quality of diet received by the fetus while in its mother’s womb
  • Stress
  • Older paternal age
  • Consuming psychoactive drugs during adolescence

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Catatonic Schizophrenia? (Etiology)

The following factors play an important role in the occurrence of Catatonic Schizophrenia:

  • Genetic factors
  • Environmental factors
  • Underlying health conditions such as:
    • Depression
    • Bipolar disorder
    • Abnormalities in the central nervous system: Problems that occur in the neurotransmitters which are naturally present in the brain

What are the Signs and Symptoms of Catatonic Schizophrenia?

The following signs and symptoms are characteristic of Catatonic Type Schizophrenia:

  • Physical immobility:
    • The individual may not be able to move, speak, or respond
    • Their body is in a rigid position  
    • They are ignorant or unconscious about their surroundings
    • Waxy flexibility is a common sign: If an arm is moved to one position, it may remain in that same position for several hours together
  • Excess mobility: The individual is very excited, he/she moves about from one place to another rapidly without any purpose
  • Extreme resistance:  The individual strongly refuse to obey any instructions and they remain adamant in their actions
  • Peculiar movements:
    • Showing unusual poses
    • May have unusual facial expressions; individuals may scowl and frown
    • They exhibit strange mannerisms
    • Stereotyped behavior is very commonly observed
  • Imitating the speech and movements of others

Other common signs and symptoms of Catatonic Schizophrenia may include:

  • Delusions, hallucinations
  • Disconnected speech
  • Unable to maintain personal hygiene
  • Unable to express emotions, expressing inappropriate emotions for the situation
  • Aggression, exploding in anger
  • Cannot be functional at the office or school
  • May always remain alone and separated from others
  • May exhibit untidy and ugly movements

How is Catatonic Schizophrenia Diagnosed?

The diagnosis of catatonic schizophrenia may involve the following exams and procedures:

  • Complete evaluation of medical and psychiatric history
  • Through physical exam
  • A detailed chat with the family and friends of the patient may help the physician assess the individual’s behavior or condition better

The following blood tests are generally performed to exclude other medical conditions:

  • Complete blood count
  • Alcohol and drugs test
  • Test for thyroid gland function

The following diagnostic criteria laid down by the DSM (Diagnostic and Statistical Manual of Mental disorders, APA) should be fulfilled in order to be diagnosed with Catatonic Schizophrenia:

  • Not able to move
  • Not able to speak
  • Remaining in the same place for any length of time
  • Overexcited behavior with no purpose
  • Adamant in not obeying the instructions
  • Peculiar movements
  • Imitating words and movement of others

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Catatonic Schizophrenia?

The following are the complications that could arise out of Catatonic Schizophrenia:

  • Severe emotional and behavioral issues
  • A constant thought of committing suicide
  • Difficulties performing everyday activities such as preparing meals, bathing, eating, dressing, etc.
  • Incapacity to attend work or school
  • Frequent hospitalization
  • Poor nutrition
  • Depression
  • Poverty, homelessness
  • Use of drugs, alcohol, and other illicit medicines
  • Conflicts within the family
  • Greater chances of becoming a victim of a crime

How is Catatonic Schizophrenia Treated?

Catatonic Schizophrenia needs lifelong treatment and management. This could involve the coordinated efforts of various specialist physicians such as:

  • Family doctor
  • Psychiatrist
  • Psychotherapist
  • Pharmacist
  • Family members
  • Case workers
  • Psychiatric nurse
  • Social worker

The treatment options may include:

Medications:

  • First generation typical  antipsychotics:
    • They can control symptoms by acting on the brain chemicals called neurotransmitters
    • They are used in the management of hallucinations, delusions, and other symptoms
  • Second generation atypical antipsychotics: They are newly found medications that help in the management of hallucinations, delusions, and other associated symptoms
  • Other medications may include:
    • Antidepressants can be used to manage depression
    • Anti-anxiety medications can be prescribed to control anxiety and aggression
    • Mood-stabilizing medications may also be used

Psychotherapy:

  • Individual therapy - cognitive behavioral therapy:
    • The mental health provider assists patients in realizing and changing harmful ideas and behavior
    • The therapy can help in improving communication skills, relationships, and the ability to work
  • Family therapy: This is done with the view that all family members must be aware of the patient’s condition and should help coordinate with the patient to cope up with the condition
  • Electroconvulsive therapy (ECT): It is the process wherein electric current is passed through the brain to generate seizures, which can reduce the effect of certain symptoms exhibited by Catatonic Schizophrenia
  • Social and vocational skills training may be imparted with the help of a therapist to live independently

Hospitalization: When the symptoms become severe, hospitalization of the patient becomes mandatory.

How can Catatonic Schizophrenia be Prevented?

  • Currently, there are no specific ways to prevent Catatonic Schizophrenia
  • Early diagnosis and treatment is needed to avoid complications
  • The treatment plan given by the physician should be strictly adhered to, in order to prevent recurrence or relapse of the disorder

What is the Prognosis of Catatonic Schizophrenia? (Outcomes/Resolutions)

  • Catatonic Schizophrenia is not a fatal disorder, but it generally affects social, intellectual, physical, and emotional behavior of an individual
  • With suitable and effective treatment, the symptoms can be controlled and the affected individuals can lead a better quality of life

Additional and Relevant Useful Information for Catatonic Schizophrenia:

Individuals with Catatonic schizophrenia require the love and support of family and friends. This may also help them obtain regular and proper treatment with faster recovery.

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 30, 2015
Last updated: Nov. 15, 2019