Understanding Catatonic Schizophrenia
What Is Catatonic Schizophrenia?
Catatonic schizophrenia is a severe, rare mental health disorder whose symptoms include a significant decrease in motor behavior that includes a decrease in voluntary movement, agitation, or hyperactivity.
It is a mental illness that is linked with several other mental health conditions, such as bipolar disorder. Additionally, it is the least diagnosed subtype of schizophrenia.
Professionals in the mental health and healthcare field no longer recognize catatonic schizophrenia as a diagnosis. Instead, schizophrenia is a mental health disorder that occurs on the schizophrenia spectrum. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) eliminated catatonic schizophrenia as an official diagnosis in 2013.
What Is Catatonia?
Catatonia refers to a syndrome characterized by a failure of the brain to transmit signals for muscle movement, mood, and thought processes, leading to abnormal behavior.
While this can happen with several other disorders, like bipolar disorder, it is often connected with schizophrenia. However, catatonia does occur more frequently with bipolar disorder and can occur with several physical health and mental health conditions.
How Common Is Catatonic Schizophrenia?
Catatonic schizophrenia is rare when compared to the other subtypes of schizophrenia; it can occur in a wide range, which can include anywhere from 10% to 25% of schizophrenia cases.
Approximately 85 out of 10,00 individuals will be diagnosed with schizophrenia. Within this group, only a few will experience catatonia-related symptoms.
How Long Does Catatonic Schizophrenia Last?
The duration of the symptoms of catatonic schizophrenia can last from hours to days.
Short episodes often last several hours to several days, while symptoms can also be intermittent over time.
What Is the Difference Between Catatonic Schizophrenia and Paranoid Schizophrenia?
Both catatonic and paranoid schizophrenia are associated with symptoms in the subtypes of schizophrenia.
Paranoid schizophrenia includes the following symptoms:
- Paranoia
- Delusions
- Hallucinations
The primary focus of paranoid schizophrenia is on paranoid beliefs and thoughts.
Catatonic symptoms often include:
- Immobility
- Unusual movements or excessive motor activity
The key features of catatonia focus mainly on behavior and motor activity.
How Many People Have Catatonic Schizophrenia?
Approximately 10% to 25% of individuals diagnosed with schizophrenia can experience catatonia.
Approximately 85 out of 10,00 individuals will be diagnosed with the symptoms of schizophrenia. Within this group, only a few will experience catatonia-related symptoms. Catatonia is rare and is diagnosed less frequently due to advances in medical treatments.
Causes of Catatonic Schizophrenia
What Causes Catatonic Schizophrenia?
Mental health professionals haven’t discovered a cause for catatonic schizophrenia, but believe there are severe factors like:
- Chemical imbalances in an individual’s brain
- Disruptions in the communication centers of the brain
- Congenital brain issues
Is Catatonic Schizophrenia Genetic?
Mental health researchers aren’t sure if a diagnosis of catatonic schizophrenia is linked to genetics.
While little is known about a possible connection between catatonic schizophrenia and a family history of mental health disorders and genetics, research has shown that the more common symptoms of catatonia occur in severe medical conditions or psychiatric illnesses that are related to genetics, such as bipolar disorder.
However, mental health experts believe that there are risk factors that can increase the risk of developing schizophrenia, including genetic mutations inherited from either of an individual’s parents. This hasn’t been confirmed.
What Part of the Brain Does Catatonic Schizophrenia Affect?
The parts of the brain affected by catatonia are the frontal and temporal lobes.
The frontal lobe is responsible for cognitive functions, which include decision-making and voluntary movement. This part of the brain is also important in governing social interactions and behavior.
Meanwhile, the temporal lobe of the brain processes sensory information, especially sounds, and forms emotional responses and memories.
Characteristics of Catatonic Schizophrenia
What Are the Characteristics of Catatonic Schizophrenia?
Several significant disruptions in motor activity and behavior characterize catatonic schizophrenia.
These behaviors and disruptions can create dysfunction in an individual’s daily life. For example, an individual can experience catatonic episodes that last for long periods and sensitivity to external stimuli.
What Triggers Catatonia?
Experts believe a catatonic state stems from neurological and medical issues. Mental health conditions can also develop the symptoms of catatonia. Examples of these psychiatric conditions are:
- Bipolar Disorder
- Mood Disorders
- Traumatic Events
- Schizophrenia
Physical or medical conditions can also be a factor in triggering catatonia. Some of those causes are:
- Autoimmune Diseases
- Infections
- Substance Use or Withdrawal
- Metabolic or Imbalances in Electrolytes
What Can I Expect if I Have This Condition?
Individuals with catatonia can experience a variety of symptoms, which often include the loss of movement, unusual postures, agitation, and mutism.
Catatonia is a neuropsychiatric subtype of schizophrenia that includes a broad range of symptoms that vary in severity and frequency. It affects your ability to function in your environment and can cause life-threatening issues if the symptoms aren’t treated as soon as possible.
Catatonic Schizophrenia Symptoms
What Are Some Catatonic Schizophrenia Symptoms?
The key symptoms of catatonia include abnormalities in behavioral and motor activity. They can also include:
- Stupor
- Catatonic excitement
- Mutisim
- Catalepsy
- Echolalia
- Echopraxia
- Grimacing
- Agitation
Individuals with catatonia can also experience these symptoms:
- Posturing
- Mannerism
- Negativism
- Stereotypy
- Waxy flexibility
Individuals with catatonia can also experience different levels of activity, including being unresponsive to their environment for a while, but can shift into a high level of activity. There are times when these shifts can lead to dangerous or impulsive behavior. When these behaviors occur, they can be a danger to others or themselves.
At Ocean View Psychiatric Health Facility, our medical and mental health team provides safe, empathetic care to help stabilize acute psychiatric symptoms associated with catatonia.
Is Catatonic Behavior a Positive Symptom of Schizophrenia?
No, the behaviors associated with catatonia aren’t considered positive symptoms of schizophrenia.
Catatonia is considered and classified as a psychomotor syndrome (psychomotor impairment) that occurs with schizophrenia. A psychomotor impairment is associated with slowed thought processes and slowed body movements. It is most commonly connected with major depressive disorder (MDD) and bipolar disorder.
What Does Catatonic Schizophrenia Look Like?
Recognizing the symptoms of catatonic schizophrenia can be difficult at first, but soon you may notice these signs of catatonia:
- The appearance of an individual being “frozen.”
- Pacing
- Inability to verbally respond
- Repetitive movements like tapping feet
- Resistance to instructions or being moved
- Repeating phrases or words said by others
- Staring or trance-like appearance
An individual with these symptoms can be aware of what’s around them, but is limited in their ability to respond or engage with the world, friends, or family.
What Does Catatonic Schizophrenia Feel Like?
Often, individuals with the symptoms of catatonia feel like they are stuck in their bodies and are unable to communicate or respond to loved ones.
The feelings of catatonia can cause distress, leading to fear, frustration, and isolation, as they are aware of their environment but can’t respond to stimuli or situations.
Do Catatonic Schizophrenia Patients Hear Voices?
Hearing voices isn’t a specific symptom of catatonic schizophrenia.
While hearing voices (auditory hallucinations) is often a symptom of schizophrenia, those with catatonic schizophrenia often do not have auditory hallucinations. Instead, catatonia is defined by abnormal emotional and motor activity responses.
How Is a Person With Catatonic Schizophrenia Most Affected?
An individual with catatonia is most often affected by extreme changes in behavior and body movements.
Often, individuals experience immobility, the inability to respond to their environment, or excessive or abnormal motor activity.
Risks of Catatonic Schizophrenia
What Are the Risks of Catatonic Schizophrenia?
Catatonia can have serious risks and complications, such as:
- Pneumonia
- Pressure ulcers caused by immobility
- Dehydration
- Physical injuries like falls while immobilized
- Malignant Catatonia
They may also have an increased risk of mental health issues, such as:
- Cognitive Impairment
- Social Isolation
Catatonia poses several serious risks to an individual’s overall well-being. To decrease the risks, effective psychiatric and medication management, found in Ocean View’s inpatient, partial hospitalization, or intensive outpatient programs, can help stabilize and manage acute psychiatric symptoms.
Are People With Catatonic Schizophrenia Dangerous?
In general, individuals with catatonia are not considered dangerous.
Since catatonia’s symptoms include severely limited mobility or excessive movement and are treatable, those with it aren’t considered a threat to themselves or others. However, some behaviors linked to catatonia, such as a lack of response or agitation, can create a breakdown in communication and understanding.
Can Catatonia Cause Brain Damage?
No, catatonia is not known to cause brain damage.
While catatonia isn’t directly linked to brain damage, some of the symptoms can lead to severe health complications, such as:
- Dehydration
- Falls or accidents while immobilized
- Malnutrition
The National Library of Medicine’s National Center for Biotechnology Information published an article, “Catatonia as a Result of a Traumatic Brain Injury,” (Case Rep Psychiatry. 2024 Mar 6; 2024:5184741. doi:10:1155/2024/5184741) available on their PubMed Central (PMC) site. The researchers completed a systematic review and discussed how physical issues, such as traumatic brain injury TBI can increase the risk of developing catatonia and its side effects.
Diagnosis for Catatonic Schizophrenia
How Do You Diagnose Catatonic Schizophrenia?
Schizophrenia is diagnosed by a mental health or health provider using a variety of methods and approaches, including, but not limited to:
- Physical Examination
- Lab Tests
- Imaging Scans
- Neurological Tests
While there isn’t one specific test to determine schizophrenia, once diagnosed, the symptoms of catatonia can be recognized through these examinations. Furthermore, to be diagnosed with schizophrenia, an individual must have two or more of schizophrenia’s key symptoms. They must also exhibit 12 signs of catatonia to be diagnosed with catatonic schizophrenia.
What Tests Will Be Done to Diagnose This Condition?
Most often, medical providers will use these tests to determine if an individual has schizophrenia:
- Imaging tests that often include magnetic resonance imaging scans (MRI), computerized tomography (CT) scans, and other scans.
- Blood, cerebrospinal fluid (spinal tap), and urine are used to detect changes in bodily fluids and to rule out other causes of behavioral or motor activity changes.
- Brain activity testing that includes an electroencephalogram (EEG), which analyzes and records electrical activity found in the brain. An EEG can rule out medical issues such as epilepsy or seizures.
How Accurate is Diagnosis?
Since the symptoms of catatonia can overlap with other mental health or neurological issues, it can be challenging to make a diagnosis.
For this reason, medical and psychiatric professionals include a comprehensive, careful, detailed history that includes medical history, family history of medical and psychiatric disorders, a review of medication, and a physical exam. Once the extensive assessment is complete, psychiatric professionals can determine if an individual has the symptoms of schizophrenia. However, catatonia is often underdiagnosed, so the diagnosis of catatonia can be complicated.
Catatonic Schizophrenia Treatment
How to Treat Catatonic Schizophrenia?
Treatment of catatonia mostly includes medications and electroconvulsive therapy (ECT).
There is a specific class of medication used as first-line treatment for catatonia. Psychiatrists will prescribe benzodiazepines to reverse the symptoms of catatonia. Examples of benzodiazepines are: lorazepam and valium.
While antipsychotics are often used to treat the symptoms of schizophrenia, they are avoided when treating catatonia because they can increase the risk of worsening catatonia.
What Kind of Doctor Treats Catatonia?
The primary type of doctor who treats catatonia is a psychiatrist.
Psychiatrists have the training and expertise to diagnose and manage the symptoms safely and effectively.
What Are Some Therapies for Catatonic Schizophrenia?
Most often, medication and electroconvulsive therapy are used to treat catatonia.
ECT sends a mild, safe electrical current through an individual’s skin and skull. The current is delivered to a specific part of the brain, triggering a small seizure that alters brain activity.The procedure occurs when an individual is under anesthesia, so they feel no pain.
How to Manage Catatonic Schizophrenia?
The symptoms of catatonia must be managed under the care of a trained psychiatrist.
Psychiatrists are trained professionals who are experts in prescribing the medications necessary to treat catatonia. Additionally, they are trained in effective therapies that can help stabilize, treat, and manage the symptoms of catatonia.
Is Medication Required to Treat Catatonic Schizophrenia?
Yes, medication is often necessary to treat catatonic schizophrenia.
How Soon After Treatment Will I Feel Better?
Since everyone is different and responds differently to treatment, you should talk with your psychiatrist to know when you will begin to feel better.
Your psychiatrist will consider your care, the treatment you are receiving, and can determine when you may start to feel the effects of the medications and ECT.
Can Catatonic Schizophrenia Be Cured?
No, catatonia can not be cured.
While catatonia and schizophrenia can’t be cured, they can go into remission (symptoms will go away and not come back). Yet, because symptoms can come back without warning, mental health professionals classify it as a lifelong mental health disorder.
Helping Loved Ones Diagnosed With Catatonic Schizophrenia
What Can I Do if a Loved One Shows Signs of Schizophrenia or a Similar Condition?
If you notice any of the symptoms of schizophrenia or catatonia, you should seek psychiatric or medical help immediately.
How to Care for Catatonic Schizophrenia?
The most important way of caring for a loved one with catatonia is to seek help from a professionally trained medical provider.
You can also help a loved one by:
- Asking them how you can help
- Encourage them to seek help from a professional
- Maintain a safe, non-judgmental tone of voice
- Remain calm
- Seek help in emergencies
How to Bring Someone Out of Catatonia?
You shouldn’t try to bring someone out of catatonia.
Treatment of catatonia should be performed only by a professionally trained mental health or medical provider. Ocean View Psychiatric Health Facility’s medical and mental health staff are trained to provide care for the acute symptoms of catatonia.
FAQs
Can people with catatonic schizophrenia hear you?
An individual experiencing catatonia’s ability to hear will vary depending on the severity of their symptoms.
Individuals with catatonia can have limited or no response to their environment. The limited ability to respond to their surroundings can make it hard for them to engage with or hear those around them.
Can Spice cause catatonic schizophrenia?
The use of Spice, a synthetic cannabinoid that has chemicals sprayed onto plant material to mimic THC, has been linked to catatonia.
The first case of catatonia caused by the consumption of Spice was described by researchers in 2014.
Do catatonic schizophrenia patients need life support?
Most cases of catatonia do not require life support treatment.
However, in extreme cases that include complications from pneumonia, dehydration, or malignant catatonia, some individuals can require life support treatment.
Does catatonic schizophrenia have an increase in dopamine?
A decrease in dopamine can increase the risk of developing catatonic schizophrenia.
The levels of dopamine in your brain can increase the risk of positive and negative symptoms of schizophrenia. In the case of catatonia, lower dopamine levels can cause catatonia because the symptoms of catatonia are associated with the negative symptoms of schizophrenia.
How to prevent catatonic schizophrenia?
Preventing catatonic schizophrenia is impossible because schizophrenia is a mental health condition that is hard to predict.
Is there a common neuronal basis for autism and catatonia?
Research has suggested that there could be a common neuronal basis for catatonia and autism.
The two may share a basis in dysfunction of GABA receptors and in abnormalities in brain structure.
The term catatonic schizophrenia was used to describe a subtype of schizophrenia, now called catatonia. The symptoms of catatonia can be treated with the help of a trained medical or psychiatric professional versed in treatments like medications and electroconvulsive therapy. Ocean View Psychiatric Health Facility’s team of psychiatrists and medical professionals can guide to symptom stabilization and management. To learn more, call us: (844) 562-1212