What is catatonic schizophrenia? To answer this question, we’ll begin by first defining basic schizophrenia, which is a serious brain or mental disorder that causes abnormal thought patterns and behaviors. There are many types of schizophrenia. This includes paranoid schizophrenia, undifferentiated schizophrenia, and many more.
While catatonic schizophrenia was once considered an actual subtype of schizophrenia, it’s no longer a separate diagnosis. Catatonic schizophrenia is a form of schizophrenia where someone experiences catatonia, a mental state that makes a person less reactive to their environment.
Catatonic Schizophrenia Symptoms
Catatonic schizophrenia causes abnormal movement and behavior. In some cases, someone may struggle to move or speak for a period of time. Those with this medical condition might also experience excessive or unusual motor activity, for example, parroting other’s words or movements.
When someone’s in a catatonic state, their speech and movements are often disconnected from their environment. They might make loud exclamations for no reason, or remain in a position even when it’s causing them physical discomfort. Catatonic states can last for hours, days, or longer and can even have the potential to be life-threatening.
During a catatonic state, a person will exhibit three or more symptoms of catatonia. These symptoms may include:
- Catatonic stupor: A complete lack of psychomotor activity and environmental interactions
- Negativism: Limited response to environmental or external stimuli
- Mutism: Little to no speech or verbal responses
- Echopraxia: Repetition of other people’s movements
- Echolalia: Parroting other’s words
- Waxy flexibility: Remaining in a position they’ve moved into until they are moved again
- Catalepsy: Holding unusual or uncomfortable positions
- Stereotypy: Engaging in repetitive movements
- Mannerism: Using exaggerated movements without a clear reason
In addition to these symptoms, someone with catatonic schizophrenia may show other, more classic schizophrenia symptoms, such as:
- Hallucination: Hearing, seeing, feeling, smelling, or tasting something that isn’t real
- Delusion: Strong beliefs that aren’t based in reality
- Disorganized thoughts and speech: Concentration issues that lead to jumbled thoughts and speech
- Flattening: Not showing any outward signs of emotion
- Social withdrawal: Isolating from friends and family members
- Lack of pleasure: Struggling to enjoy activities or experiences
“Symptoms of catatonia in schizophrenia may be marked by unresponsiveness and immobility or, in some cases, mutism, often starting with minimal to no reactivity to surroundings and environment. Symptoms are uncontrollable even while a person may appear healthy and able.”Talkspace therapist Elizabeth Keohan, LCSW-C, MSW
Complications for those with catatonic schizophrenia
Catatonic schizophrenia can also result in several complications that result from catatonic behavior. Complications can include:
- Depression: This may include suicidal thoughts or behavior
- Malnutrition: Symptoms may lead to poor eating habits
- Hygiene problems: Symptoms may also lead to problems with hygiene and basic self care
- Substance abuse: This may include abuse of alcohol, pain medication, and illicit drugs
- Joblessness and homelessness: Symptoms may prevent someone from holding a job, eventually being unable to pay for housing
- Incarceration: The complications above may lead to crime and imprisonment
- Other complications: Might include family problems and an inability to be properly educated
Diagnosing Catatonic Schizophrenia
A number of things can cause catatonic symptoms outside of schizophrenia, including mental health conditions like bipolar disorder, depression, and medical conditions like epilepsy and stiff person syndrome.
When someone shows symptoms of catatonic schizophrenia, healthcare providers will conduct both psychological evaluations and medical exams to learn more about the condition and rule out other potential causes.
People will usually be asked to undergo a psychiatric evaluation so the healthcare provider can learn more about catatonic symptoms and determine how long someone has been experiencing them. It’s worth noting, though, that someone in a catatonic state may not always be able to respond to questions. In these cases, a care provider may need to speak with spouses, domestic partners, or family members about physical symptoms or conditions.
What Causes Catatonic Schizophrenia?
Even though studies show that schizophrenia is highly heritable, it isn’t caused by genetics alone. Experts don’t fully understand the causes of schizophrenia, but it’s believed that genetic, psychological, and environmental factors can all play a role. It’s widely accepted that brain dysfunction is a contributor and that neurotransmitter imbalance is likely at play.
It’s possible that certain people have the potential to develop schizophrenia when exposed to risk factors. For example, toxin exposure might increase someone’s risk. If someone is vulnerable to schizophrenia, symptoms of the condition could be triggered by additional risk factors, including:
- Viral infections during early childhood
- Childhood trauma or abuse
- Substance abuse in adolescence
- Complications during pregnancy
- Extreme levels of stress
Studies also show that men are significantly more likely to develop schizophrenia than women. The reason for this is unknown, but it’s been theorized that hormones might play a role. Men are more likely to experience symptoms in their early 20s, while women typically experience an onset of symptoms in their late 20s to early 30s.
“Causes for catatonic schizophrenia point to imbalances in brain functioning with determinants resting in both genetics and imbalances amongst specific neurotransmitters such as dopamine and serotonin. First line treatment includes medication that has proven effective; while research suggests a significant reduction of its occurrence overall.”Talkspace therapist Elizabeth Keohan, LCSW-C, MSW
Treatment for Catatonic Schizophrenia
Several forms of treatment have been found effective in managing schizophrenia. Though the condition is lifelong, effective treatment is possible. Catatonic symptoms generally won’t persist forever, but treatment is still recommended.
Medication is the first line of treatment for schizophrenia. While antipsychotics are the primary form used to treat schizophrenia, they can, in some cases, increase the severity of catatonia symptoms. Individuals who present catatonic schizophrenic behavior are often treated with benzodiazepines, which depress the central nervous system and can quickly relieve the catatonic symptoms.
Sedatives like barbiturates also suppress the central nervous system and may improve catatonic symptoms. In certain cases, someone may be given medication via an IV line. Not only does this lead to faster results, but it can treat people who aren’t responsive enough to take medication orally.
People with severe or persistent symptoms may be treated through some form of brain stimulation. Electroconvulsive therapy (ECT) exposes the brain to short bursts of electrical current.
Although ECT is highly effective at treating schizophrenia with catatonic symptoms, it has potentially harmful side effects like short-term memory loss, which is why it’s not used as the first line of treatment.
Another form of brain stimulation used to treat chronic catatonia is transcranial magnetic stimulation (TMS), which activates nerve cells in the brain via magnetic pulses. Some studies suggest that TMS may have fewer side effects than ECT. However, research on TMS is still limited and experts don’t fully understand how it impacts the brain.
People who experience severe catatonic symptoms may be unable to care for themselves and require hospitalization. Not only can they receive specialized treatment for chronic catatonia while hospitalized, but other basic needs, such as nutrition, sleep, and general hygiene, are met.
Once symptoms of catatonia are managed, the benefits of psychotherapy can be entertained. Psychotherapy can teach people to manage other symptoms of chronic schizophrenia and may help them become more aware of the early signs of catatonia. Long-term, most people manage their condition with a combination of medication and therapy.
Get Professional Help with Talkspace
If left untreated, catatonic schizophrenia can lead to many complications, including malnutrition, depression, and an inability to lead a satisfying life. If you or a loved one has shown symptoms of this condition, it’s important to receive a proper diagnosis so that you can start treatment. Even though there’s no way to cure schizophrenia, it’s very possible to manage symptoms and reduce the impact that it has on your life.
If you or a loved one needs help defining, diagnosing, or treating catatonic schizophrenia, Talkspace is there for you. Talkspace is an online therapy platform that provides online support from real mental health experts who can do everything from answering questions like “what is catatonic schizophrenia?” to helping develop effective strategies for treatment.