Catatonic Schizophrenia: Symptoms, Causes and Treatment

Catatonic Schizophrenia Treatment Atlanta, GA
Picture of Medically Reviewed By: Dr. Joshua Yager M.D.

Medically Reviewed By: Dr. Joshua Yager M.D.

Dr. Joshua Yager is an Atlanta native, board-certified family practice physician who is dedicated to the health and wellbeing of his community.

Table of Contents

Catatonic schizophrenia was previously classified as a distinct subtype of schizophrenia, but this classification is no longer used by mental health professionals. Instead, catatonia is now identified as a possible symptom rather than a separate condition when diagnosing schizophrenia. Although catatonia can present serious challenges, it is generally manageable with medications or other therapeutic interventions.

What is Catatonic Schizophrenia?

Catatonia, previously categorized under catatonic schizophrenia, is a symptom complex that can appear in individuals with schizophrenia. This condition is characterized by a fluctuation between excessive motor activity and a lack of response or movement.

Individuals experiencing catatonia might exhibit minimal physical movement and fail to respond to instructions. Conversely, some may show unusually “excessive” and “peculiar” behaviors, such as echolalia, where they repetitively mimic sounds, or echopraxia, where they repetitively mimic movements. This state of heightened activity is known as catatonic excitement.

The primary manifestation of catatonia is in extreme motor behaviors; some individuals might become completely immobile and unresponsive, while others might display inexplicable hyperactivity.

What is Catatonia?

Catatonia is a syndrome characterized by abnormal muscle movement and behavior due to the brain’s impaired handling of these signals. It’s often linked with various conditions, but schizophrenia is a common association. However, it’s now understood that bipolar disorder frequently involves catatonia, and it can accompany many other medical and mental health disorders.

Catatonia manifests in three primary forms:

  • Excited Catatonia: Individuals exhibit increased movement, such as pacing or agitated behaviors. They may engage in unusual or exaggerated actions, repetitive movements, or mimicry of speech and actions of others nearby.
  • Withdrawn Catatonia: This type is more recognizable as affected individuals show minimal or no response to external stimuli. Symptoms include muteness, an absence of emotional expression, remaining motionless, or maintaining unusual postures for long durations.
  • Mixed Catatonia: This type incorporates elements of both excited and withdrawn catatonia, displaying a combination of hyperkinetic and hypokinetic characteristics.

Symptoms of Catatonic Schizophrenia

Previously thought to be exclusive to schizophrenia, catatonic symptoms are now recognized in various mental disorders, including neurodevelopmental, psychotic bipolar, and depressive disorders. Individuals experiencing catatonic schizophrenia may display a range of physical movements from complete stillness to inexplicable excitability and hyperactivity, which can last from minutes to days.

Key symptoms of catatonic schizophrenia include:

  • Stupor: Near-unconsciousness or insensitivity to the environment.
  • Catalepsy: A lack of voluntary motion where limbs maintain placed positions.
  • Waxy Flexibility: Limbs remain in positions set by others.
  • Mutism: No verbal response or speech.
  • Negativism: A marked resistance to instructions or external stimuli.
  • Posturing: Maintaining unusual postures, often defying gravity.
  • Mannerisms: Odd, exaggerated movements.
  • Motor Abnormalities: Unexplained repetitive movements.
  • Agitation: Restlessness that may lead to aggression.
  • Grimacing: Making twisted facial expressions.
  • Echolalia: Repeating another’s words meaninglessly.
  • Echopraxia: Mimicking another’s movements without purpose.

These symptoms often alternate with brief episodes of unexplained excitability or resistance. A diagnosis of catatonia typically requires the presence of at least three of these symptoms. While more commonly associated with schizophrenia, catatonia can manifest in other mental disorders.

Additionally, individuals with catatonic schizophrenia might exhibit typical schizophrenia symptoms, including:

  • Delusions
  • Hallucinations
  • Disorganized Speech
  • Diminished Emotional Expression
  • Lack of Self-Awareness
  • Cognitive Challenges such as Difficulty Concentrating or Organizing Thoughts.

Due to the debilitating nature of these symptoms, individuals often require intervention from family members or close associates to seek mental health treatment.

Understanding the Causes of Catatonic Schizophrenia

The precise causes of schizophrenia, including its catatonic subtype, remain elusive to experts, though it is believed to stem from a combination of physical, genetic, and environmental factors.

  • Brain Chemistry: Neurotransmitters, which facilitate communication between brain cells, may be imbalanced in those with schizophrenia. This imbalance can significantly affect behavior and cognition.
  • Developmental Factors: Abnormalities in brain development pre-birth might contribute to the condition. These congenital issues are often linked to how the brain forms and functions.
  • Brain Connectivity: Schizophrenia might also arise from disruptions in the communication pathways between different brain regions. These pathways, made up of neuron networks, are crucial for coordinating complex processes across various brain areas. Disruptions here might trigger schizophrenia symptoms.
  • Risk Factors: Several risk factors are believed to heighten the likelihood of developing schizophrenia. These include genetic predispositions, exposure to viruses or malnutrition in the womb, psychosocial factors, and recreational drug use. While these factors are associated with an increased risk, they do not definitively cause schizophrenia but might trigger its development in someone already predisposed.

How is Catatonic Schizophrenia Diagnosed?

Catatonic schizophrenia is identified by qualified medical or mental health professionals. Often, individuals diagnosed with this condition have previously been diagnosed with schizophrenia. The diagnosis may be refined to include a catatonic specifier if catatonic symptoms are observed.

The identification of catatonic schizophrenia typically occurs swiftly during medical or psychiatric assessments, as the symptoms, such as unresponsiveness, stillness, or unusual postures, are quite distinct and easily recognizable. The most frequently noted signs of catatonia include immobility and mutism.

For those exhibiting catatonic symptoms, it is critical to adjust their treatment and medication specifically to address catatonia, which may differ from standard schizophrenia treatments. Early diagnosis is vital to manage the condition effectively. Additionally, individuals showing signs of catatonia might undergo an EEG to check for potential brain injuries or neurological issues that could be influencing their symptoms.

Catatonic Schizophrenia Treatment and Management

Not all individuals with schizophrenia will experience catatonia, but it remains a significant concern. Effective treatment options are available to help manage and alleviate the symptoms associated with schizophrenia and catatonia.

At West Georgia Wellness Centers Residential Mental Health Treatment Center in Atlanta, GA, we provide comprehensive care for a variety of mental health disorders, including schizophrenia, depression, anxiety, OCD, and Trauma. We believe in the potential for recovery and offer tailored treatment plans to support each individual’s journey toward wellness.

For detailed information on our mental health services and to discuss the right treatment approach for you or your loved one, please contact our mental health therapy center in Georgia today at 470-226-0238 or fill out our online contact form.

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