Schizophrenia is a serious mental health condition characterized by disruptions in thought processes, emotional responsiveness, perceptions, and social interactions. Although the severity will vary from one person to another, it’s a persistent condition that can be severe and disabling. 

Globally, schizophrenia is considered a disability and can affect educational and occupational performance. Those with the disorder are two to three times more likely to die early than the general population. It’s often due to preventable physical diseases, such as infections, metabolic disease, and cardiovascular disease. 

According to the World Health Organization, an estimated 20 million people are affected by the condition globally. According to the previous version of the DSM-IV, there are five types of schizophrenia: disorganized type, paranoid type, catatonic type, undifferentiated type, and residual type. However, the current DSM-V only uses these types, including paranoia, disorganized speech and behavior, and catatonia. 

Schizophrenia will be diagnosed if the individual has at least two of the following symptoms for  over a month. These include:

  • Disorganized speech
  • Delusions
  • Hallucinations
  • Very disorganized or catatonic behavior
  • Negative symptoms, including reduced emotional response

For a person to receive a schizophrenia diagnosis, one of their symptoms must be hallucinations, delusions, or disorganized speech. These symptoms must interfere with their school life, work-life, social life, or the ability to take care of themselves. 

Today, we’re going to focus on catatonic schizophrenia and talk about the symptoms, diagnosis, and how it’s treated.

What Is Catatonic Schizophrenia?

Catatonia refers to symptoms that could develop in a person with schizophrenia. It might include periods where the person moves very little or doesn’t respond to instructions. It falls on the other end of extreme, and the person might demonstrate motor activity that’s considered peculiar or excessive. This includes mimicking sounds or mimicking movements, known as catatonic excitement. 

The risk of developing catatonic schizophrenia is the same as developing schizophrenia in general, and symptoms will involve flipping between under activity and hyperactivity. Catatonia only occurs in some of those with schizophrenia. Fortunately, there are various effective treatments for the symptoms.

What Are the Symptoms of Catatonic Schizophrenia?

Thanks to improved treatments, catatonic schizophrenia is rarer than it once was before. Catatonic states are more likely to be found in other types of mental illness, including neurodevelopmental conditions that affect children during development, depressive disorders, or psychotic bipolar. 

Those with catatonia will flip between decreased and excessive motor activity. However, with the advances in modern medicine, those with catatonic schizophrenia can manage their symptoms easier. It increases the odds of having a happier and healthier life. 

To be diagnosed with catatonic schizophrenia, you must present at least three of the following symptoms, these include:

    • Catalepsy: Adopt unusual postures
    • Stupor: No psychomotor activity or no interaction with the environment
    • Wavy flexibility: When an examiner places the individual’s arm in a position, they maintain the position until it’s moved again
    • Negativism: Meaning there is little or no response to instructions or external stimuli
    • Mutism: Very limited verbal response
    • Mannerism: When a person carries out odd or exaggerated actions
    • Posturing: When the individual actively holds a posture against gravity
    • Stereotypy: When a person has repetitive movements without any explanation 
    • Grimacing
    • Agitation: When the person is agitated for no known reason
    • Echopraxia: When the individual mimics another person’s movements
    • Echolalia: When the individual mimics another person’s speech

Unfortunately, without the necessary treatment, catatonic episodes can last for days, sometimes even weeks. 

Risk Factors for Catatonic Schizophrenia

catatonic schizophrenia

As you’d expect with schizophrenia, the risk factors of developing catatonic schizophrenia are the same. Schizophrenia symptoms typically appear in early adulthood. Men often experience their initial symptoms in their late teens or early 20s, while women show first signs of the illness in their 20s and 30s. Other subtle signs may appear earlier in life, including poor school performance, reduced motivation, and troubled relationships.

The most common risk factors for the condition include the following:

  • Viral infection: There are studies showing that viral infections could predispose a child to develop schizophrenia. Prenatal viral or bacterial infections and inflammation have been shown to play significant roles in the genesis of the disorder. Although the specific mechanism is unclear, findings suggest that the maternal inflammatory response might be associated with fetal brain injury.
  • Genetics: You’re more likely to develop schizophrenia if someone in your family has it. Your chances increase by ten percent if your parents, brother, or sister have it. If both parents have it, the odds spike dramatically to a 40 percent chance of having the disorder. 
  • Fetal malnutrition: During the fetal stage, if the fetus suffers from malnutrition, the odds of developing schizophrenia increase. 
  • Stress early in life: A child that endures severe stress early in life increases the chances of developing schizophrenia. Schizophrenia can occur right after a stressful experience during childhood.
  • Childhood abuse or trauma: Again, severe stress can contribute to the development of schizophrenia. For example, if the child was physically or sexually abused, the stress can cause them to develop the disorder.
  • Age of parents at birth: Women that give birth at an older age have a higher risk of having a child who will develop schizophrenia.
  • Drugs: Using mind-altering drugs during adolescence can increase the odds of developing schizophrenia. Drugs like marijuana have been linked to schizophrenia. In 1995, a study out of Denmark found that two percent of diagnoses were associated with marijuana. By 2010, that figure increased to eight percent. 

What Are the Causes of Catatonic Schizophrenia?

Despite rigorous research, the cause of catatonic schizophrenia remains a mystery. Research has been consistent that most forms of schizophrenia are caused by brain dysfunction. However, the type of brain function that occurs is still unknown. It’s assumed to be a combination of environmental and genetic triggers like stress. 

Experts are under the impression that it could be caused by an imbalance of dopamine that’s involved in the onset of schizophrenia. The imbalance is most likely caused by genes that make a person susceptible to the disorder. The levels of serotonin, another neurotransmitter, might also be involved.

How is Catatonic Schizophrenia Diagnosed?

If your primary care physician suspects you have catatonic schizophrenia, they’ll recommend a thorough assessment of your medical and psychological history. They’ll conduct a series of tests to aid in their diagnosis, which include the following:

  • Physical exam: The patient’s heart rate, weight, height, blood pressure, and temperature will be checked. The doctor will listen to the lungs and heart and check the abdomen. 
  • CBC (Complete blood count): The testing will look for the presence of drugs or alcohol and check thyroid function. 
  • MRI or CT scan: The objective is to find any abnormalities in the brain’s structure.
  • EEG (Electroencephalogram): This test checks on brain function.
  • Psychological evaluation: A psychiatrist will ask the individual about their feelings, thoughts, and behavior patterns recently. They’ll go over a list of symptoms, ask when it started, find out how severe they are, and if they affect the person’s life. They’ll also ask if the person has thought about harming themselves or others. 

Diagnosing this disorder isn’t easy, and it may take a prolonged period to determine if it’s catatonic schizophrenia. Other conditions, such as seizure disorder, mania, substance abuse, and severe depression, share characteristics of catatonic schizophrenia and must be ruled out first. 

How is Catatonic Schizophrenia Treated?

Unfortunately, schizophrenia is a lifelong condition that requires management. However, catatonic symptoms may not persist. Those with the disorder require treatment on a permanent basis, even if their symptoms disappear for a while and the individual believes they’re better. For all forms of schizophrenia, treatment is essentially the same. However, the methods will vary depending on a person’s age, health, and the severity of their symptoms. 

Medication

Treating schizophrenia could require various medications, such as barbiturates, benzodiazepines, antidepressants, and antipsychotics. This will all depend on the symptoms the individual is experiencing. 

ECT

Electroconvulsive therapy is a procedure where an electric current is sent through the brain to produce convulsions. It’s used to treat those with catatonic schizophrenia who haven’t responded to standard treatment options. 

Hospitalization

During severe episodes, hospitalization might be necessary for the safety of the individual. In a hospital, the person will get proper sleep, nutrition, and hygiene. 

Psychotherapy

Medication is the primary form of treatment. However, psychotherapy may be administered in conjunction to treat a person. If symptoms are severe, it may not be an appropriate option.

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