Catatonic Schizophrenia: Causes, Signs, Symptoms, Diagnostic Criteria, Diagnosis

What is Catatonic Schizophrenia?

Catatonic schizophrenia is a schizophrenia a sub type that entails extremes of behavior. In fact, at one side or in some situations/ at some times patient is unable to speak, respond or move. There is an almost no activity to the extent that virtually all the movement stops, same as the catatonic stupor.

What is Catatonic Schizophrenia

On the other side/ at some times, they are suddenly hyperactive and become highly excited that they mimic movements or sounds that they often listen and so this is known as catatonic excitement. So, catatonic schizophrenia may be defined as a combination of catatonic stupor and catatonic excitement.

Catatonic schizophrenia patients may also notice meaningless actions repetitively performed as a stereotypic behavior and this excludes their involvement in any type of productive activity.

Individuals with the complaint of catatonic schizophrenia may assume positions of bizarre body or manifest facial expression or unusual limb movements, thus it leads to misdiagnosis resulting with tardive dyskinesia.

A catatonic schizophrenia patient may stay for long periods immobile, especially; in positions we consider it to be highly uncomfortable. In fact, you cannot try repositioning them. The individual may oppose any such attempt to change the way she/he appears.

Catatonic schizophrenia is rarer today than earlier times, because now the treatments have improved. Now, experts believe to be in catatonia state is likely to affect individuals with various mental illnesses types, rather than schizophrenia.

Today, there are treatments available and patients suffering with catatonic schizophrenia are able to manage the symptoms, thus making it possible to lead a much healthier and happier life.

Do Children Get Affected Differently by Catatonic Schizophrenia from Adults?

Though, catatonic schizophrenia does not see children in a different way from the adults, the fact stays that if the signs come into notice during childhood, it may be easier to cure. Generally, the problem is that schizophrenia is not easy to identify during childhood. The diagnosis is apparent during the adolescence. Nevertheless, doctors confirm that some catatonic schizophrenia symptoms can be identified from early childhood. Once these symptoms are diagnosed, doctors can give some effective treatments.

Is Catatonic Schizophrenia Serious?

Catatonic schizophrenia is a serious disease and it can affect the life of a person in all the areas. Catatonic schizophrenia does not cause death directly, but complications may cause harm. Individuals with catatonic schizophrenia are mostly not aware of their problem, unless they undergo treatments. They can be identified as they move in a manic style or sit unmoving. This is the reason such people affected with catatonic schizophrenia find difficulty in holding a job and also become homeless. They are easily victimized or get into criminal offense. A catatonic schizophrenic falling into the practice of substance abuse, suicide and smoking may lead to the death door.

How Catatonic Schizophrenia Affects the Body?

Catatonic schizophrenia affects your body to the extent that your body becomes impassive to external motivations or spur. The other way that the catatonic schizophrenia affects the body is by a condition known as waxy flexibility. The seriousness of this catatonic schizophrenia is that people with this disorder do not move their body parts and stay in one position. For instance, a catatonic schizophrenia patient having a bent arm will stay with it even for a long period and will not consider straightening it. Apart from this, schizophrenia involves misinterpreting or being unaware of that is real. This is the reason that people affected with catatonic schizophrenia are likely to engage in activities that may have a negative impact on the body, such as alcoholismsuicidal thoughts and violence towards others or one’s self.

Other Diseases in Association with Catatonic Schizophrenia

A person affected with catatonic schizophrenia may have a multitude of other mental disorders. This entails the peril of self-harming and also causing harm to others. Apart from this, the catatonic schizophrenia makes patient susceptible to drug abuse and alcoholism more common. Catatonic schizophrenics may be smokers and if so, the common complications of the lungs and heart diseases may include. It is common for a catatonic schizophrenia affected person to be cured for other disorders at the same time. This means the catatonic schizophrenia patient can be cured for catatonic schizophrenia and disorders such as intense anger or depression.

Causes of Catatonic Schizophrenia

The catatonic schizophrenia causes are identical to schizophrenia causes. However, the scientists are not aware of the real reasons causing catatonic schizophrenia and schizophrenia, yet the fact cannot be denied that the primary factor is focused on genetics. People having sibling or parents with the complaint of schizophrenia are more prone to be diagnosed with the same illness than others. Even an identical twin having the same ailment indicates the other twin is likely by 40 to 65 times to have catatonic schizophrenia than other moderate person. The functioning of the brain includes neurotransmitters and chemicals, thus is works differently with catatonic schizophrenia affected victims. Scientists who compared the schizophrenia affected people’s brains to people without this disease noticed the brain structures showing differences.

The catatonic schizophrenia or the schizophrenia sub-types causes are unknown. Conversely, the research indicates catatonic schizophrenia most forms are caused by dysfunction of the brain, but why there is dysfunction of the brain is not known. Most likely, it may be due to the combination of environmental triggers and genetics.

Experts believe that there is an imbalance of neurotransmitter and dopamine involved in the inception of catatonic schizophrenia. It is believed that this imbalance may be caused by your genes, thus making it prone to illness. In fact, some researchers also voice their opinion that the neurotransmitters, such as serotonin levels may also be involved. Experts observe the key functions in the brain and its changes that include behavior, emotion and perception, thus concluding the brain represents schizophrenias biological site.

The research also states that catatonic schizophrenia may be caused due to the faulty signaling receiving in the brain.

Signs and Symptoms of Catatonic Schizophrenia

The signs and symptoms of catatonic schizophrenia are noticeable. Symptoms are when the patient describes or senses something or exhibits a sign that doctors observe. For instance, a symptom may be drowsiness, while the sign may be the dilated pupils. The signs and symptoms of catatonic schizophrenia include:

  • Physical immobility is the major symptom of catatonic schizophrenia. In this condition, the patient does not move or speak. They just hold their body in one fixed position or stare. They are unaware of the enveloped surroundings.
  • Excessive mobility is another major symptom of catatonic schizophrenia. This is a state where the patient keeps moving excitedly for no useful or specific reasons. This includes energetically pacing around, making unusual and loud utterances and walking in circles.
  • Another symptom of catatonic schizophrenia is waxy flexibility. This condition refers to physical immobility. For instance, the patients arm if moved by another person; it remains for hours in the same position.
  • Strange movements are also symptoms of catatonic schizophrenia. The posture of the patient in this condition is inappropriate or unusual. The mannerisms may be bizarre.
  • Uncooperativeness is another symptom of catatonic schizophrenia. In this condition, the patient may not move and may not even respond to instructions or say anything.
  • Echopraxia is a symptom of catatonic schizophrenia. The patient in this condition repeats a gesture or movement that is done by someone or another person, or may get obsessed in some specific way, follow a routine or ritual with passion.
  • Echolalia is a symptom of catatonic schizophrenia. In this condition, the patient may repeat words which someone just said.

Apart from these above mentioned catatonic schizophrenia symptoms examples, patients may exhibit the following schizophrenia symptoms and signs:

  • Delusions might be a symptom of catatonic schizophrenia. The patient has spurious beliefs of persecution or guilt. He/she may have a feeling that some external force or person controls things. It is not uncommon with schizophrenia patients to describe plots being plotted against them. They believe of having extraordinary gifts and powers. Some schizophrenia patients may hide to protect themselves from a likely or probable persecution.
  • Thought disorder may be another sign of catatonic schizophrenia. There will be no logical reason and the person may jump from one to another subject. The speaker may find it hard to follow as the speech may be a slurred speech or also confused. In fact, sometimes, the patient also believes somebody is messing her or his mind.
  • Catatonic schizophrenia symptoms can include hallucinations. There is a common feeling of hearing voices, tasting, feeling or smelling things that are not there, but the patient finds it to be real.
  • Poor emotional expression may be a sign of catatonic schizophrenia. There may be inappropriate response to sad or happy occasions.
  • Lack of motivation could be symptom of catatonic schizophrenia. The patient loses the drive. Thus, it is very important for the patient to understand this loss of drive is owing to his/her illness and does not relate to laziness.
  • Being unaware of illness can be a sign of catatonic schizophrenia. Delusions and hallucinations seem real for patients to the extent that they do not accept they are sick and refuse taking medications fearing side-effects.
  • Patients with catatonic schizophrenia might show symptoms of social withdrawal. A catatonic schizophrenia patient withdraws socially and this happens because he/she believes somebody may harm them. The fear of interacting due to poor social skills also leads to social withdrawal.
  • Individuals with catatonic schizophrenia may face cognitive difficulties. The ability of the patient to concentrate, plan ahead and remember things and to organize gets affected. Moreover, communication also becomes more difficult.

There may be angry outburst, rambling of speech, uncoordinated movements and poor personal hygiene. Without proper treatment, it may continue for days and also weeks.

Patients with catatonic schizophrenia symptoms cannot avail on their own some medical assistance. This is because as the symptoms subside, they believe they are fine and so do not seek cure. In fact, most often, seeking medical assistance is initiated by a good friend or a family member.

Tests to Diagnose Catatonic Schizophrenia

A physician suspecting a patient may be affected with catatonic schizophrenia surely recommends a range of tests and exams, medical and psychological so that it helps in the diagnosis. However, the diagnostic exams and tests for catatonic schizophrenia may include:

  • CBC or Complete Blood Count test for catatonic schizophrenia. This refers to complete blood count that allows checking for drugs and alcohol, besides thyroid function
  • EEG for catatonic schizophrenia refers to electroencephalogram that checks the functioning of the brain.
  • Physical exam for catatonic schizophrenia refers to the height, heart rate, weight, temperature and blood pressure checking. The abdomen, lungs and heart is checked by the doctor.
  • Psychological evaluation for catatonic schizophrenia involves a psychiatrist asking the patient about the feelings, thoughts and behavior patterns. Even discussions on symptoms, the severity, when it started and how it affects is done. The doctors try finding out when the episodes occurred and the frequency it occurs.
  • MRI for catatonic schizophrenia refers to magnetic resonance imaging or computed tomography CT scan, the main key is to find abnormalities in the brain or to consider if there are brain lesions.

The doctor will make efforts in finding out whether the patient has any intentions of harming other people or self-harming thoughts.

The doctor is a psychiatrist normally and he/ she will try talking to the patient’s family and friends. If the patient is found to be totally unresponsive or the behavior is inappropriate, the doctor will look for catatonic signs. An all-inclusive patient history for diagnosing catatonic schizophrenia entails:

  • The overall health history of the patient suffering from catatonic schizophrenia.
  • Earlier problems relating to mental health
  • Psychiatric disorders family history, if any
  • Starting of psychosis symptoms
  • Severity and frequency of catatonic schizophrenia episodes
  • Daily activities, stress sources, wake/sleep patterns
  • Therapies the patient tried till then and how it worked and the side effects
  • Religious/spiritual activities and beliefs of the sufferer of catatonic schizophrenia
  • Exercise habits and diet
  • Family situation, significant relationship and living situation of a patient.

Diagnostic Criteria for Catatonic Schizophrenia

For catatonic schizophrenia diagnosis to be confirmed officially, the patient must clear the specific criteria of DSM symptom. DSM represents the Diagnostic and Statistical Manual of Mental Disorders. This was published by the American Psychiatric Association. This is a manual used to diagnose mental conditions by health care professionals and insurance companies when there is a need to decide on reimbursing the medical expenses of the patient. The catatonic schizophrenia diagnostic criteria include:

  • Stupor (noticeable decrease in reactivity with respect to the environment and in impulsive movements and activity.)
  • Rigidity (maintaining rigid posture regardless of the efforts taken to be moved.)
  • Posturing (Maintenance of bizarre postures and voluntary assumption.)
  • Excitement (visible purposeless motor activity, without any external stimuli influence.)
  • Negativism (visible aimless resistance to attempts or instructions to be moved, or showing movement in the opposite direction)
  • Waxy flexibility (maintenance of body and limbs in externally imposed positions.)
  • Other symptoms such as perseveration of phrases and words and command automatism (fulfillment or observance to instructions automatically.)

A perfect diagnosis for catatonic schizophrenia is time consuming. A catatonic schizophrenia diagnosis may sometimes take a longer time than expected to confirm a patient has catatonic schizophrenia. On the other hand, other illnesses/conditions, seizure disorder, mania, severe depression or substance abuse may be considered as such conditions overlap the symptoms and signs.

Note: Bear in mind not all catatonic symptoms refers to a person affected with catatonic schizophrenia. A symptom of catatonic may be provoked by due to drugs and alcohol, metabolic disturbances, some organic brain disease and may be apparent in certain mood disorders occasionally, such as depression.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 30, 2019

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