Catatonic Schizophrenia: Causes, Symptoms and Treatment

Catatonic Schizophrenia

What is catatonic schizophrenia?

Catatonic schizophrenia is a set of symptoms that might develop in some schizophrenia patients. In such cases, the individual does not react to instructions and moves very little.

On the other extreme, the individual can display excessive and unusual motor activity, such as echolalia (impersonating other people’s sound or movement) or Echopraxia (impersonating other people’s movement). The condition is known as catatonic excitement.

The purpose of this article is to provide a list of symptoms, their causes, diagnosis and treatment for catatonic schizophrenia.

What is catatonia?

The term catatonia refers to a syndrome characterized by a collection of symptoms in which the brain does not manage the signals for muscle movement as it should and you behave abnormally. Catatonia is often associated with schizophrenia, but it can happen with many other conditions as well. Catatonia used to be associated mostly with schizophrenia, however, bipolar disorder has been more frequently linked to catatonia in recent years, as have various medical conditions and mental disorders.

An individual suffering from catatonia can either be excited, withdrawn, or mixed.

  • Excited/hyperkinetic: There is an increased tendency to move (such as pacing), agitated behavior, abnormal or exaggerated movements, repetitive movements and speech, or copying what someone else is doing.
  • Withdrawn/hypokinetic: People suffering from this type of catatonia often have very limited responses to what’s happening around them – or none at all. There may be no feelings or facial expressions, they may be completely still or stare, or they may remain in an unusual position for a prolonged time.
  • Mixed: It is a form of catatonia that combines hyperkinetic and hypokinetic characteristics.

Difference between catatonic schizophrenia and paranoid schizophrenia

The term “paranoid schizophrenia” is also obsolete in the sense that it no longer applies to a diagnosis. Experts considered paranoia, delusions, and hallucinations to be the key characteristics of paranoid schizophrenia. The term catatonic schizophrenia refers to schizophrenia in which catatonia is the most prominent feature.

How does it affect people?

Schizophrenia typically strikes men between 15 and 25 years of age, and those assigned as male at birth are more likely to develop it. Women and people with female birth designations typically experience it between the ages of 25 and 35. There is no difference in the rate of occurrence based on gender. There are rare instances of children developing schizophrenia, and their cases are usually more serious than those of adults. The most common cause of catatonia in childhood is schizophrenia, not adult catatonia.

How does this condition affect my body?

There are many processes in your brain that are disrupted when you have schizophrenia, such as your attention and memory abilities, your senses, and more. Most people with schizophrenia have more subtle presentations in between these extremes, such as high levels of activity or no activity at all. Schizophrenia that involves catatonia often stands out as the only form of schizophrenia that involves movement.

Facts about catatonic schizophrenia

Catatonic schizophrenia can be summarized by these key points. In the main article, you can find more details and supporting information.

  • Schizophrenia only causes catatonia in some individuals
  • Flipping between hyperactivity and inactivity can be a symptom
  • Catatonic schizophrenia is at risk for the same factors as schizophrenia in general
  • Treatments for catatonic schizophrenia are now available in many forms

Related: Types of Schizophrenia

Catatonic schizophrenia risk factors

A number of factors contribute to the development of catatonic schizophrenia, as they do for other schizophrenia subtypes, including:

  • Genetics – Families with histories of schizophrenia are at greater risk of developing it themselves, as well.
  • Viral infection – The development of schizophrenia may be predisposed to by viral infections in children.
  • Fetal malnutrition – There is a greater risk of schizophrenia developing in the fetus if it suffers from malnutrition during pregnancy.
  • Stress during early life – Schizophrenia may be caused by severe stress at a young age. Schizophrenia is often preceded by stressful experiences.
  • Trauma or abuse during childhood.
  • Age of parents at birth – A child raised by older parents is more likely to develop schizophrenia.
  • Drugs – During adolescence, using substances that affect the mind dramatically increases the risk of schizophrenia.

Also, check: Side Effects of Overthinking

Causes of catatonic schizophrenia

Catatonic schizophrenia has no known cause. According to research, mental disorders are generally caused by a malfunctioning of the brain. However, we do not currently understand exactly why this malfunction occurs. Stress, genetics, and environmental factors are likely to play a part in its development.

Schizophrenia is thought to be caused by an imbalance of dopamine, a neurotransmitter. Genes that make someone susceptible to the illness are believed to be behind this imbalance. According to some researchers, serotonin may play a role, as well as other neurotransmitters.

Check: Types of Overthinking

Symptoms of catatonic schizophrenia

Symptoms of catatonic schizophrenia
Catatonic Schizophrenia Symptoms

A better understanding of treatment has made catatonic schizophrenia much less common compared to the past. Catatonic states are now more common in mental illnesses other than schizophrenia, such as neurodevelopmental illnesses (which affect children’s nervous systems during the development stage), psychotic bipolar disorders, and depressive disorders.

When people suffer from catatonia, their motor activity fluctuates between decreased and excessive.

The latest treatments for catatonic schizophrenia help patients manage their symptoms more effectively, improving their chances of living a happier and healthier life.

There are at least three catatonic schizophrenia symptoms present in catatonic patients:

  • Stupor – inactivity, and inability to interact with the environment
  • Catalepsy may lead to abnormal postures
  • Waxy Flexibility – if an area is placed on a patient, the area will stay in this position until the area is moved again
  • Mutism – limited ability to communicate verbally
  • Negativism – little or no response to external stimuli or instructions
  • Posing – holding a posture actively against gravity
  • Mannerism – the act of performing odd, exaggerated actions
  • Stereotypy – the act of repeating a sequence of movements in the same way without any apparent reason
  • Agitation – with no known cause
  • Grimacing
  • Echolalia – mimicking the speech of another
  • Echopraxia – the imitation of the movement of another

It is a fact that a catatonic episode can last days or weeks without treatment.

Read: Body-Focused Repetitive Behavior

Schizophrenia symptoms

Schizophrenia is also characterized by the following symptoms, among others:

  • Delusions: There may be an overwhelming sense of persecution among the patient. Alternately, they may believe they possess extraordinary abilities.
  • Hallucinations: A hallucination is a sense of hearing voices (audible hallucination), but can also involve visions (seeing things you don’t see) or any other sensory experience.
  • Thought disorder: The person can talk about several subjects at once without a logical reason. A patient’s speech may be difficult to understand and muddled.
  • Absence of motivation (abolition): This can result in the patient losing their drive. They stop doing everyday things, like washing and cooking.
  • Poorly expressed emotions:  If a happy or sad event happens, they may not respond appropriately.
  • Social withdrawal: Psychosis patients often withdraw from social interactions because they think that someone is going to hurt them.
  • A lack of awareness of illness (“poor insight”): The patient does not realize they are ill due to the hallucinations and delusions they see.
  • Cognitive difficulties: Patients have difficulty concentrating, remembering things, planning ahead, and communicating.

Catatonic schizophrenia sufferers are not generally able to get medical treatment on their own. Family members and friends often seek medical assistance.

Read: Nail Picking Disorder

Diagnosis of catatonic schizophrenia

The doctor who suspects the patient of catatonic schizophrenia will order a number of medical and psychological tests to further assist him in diagnosing the illness. These tests may include:

  • Physical exam – Checks are made on the patient’s height, heart rate, weight, temperature, and blood pressure. Doctors will check the abdomen, heart, and lungs.
  • Complete blood count (CBC) – A thyroid function test is also performed – to check for alcohol and drug use.
  • MRI or CT scan – An attempt is made to determine if the brain structure is abnormal.
  • EEG (electroencephalogram) – to determine if the brain is functioning properly.
  • Psychological assessment – In general, a psychiatrist will question the patient (if possible) about his or her thoughts, feelings, and behaviors. It will be discussed when the symptoms began, their severity, and the impact they have on the patient. If they ask the patient whether he or she is contemplating harming himself or others, they will be more likely to believe so.

The diagnosis of catatonic schizophrenia can be difficult. As with catatonic schizophrenia, it is important to rule out other conditions first. These include mania, seizure disorder, drug abuse, and severe depression.

Check: Tips to overcome Depression

Treatment options for catatonic schizophrenia

A person with schizophrenia may experience catatonic symptoms for the entirety of their life, even though the condition may last throughout their lifetime. The symptoms of schizophrenia must be treated on an ongoing basis, even when the patient believes the symptoms have disappeared and that they are better than before.

All forms of schizophrenia are treated essentially the same way. The diagnosis and treatment methods differ depending on the type and severity of symptoms, the patient’s health, and age.


  • Benzodiazepines – It is typically used for catatonic schizophrenia and acts as a tranquilizer. An intravenous (injection into a vein) dose of the drug is fast-acting. Long-term use can lead to dependency. It may take several days or weeks for the patient to complete the course of this medication.
  • Barbiturates – A depressant or sedative is a medication that produces similar effects. The central nervous system is suppressed by these drugs. Depending on their strength, they can sedate or anesthetize you. Barbiturates quickly relieve catatonia symptoms. It is possible to become dependent on something if it is used for a long time. Barbiturates are used less frequently for treating catatonic schizophrenia with this drug.
  • Mood stabilizers and antidepressants – Catatonic schizophrenia patients are often suffering from other mental health problems, such as depression.

Recommended: Multiple Strategies To Control Overthinking

Other catatonic schizophrenia treatments

ECT (electroconvulsive therapy) – is a method that uses an electrical current to control seizures (convulsions) in the brain. When medications and other treatments do not work, ECT can be used to treat catatonic patients. There is a possibility of short-term memory loss as a side effect.

Hospitalization – When a severe episode occurs, this may be needed. Hospitals provide a safer environment for patients. They provide them with healthy nutrition, rest and hygiene, in addition to providing the right treatment.

Psychotherapy – Psychotherapy may be helpful for patients with catatonic schizophrenia, but psychotherapy may not be appropriate if symptoms are severe. Medication is the primary means for treating cats with catatonic schizophrenia.

Occupational and social skills training – one of the most important steps in the recovery process for the patient is the ability to live independently. By teaching good hygiene habits, preparing nutritious meals, and communicating better, the therapy can help patients. In addition, you may receive help finding a job, finding housing, or joining a self-help group.

Compliance (adherence) – Complying or adhering to the appropriate dosage and timing of medication is considered compliance in medicine. Patients with schizophrenia often lack compliance with their treatment plans. The patient may stop taking the medication for a prolonged period of time, affecting the patient’s life as well as the lives of others around him or her.

Recommended: How to help someone with Depression

Coping with catatonic behavior in schizophrenia

There is nothing more frightening than witnessing someone you care about suffer from catatonic behavior due to schizophrenia. If you notice any symptoms of catatonia like rigidity or stupor or erratic and extreme movements, it is vital that you remain educated – about symptoms, diagnosis, and effective treatment.

It may be necessary for you to intervene and describe your loved one’s catatonic behaviors to their doctor, depending on their severity and type of symptoms. In order to ensure that schizophrenia is well managed and controlled, make sure to encourage your loved one to follow their treatment plan and work with their mental health professional.

It’s also important to remember self-care, which is essential for providing support to someone suffering from mental illness. Be sure to get enough sleep, eat healthy, exercise, and spend time relaxing and having fun.

Complications of catatonic schizophrenia

Symptoms of untreated catatonic schizophrenia often affect the patient across all areas of his or her life; these problems may have a financial, behavioral, and legal impact. Here are some of the complications that can occur:

  • A significant proportion of patients with schizophrenia have depressive episodes, suicidal thoughts and suicidal behavior.
  • Malnutrition.
  • Hygiene problems.
  • Substance abuse. A variety of drugs and alcohol may be available.
  • Poverty and homelessness result from inability to find or maintain employment.
  • Prison.
  • Conflicts within the family.
  • Unable to study or go to school.
  • A victim of crime or a criminal.
  • Smoking-related diseases.

Read: Tongue Biting Disorder

The outlook

The symptoms of schizophrenia are often long-term, but an experienced psychiatric team can treat catatonic episodes associated with the condition.

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