Catatonic schizophrenia is serious neurological or psychological condition in which two kinds of behaviors are typically displayed: stupor and motor rigidity or excitement. When people experience rigidity or stupor, they are unable to speak, respond or even move. In other cases, people will exhibit severe excitement or mania. Those experiencing catatonic excitement will exhibit manic behaviors such as babbling or speaking incoherently. Those suffering from catatonic stupor remain in this motionless state for extended periods of time.

Catatonic Patient

Common Characteristics

The catatonic schizophrenic evidence strange positions and movements, or long periods of motionlessness. She may stay in uncomfortable-looking positions for long periods. She also resists attempts to reposition them in more comfortable or natural positions.

In addition to a lack of mobility, the catatonic schizophrenic may display excessive movement. In cases where people experience excitability as a symptom, they may move in an erratic and extreme manner. Pacing in a repeated pattern and making loud exclamations may also occur. These actions serve no purpose and are not in response to an environmental stimulus or event.​

People with this disorder may also have other signs of schizophrenia including hallucinations, delusions, cognitive problems, social withdrawal, bursts of anger, poor personal hygiene, social issues, and an inability to express emotions.

Diagnosis

Catatonic schizophrenia is typically diagnosed through a series of medical exams and psychological evaluations. Patients receive a medical exam to assess overall physical health. A blood test is usually given to check for the presence of drugs and alcohol. MRIs and EEG may then be used to check brain function and to look for any lesion or unusual brain wave patterns.

During the psychological evaluation, a patient will be asked questions about their thoughts and behaviors. A psychiatrist will attempt to discover how long the patient has been experiencing the symptoms in question. In some cases where the patient is in a catatonic stupor, he or she may be unable to provide such information. In such instances, the doctor will assess such symptoms and may interview family members about the patient's past behavior.

Misdiagnosis

Because this type of schizophrenia is characterized by motor symptoms, it is sometimes mistaken for a psychotic mood disorder.

Likewise, the catatonic schizophrenic may sometimes display facial contortions, strange limb movements, or unusual body positions, and are therefor me they are sometimes misdiagnosed with a disorder known as tardive dyskinesia.

Catatonic schizophrenia is also often marked by echolalia (repeating what others say and echopraxia (copying another person's movements), which might sometimes lead to a misdiagnosis of Tourette's syndrome.

Treatment

Catatonic schizophrenia is a lifelong, chronic condition. Even when the patient does not exhibit symptoms of the disorder, they are still schizophrenic and require ongoing treatment to prevent the return of symptoms.

Medication

Medication is the most common form of treatment for schizophrenia.

Benzodiazepines are perhaps the most common approach to treatment. These drugs act as depressants on the central nervous system, which is why they are often used to treat anxiety. Because these drugs are fast-acting, they can often relieve catatonic symptoms quite quickly. However, they can be habit-forming, especially if when used as a long-term treatment.

Other drugs such as barbiturates, antidepressants, and antipsychotics are occasionally used to treat catatonic schizophrenia, but they are not as effective as benzodiazepines.

ECT

Electroconvulsive therapy (ECT), or shock treatment, has sometimes been used to treat catatonic schizophrenia. This technique involves sending an electrical current through the brain. Since ECT is so controversial and can produce severe side effects such as memory loss, it is generally only used in severe cases where patients have not responded to medications, are severely depressed, and are at risk of suicide.

Psychotherapy

While medication is usually the first-line approach to treatment, it is often combined with psychotherapy. Psychotherapists help patients better understand their feelings, behaviors, and responses. People in therapy learn a variety of coping skills and acquire new ways of dealing with stressful events in their lives.

With appropriate treatment, an individual suffering from catatonic schizophrenia can find relief from their symptoms. Treatment can also help patients avoid many of the dangerous complications associated with this disorder including substance abuse, family issues, and suicide.