Catatonic schizophrenia: Symptoms, causes, and treatments

Catatonic schizophrenia refers to a certain complex of symptoms that a schizophrenic patient may develop. This may be manifested in hardly moving or failing to follow directions. Alternatively, a patient may also experience something called catatonic excitement, characterized by extreme motor activity such as mimicking sounds and movements.

Only some patients develop catatonic schizophrenia, with symptoms alternating between hyperactive and hypoactive.

Signs and symptoms of catatonic schizophrenia

Catatonic symptoms are not as frequent nowadays due to treatment improvements. They are now seen more often in other disorders including bipolar disorder and neurodevelopmental conditions.

Signs and symptoms of catatonic schizophrenia include:

• Stupor – no movement or involvement in one’s environment
• Catalepsy – unusual postures
• Waxy flexibility – if a patient’s body part is placed in a position it will not be moved until someone else moves it
• Mutism – limited verbal responses
• Negativism – little to no response to external stimuli
• Posturing – holding a posture against gravity
• Mannerism – carrying out odd or exaggerated actions
• Stereotypy – repetitive movements for no reason
• Agitation
• Grimacing
• Echolalia – mimicking another person’s speech
• Echopraxia – mimicking another person’s movement

Symptoms may persist for several days if proper treatment is not administered.

What causes catatonic schizophrenia?

It is not clear what causes catatonic schizophrenia and why only some patients experience it while others do not. Researchers speculate that a combination of genetic and environmental factors contribute to the onset of catatonic schizophrenia – and the schizophrenic disorder in general.

It’s been observed that a dopamine imbalance may have to do with the onset of schizophrenia which may also be caused by genetics. The neurotransmitter serotonin may play a role here, too.

Risk factors for catatonic schizophrenia are the same as for schizophrenia:

• Genetics
• Viral infections
• Fetal malnutrition
• Stress in early life
• Childhood abuse or trauma
• Older age of parents at birth
• Drug use in adolescence

Diagnosis and treatment options for catatonic schizophrenia

Patients suspected of catatonic schizophrenia will undergo several medical and psychological tests, including a physical examination, complete blood count, MRI and CT scans, electroencephalogram, and a psychological evaluation.

Properly diagnosing catatonic schizophrenia may be a challenge, as it can mimic other conditions like mania and seizure disorders, and so these other conditions are often ruled out first before confirming a diagnosis of catatonic schizophrenia.

Medications are often prescribed to treat catatonic schizophrenia. These include benzodiazepines, barbiturates, antidepressants, and mood-stabilizing drugs.

Other treatments may include electroconvulsive therapy in which an electrical current is sent to the brain, hospitalization (where patients can receive proper nutrition, sleep, and be monitored and stabilized), psychotherapy, social and vocational training, and proper compliance to medication treatment.

Treatments depend on the symptom severity along with other factors.

Sources:
http://www.medicalnewstoday.com/articles/192263.php
http://www.medicalnewstoday.com/articles/192263.php#causes_catatonic