Tuesday, October 20, 2020

Catatonic Schizophrenia | Psych Central

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Catatonic schizophrenia is the raresttype of schizophrenia. The symptoms are especially unusual, involving significant psychomotor oddities and disturbances. Individuals with other types of schizophrenia may occasionally display catatonic symptoms as well, although they typically last for only a brief period of time.

Symptoms of catatonic schizophrenia

In catatonic schizophrenia the individual must prominently display at least two of the following bizarre symptoms:

  • The patient doesn’t move – he/she is fairly or completely unresponsive to his/her surroundings or remains in a rigid posture (“catatonic stupor”)
  • The patient moves excessively, but the movement is not in response to something specific and appears to have no purpose (“catatonic excitement”)
  • The patient refuses to speak or is unable to speak, and / or resists being moved (or refuses to respond to any instruction to move) (“catatonic negativism”) in any way while maintaining a rigid stance (“catatonic rigidity”)
  • The patient voluntarily moves in very unusual or bizarre ways, or assumes a very strange or inappropriate stance (“catatonic posturing”)
  • The patient senselessly mimics the words or movements of someone else, known as echolalia and echopraxia respectively

Associated Characteristics

Although the primary symptoms of this rare type of schizophrenia are psychomotor in nature, individuals may display other typical schizophrenic symptoms as well. For example, their speech may be disorganized, they may avoid social interaction, and they may have a very limited range of emotional response. Hallucinations and delusions may also be present, but usually not to a significant degree. Poor hygiene and problems with work and school performance are also not uncommon.

Treatment

As with other types of schizophrenia, treatment for catatonic schizophrenia primarily involves the use of antipsychotic medications. If the patient responds well to mediation, he/she may also benefit from individual, group, or family therapy, vocational skills training or vocational rehabilitation, and other types of psychosocial interventions.

Other Related Aspects

Individuals with catatonic schizophrenia have significant risks due to the unusual nature of their symptoms. For example, if they engage in excessive movement due to excitement, they may end up accidentally injuring themselves or someone else. During a stupor or extended period of rigid posturing, they will stop eating and drinking. This can lead to severe dehydration and malnutrition.

Excessive movement and / or lack of sleep can also lead to exhaustion. It is not uncommon for them to require inpatient medical treatment (in addition to psychiatric treatment) to stabilize them physically.

Since this particular type of schizophrenia is so rare, it is always important that the patient is screened for substances or a medical condition that may be causing the catatonic-like symptoms.

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