In the past, catatonia was considered to be a subtype of schizophrenia. It’s understood now that catatonia can occur in a broad spectrum of psychiatric and medical conditions.
Although catatonia and schizophrenia can exist as separate conditions, they are closely tied to one another. The first medical acknowledgement of catatonic behavior involved people with schizophrenia.
People with catatonic symptoms in schizophrenia exhibit unusual styles and levels of physical movement. For example, such a person may move their body erratically or not at all. This state may continue for minutes, hours, even days.
Symptoms of catatonic schizophrenia may include:
- stupor (a state close to unconsciousness)
- catalepsy (trance seizure with rigid body)
- waxy flexibility (limbs stay in the position another person puts them in)
- mutism (lack of verbal response)
- negativism (lack of response stimuli or instruction)
- posturing (holding a posture that fights gravity)
- mannerism (odd and exaggerated movements)
- stereotypy (repetitive movements for no reason)
- agitation (not influenced by eternal stimuli)
- grimacing (contorted facial movements)
- echolalia (meaningless repetition of another person’s word)
- echopraxia (meaningless repetition of another person’s movements)
The catatonic state may be punctuated by times of polar opposite behaviors. For example, someone with catatonia may experience brief episodes of:
- unexplained excitability
Just because a person has catatonic symptoms doesn’t mean that person has schizophrenia.
Causes of catatonia
The causes of catatonic disorders vary from person to person, but researchers believe irregularities in the dopamine, gamma-aminobutyric acid (GABA), and glutamate neurotransmitter systems are the primary cause.
It isn’t unusual for catatonia to be accompanied by other neurological, psychiatric, or physical conditions.
Causes of schizophrenia
While causes of schizophrenia are unknown, researchers believe that a combination of factors contribute to its development, including
- brain chemistry
For example, a person who already has a predisposition to the disorder may experience a full episode after a night of engaging in drug use. This is because mind-altering substances also contribute to changes in brain chemistry. When combined with existing chemical imbalances in a person’s brain, the impact of drugs and alcohol can be strong.
When to see a doctor for catatonic schizophrenia
If you or someone you love is experiencing any symptoms of catatonic schizophrenia, you should see your doctor as soon as possible. If you believe that someone is having a catatonic episode, seek medical help immediately.
Only a medical doctor can diagnose catatonic schizophrenia. In order to do so, a doctor may perform some or all of the following tests:
- EEG (electroencephalogram)
- MRI scan
- CT scan
- physical examination
- psychiatric examination (performed by a psychiatrist)
Typically, the first step in treating catatonic schizophrenia is medication. Your doctor might prescribe lorazepam (Ativan) — a benzodiazepine — injected either intramuscularly (IM) or intravenously (IV). Other benzodiazepines include:
Sometimes psychotherapy is combined with medication to teach coping skills and how to deal with stressful situations. This treatment also aims to help people who have mental health issues associated with catatonia learn how to collaborate with their doctor to manage their condition better.
Although schizophrenia may be a lifelong condition in some cases, catatonic episodes associated with the condition can be effectively treated by an experienced psychiatric team.