Catatonic schizophrenia is a type of psychotic disorder that may develop in some schizophrenic patients. It involves periods where a person is unable to move their bodies and respond to specific instructions. ¹
However, some people may experience what’s known as catatonic excitement. This is when an individual starts to act “excessively” through their motor activity. They may show signs of echolalia (mimicking sounds) and/or Echopraxia (mimicking movements).
Throughout this article, we’re going to review everything you need to know about catatonic schizophrenia. At the end, we invite you to ask further questions.
What are Catatonic Schizophrenia Symptoms?
Catatonia isn’t as common as it used to be as treatments have improved. Not to mention, those with schizophrenia are less likely to experience catatonia than those struggling with other mental illnesses, such as:
- Depressive disorders
- Neurodevelopmental (primarily affects children’s nervous system)
- Psychotic bipolar disorder
Those who experience catatonia tend to experience two different episodes: 1.) decreased motor activity and 2.) increased motor activity.
Catatonia diagnosis is determined when a patient struggles with at least three of the following symptoms: ²
- Catalepsy – performing unusual postures
- Echolalia – imitating someone else’s speech
- Echopraxia – imitating someone else’s movements
- Mannerism – unusual or exaggerated actions
- Mutism – limited to no verbal communication
- Negativism – limited to no response to instructions
- Posturing – holding a posture that goes against gravity
- Stereotypy – repeating a movement for no reason
- Stupor – inability to move, doesn’t interact with environment
- Waxy flexibility – not moving a limb after it has been placed in a position
The length of catatonic episodes depends on the individual. Some experience a single one for a few days while others may be stuck in one for weeks.
What are Schizophrenia Symptoms?
Besides catatonic symptoms, a patient may also experience schizophrenia symptoms. These can include: ³
- Auditory or visual hallucinations
- Delusional thoughts (believing something is real when it isn’t)
- Difficulty concentrating
- Difficulties retaining information (learning problems)
- Disorganized speech
- Easily distracted
- Loss of interest in activities you once enjoyed
- Loss of overall joy and happiness
- Reduction in speaking and conversing with others
- Unable to show emotions (some psychiatrists refer to this as “flat expression”)
Due to the weight of both catatonic and schizophrenia symptoms, patients are usually unable to find the proper help on their own. In turn, family members and friends are required to step in to lead patients on a path to recovery.
Catatonic Schizophrenia Causes and Risk Factors
While scientists aren’t 100% sure what causes catatonic schizophrenia, we do know there are a number of factors that puts a person at risk for developing this condition. These include:
- Childhood Abuse and Trauma – If you struggled with any form of trauma as a child (psychical, emotional, sexual), you are more likely to develop schizophrenia and other mental illnesses. ⁴
- Fetal Malnutrition – Fetuses who suffer from malnutrition during pregnancy have been found to be at an increased risk of developing schizophrenia. ⁵
- Genetics – Research has confirmed that if your family has a history of schizophrenia, there is a higher chance of you developing it. ⁶
- Parents Age at Birth – It’s been discovered that those with older parents are more at risk of developing schizophrenia. ⁷
- Stress – Higher levels of stress can lead to an increased risk of all types of mental illness. This is especially true if a person experiences lots of stress at an early age or if a person is already vulnerable to schizophrenia. ⁸ ⁹
- Viral Infection – Some studies have found that children who are exposed to viral infections may be more at risk of developing schizophrenia. ¹⁰
It’s worth noting that substance abuse has also been linked to the development of schizophrenia. However, it’s been found that drugs or alcohol will only cause schizophrenia in individuals who are already vulnerable to the condition. ¹¹
How is Catatonic Schizophrenia Diagnosed?
If your doctor believes you’re struggling with catatonic schizophrenia, they’ll run a number of medical and psychological tests in order to ensure diagnosis. These may include: ¹²
- Complete Blood Count (CBC) – typically to check for alcohol or drugs, but will also confirm there aren’t other underlying diseases causing your symptoms.
- Electroencephalogram (EEG) – gives doctors insight into your brain functions.
- MRI and/or CT Scan – checks to see if there are any abnormalities within your brain structure that could indicate schizophrenia.
- Phycological Evaluation – A psychiatrist will interview you concerning a number of aspects of your life. From your thoughts, feelings, and behaviors to the symptoms you’re experiencing and their severity. They may also ask about family history.
- Physical Exam – By checking up on a number of aspects of your physicality, doctors will have the ability to see how your overall health is going and whether or not you’re experiencing symptoms of another condition.
The nature of diagnosing catatonic schizophrenia is to rule out any other possible conditions. Due to this, it can take some time before medical professionals come to a proper diagnostic.
How to Treat Catatonic Schizophrenia
There are a few different ways to treat catatonic schizophrenia depending on your age, health, symptoms, and severity. However, catatonic schizophrenia is typically treated in a similar fashion to that of regular schizophrenia.
The reason for this is schizophrenia is a lifelong condition rather than a one-and-done deal. When an individual addresses schizophrenia symptoms throughout the entirety of their lives, it’s likely catatonic schizophrenia will not return.
Schizophrenia is treated through two different methods:
There are a few different medications a psychiatrist may recommend depending on your situation. These include:
- Benzodiazepines – A tranquilizing drug that’s typically used for catatonic schizophrenia. When used over the course of a several days to weeks, benzodiazepines hold the ability to work quickly and effectively in helping people overcome catatonia symptoms. ¹³
- Barbiturates – By suppressing the central nervous system (CNS), barbiturates have been found to relieve symptoms of catatonic schizophrenia. It’s important to note that these drugs are highly addictive and for this reason, aren’t used as frequently as benzodiazepines. ¹⁴
- Antidepressants – If you struggle with catatonic schizophrenia, there’s a good chance you’re also struggling with another mental health disorder. For this reason, antidepressants may be prescribed – especially if you’re struggling with depression. ¹⁵
In order to address schizophrenia itself, a mental health professional may recommend antipsychotic drugs in order to ease long-term symptoms. ¹⁶ There’s a long list of antipsychotic medication that tends to have varying effects and it may take some time before your doctors find one that works well for you.
It’s also important to note that these medications should only be taken as a doctor suggests. Unfortunately, medication can have addictive qualities and, in turn, cause an individual to develop worse consequences than they struggled with before.
2.) Therapeutic Treatments
Alongside medication, it’s common for people to also enroll in various forms of therapy. The types of therapy for both catatonia and schizophrenia vary depending on the individual, but there are a number of options to choose from. These include:
- Psychotherapies – The most common therapies for mental illness. Psychotherapies allow individuals to identify negative thought and behavior patterns. From there, a psychologist will work on helping you overcome these patterns along with identifying what may trigger symptoms. ¹⁷ It’s worth noting that psychotherapies tend to be ineffective in people with severe catatonic schizophrenia.
- Electroconvulsive Therapy (ECT) – If a catatonic patient hasn’t responded to medication and/or other forms of treatment, ECT may be suggested. This involves an electric current passing through the brain in order to produce a controlled seizure. While there are some side effects to this procedure, they’re usually temporary. ¹⁸
- Social and Vocational Skills Training – When recovering from catatonic schizophrenia, it can be difficult to start living on your own. Such trainings can help people learn proper hygiene, how to make a nutritional meal, and how to communicate better with others. Some groups will help individuals find work, housing, and other self-help groups. ¹⁹
Being the severity of a catatonic episode, some people may require hospitalization in order to receive the right treatment.
Other Treatment Options: All-Natural Alternatives
Within the past few decades, all-natural alternatives have become increasingly popular among those struggling with mental health. While it’s never advised to opt for these alternatives over what your doctor recommends, many tend to use these alongside traditional medications and therapies for further relief.
In terms of schizophrenia, the following have found to be beneficial:
- Vitamin Treatment – Recent research has discovered that those who struggle with schizophrenia tend to have low blood levels of folic acid (or vitamin B9). ²⁰ With that, a 2014 research review discovered that taking B vitamins (such as B12 and B6) can help reduce symptoms. ²¹ Vitamin C, E, and D have also been found to be beneficial. Most notably, in adolescents struggling with schizophrenia. ²²
- Omega-3 Fatty Acids – Fish oil supplements that are rich in omega-3 fatty acids add nutrients in our bodies that help reduce inflammation. Some studies suggest that inflammation may play a role in mental illness. ²³ In one particular study, it was discovered that young people who were at high risk of schizophrenia were less likely to develop the condition when they took fish oil supplements. ²⁴
- Glycine – As an amino acid (or protein building block), glycine works alongside glutamine in order to support brain function. Some studies suggest that when glycine is taken in high doses, it can help to increase the effects of antipsychotic medication typically used in schizophrenia treatment. It should be noted that some exceptions have been discovered. For example, glycine has been found to reduce the effective properties of clozapine. ²⁵
It’s worth mentioning that a stable diet is highly beneficial to those struggling with schizophrenia. Some studies suggest that gluten-free diets are able to reduce schizophrenia symptoms. ²⁶ Overall, eating healthier helps to promote more positive energy in the brain-gut connection and, in turn, give you the ability to better overcome symptoms.
Catatonic Schizophrenia Complications
When left untreated, catatonia can cause a number of health, financial, legal, and behavior problems that will go onto affect different areas of your life. While there is no list that can categorize all these complications, some include: ²⁷
- Depression and suicidal ideation
- Family conflicts
- Hygiene difficulties
- Inability to attend school or maintain a job
- Prison (getting involved in a crime)
- Smoking-related health conditions
- Substance abuse
If you are struggling with any of the above issues, there are a number of resources available.
If you or someone you love has considered suicide, it’s important to seek help immediately. If you have no one to reach out to, you can contact the National Suicide Prevention Lifeline at 1 (800) 273-8255. If you or someone is in a life-threatening situation, it’s vital to call 911 or go to your nearest emergency room.
Being the severity of catatonic schizophrenia, it’s incredibly important for you to seek out the proper treatment. Episodes of this condition can be properly treated and give you the ability to address schizophrenic symptoms or symptoms of other mental health conditions.
Overcoming any mental illness isn’t easy. However, with the right treatment route and a sense of motivation, you can go onto live a fulfilling life.
Still have questions about catatonic schizophrenia?
We invite you to ask them in the comments section below. If you have any further knowledge to share – whether personal or professional – we’d also love to hear from you.
¹ NCBI Bookshelf (StatPearls): Catatonic Schizophrenia
² World Journal of Psychiatry (Baishideng Publishing Group Inc): Catatonia: Our current understanding of its diagnosis, treatment, and pathophysiology
³ National Institute of Mental Health (NIMH): Schizophrenia
⁴ frontiers in neuroscience: Childhood Trauma in Schizophrenia: Current Findings and Research Perspectives
⁵ Schizophrenia Bulletin (Oxford University Press): Prenatal Nutritional Deficiency and Risk of Adult Schizophrenia
⁶ The Psychiatric clinics of North America (HHS Public Access): The Role of Genetics in the Etiology of Schizophrenia
⁷ The American journal of psychiatry (HHS Public Access): Parental Age and Risk of Schizophrenia in Adult Offspring
⁸ National Institute of Mental Health (NIMH): 5 Things You Should Know About Stress
⁹ CNS spectrums (HHS Public Access): Could Stress Cause Psychosis in Individuals Vulnerable to Schizophrenia?
¹⁰ Progress in neuro-psychopharmacology & biological psychiatry (HHS Public Access): Viral infection, inflammation and schizophrenia
¹¹ Dialogues in clinical neuroscience: Substance abuse in patients with schizophrenia
¹² Psychiatry (Edgmont) (Matrix Medical Communications): Clinical Manifestations, Diagnosis, and Empirical Treatments for Catatonia
¹³ National Library of Medicine (PubMed): Benzodiazepines for catatonia in people with schizophrenia and other serious mental illnesses
¹⁴ National Library of Medicine (PubMed): Catatonia: a syndrome appears, disappears, and is rediscovered
¹⁵ Medicine (Wolters Kluwer Health): Successful Treatment of Treatment-Resistant Schizophrenia in a 10-Year-Catatonic Patient by Augmentation of Selective Serotonin Reuptake Inhibitors
¹⁶ Federal Bureau of Prisons Clinical Guidance: Pharmacological Management of Schizophrenia
¹⁷ The Journal of Psychotherapy Practice and Research (American Psychiatric Publishing): Psychotherapy of Schizophrenia
¹⁸ World Journal of Psychiatry (Baishideng Publishing Group Inc): Electroconvulsive therapy in catatonic patients: Efficacy and predictors of response
¹⁹ Schizophrenia Bulletin (Oxford University Press): Recent Advances in Social Skills Training for Schizophrenia
²⁰ Journal of Research in Medicinal Sciences (Wolter Kluwer): Folate and vitamin B12 in schizophrenic patients
²¹ CBNS drugs (HHS Public Access): Vitamin Supplementation in the Treatment of Schizophrenia
²² Integrative Medicine Insights: The Role of Vitamins and Minerals in Psychiatry
²³ frontiers in Psychiatry: What Is the Role of Dietary Inflammation in Severe Mental Illness? A Review of Observational and Experimental Findings
²⁴ Nature Communications: Long-term outcome in the prevention of psychotic disorders by the Vienna omega-3 study
²⁵ MDedge Psychiatry: Glutamate: New hope for schizophrenia treatment
²⁶ National Library of Medicine (PubMed): The gluten connection: the association between schizophrenia and celiac disease
²⁷ Primary Care Companion to The Journal of Clinical Psychiatry (Physicians Postgraduate Press, Inc.): Dread Complications of Catatonia: A Case Discussion and Review of the Literature