What Are the Main Features and Risk Factors of Catatonic Schizophrenia?
It is a kind of symptom that is developed in some patients with schizophrenia. It shows a phase in which an individual moves very little and does not respond to instructions and in extreme condition, one may demonstrate motor activity that is considered “excessive” and “peculiar,” such as echolalia (mimicking sounds) or Echopraxia (mimicking movements) which is called as catatonic excitement.
In this state one is not able to differentiate between what is real or what is fake and this stage is called psychosis. This disease affects a person in a very extreme way like that individual might stay still or mute, or might be hyperactive for no reason.
Facts Regarding Catatonic Schizophrenia
Some of the common facts regarding schizophrenia are given below:
A. It mainly happens to those suffering from schizophrenia.
B. Common symptoms of this disease are flipping between hyperactivity and under activity.
C. Common risk factors of the catatonic disease are the same as those for schizophrenia in general.
Symptoms of Catatonic Schizophrenia
Some of the common symptoms of this mental illness are listed below:
Stupor – This means the individual has no psychomotor activity, no interaction with the environment
Catalepsy – This symptom includes adopting or performing unusual postures.
Waxy Flexibility – Under this condition, the individual will not change his/her arm position unless changed by someone, they will remain in the same position till it is moved again.
Mutism – Such individuals show only limited verbal responses.
Negativism – Individuals show very little or no response to instructions or external stimuli.
Posturing – In this condition, individuals will be actively holding a posture against gravity.
Mannerism – Performing or carrying out odd, exaggerated actions
Stereotypy – Showing or performing repetitive movements without an apparent reason
Agitation – for no known reason
Grimacing
Echolalia – mimicking another person’s speech
Echopraxia – mimicking another person’s movements
Risk of Catatonic Schizophrenia
Genetics – If in a family anyone is suffering from schizophrenia than in that case individuals have the risk of developing it themselves.
Viral Infection – In early age cases like in children, it may also develop from viral infection.
Fetal Malnutrition – If during pregnancy stage one is not fed with proper nutrition, the foetus has chances of developing schizophrenia.
Stress during Early Life – One of the common causes of developing schizophrenia is stress in life.
Childhood abuse or Trauma - It can also be a reason behind developing schizophrenia.
Age of Parents at Birth – Individuals older in age have a higher risk of having children who develop schizophrenia.
Drugs – Consuming drugs that affect the mind during adolescence may increase the risk of developing schizophrenia.
Diagnosis of Catatonic Schizophrenia
Methods by which catatonic schizophrenia can be diagnosed are:
A. Physical Exam – By proper examination of the patient's height, weight, heart rate, blood pressure, and temperature. The doctor will listen to the heart and lungs and check the abdomen.
B. CBC (complete blood count) – Counting of blood is done to check for alcohol and drugs, as well as thyroid function of the body.
C. MRI or CT Scan – The aim behind performing this checkup is to look for any abnormalities in brain structure.
D. EEG (electroencephalogram) – To check for brain function.
E. Psychological Evaluation – In this process, a psychiatrist will ask the patient (if possible) about their thoughts, feelings, and behaviour patterns. They will also be asked about the symptoms, when they started, how severe they are, and how they affect the patient’s life. They will also ask whether the patient has thoughts about harming themselves or others.
FAQs on Catatonic Schizophrenia: Key Facts for Biology Students
1. What is catatonic schizophrenia?
Catatonic schizophrenia is an older term for a condition now understood as catatonia, a serious neuropsychiatric syndrome characterised by severe disturbances in motor behaviour. It can manifest as either extreme immobility and unresponsiveness or as excessive, purposeless motor activity. While historically linked to schizophrenia, catatonia is now recognised as a specifier that can occur with several other mental and medical conditions, including bipolar disorder.
2. What are the primary symptoms of catatonic behavior?
A person with catatonia may exhibit a wide range of motor and behavioural symptoms. The most common signs include:
- Stupor: A state of near-unconsciousness where the person does not react to their surroundings.
- Mutism: A complete lack of verbal response.
- Waxy Flexibility: The person’s limbs can be moved into a new position and will remain there for a long time.
- Posturing: Actively holding a rigid posture against gravity.
- Echolalia: Meaninglessly repeating words or phrases spoken by another person.
- Echopraxia: Mimicking the movements of another person.
3. What are the potential causes of catatonia?
The exact cause of catatonia is not fully understood, but it is believed to involve a dysfunction in key neurotransmitter systems in the brain. Research points towards imbalances in dopamine, GABA (gamma-aminobutyric acid), and glutamate pathways, which regulate mood, behaviour, and movement. Genetic predispositions, underlying psychiatric disorders like schizophrenia or bipolar disorder, and various medical conditions can also trigger a catatonic state.
4. How is catatonia diagnosed and treated?
Diagnosis is based on clinical observation, where a doctor looks for a set number of characteristic symptoms as defined in diagnostic manuals like the DSM-5. The primary treatment involves medications, particularly benzodiazepines like Lorazepam, which are often highly effective. If medication fails or the condition is life-threatening (malignant catatonia), Electroconvulsive Therapy (ECT) is considered the gold-standard treatment and can lead to rapid improvement.
5. What is the difference between catatonia and a stupor?
The key difference is that a stupor is a single symptom, while catatonia is a broader syndrome. A stupor refers specifically to a state of unresponsiveness and immobility. Catatonia, however, is the overall condition that includes stupor along with other possible signs like waxy flexibility, posturing, mutism, or even excessive agitation. Therefore, a person experiencing catatonia may be in a stupor, but stupor is just one component of the full catatonic syndrome.
6. Why is it important to differentiate catatonic symptoms from other conditions?
Differentiating catatonic symptoms is critical because it directly impacts treatment and outcomes. Misdiagnosing catatonia as just severe depression or the negative symptoms of schizophrenia could lead to ineffective or harmful treatments. Catatonia responds uniquely well to specific interventions like benzodiazepines and ECT. Correct identification ensures the patient receives this targeted, often life-saving, therapy promptly. Furthermore, since catatonia can be a medical emergency, rapid and accurate diagnosis is essential for patient safety.
7. Can catatonia occur outside of schizophrenia?
Yes, absolutely. This is a critical modern understanding that has shifted from historical views. While strongly associated with schizophrenia in the past, it is now known that catatonia occurs more frequently in individuals with mood disorders like bipolar disorder and major depression. It can also be caused by a wide range of general medical conditions, including autoimmune diseases, metabolic abnormalities, and infections affecting the central nervous system.
8. How do advanced treatments like ECT and TMS work for catatonia?
Electroconvulsive Therapy (ECT) works by inducing a brief, controlled seizure in the brain under general anaesthesia. This is believed to reset abnormal brain activity and restore the balance of neurotransmitters, making it highly effective for severe, treatment-resistant catatonia. Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that uses magnetic pulses to stimulate nerve cells in specific brain regions associated with mood and movement, offering a treatment alternative with fewer cognitive side effects.
9. Can you provide a hypothetical example of a person exhibiting catatonic behavior?
Imagine a patient in a hospital who remains completely still in their bed for hours (immobility) and does not speak when talked to (mutism). If a nurse gently lifts the patient's arm to check their pulse, the arm stays in that raised position even after the nurse lets go (waxy flexibility). The patient may also hold an unusual, rigid body position for a long time (posturing). This combination of motor disturbances is a classic example of catatonic behavior.
