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Author Topic: What is Catatonic Schizophrenia?  (Read 1176 times)

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What is Catatonic Schizophrenia?
« on: January 19, 2025, 07:34:25 AM »
Source: https://www.medicalnewstoday.com/articles/192263

Dated: November 13, 2024

Catatonia refers to a set of symptoms that might develop in some individuals with schizophrenia. It can include periods where the person moves very little and does not respond to instructions.

Periods of hyperactivity called catatonic excitement also occur. This is when the individual demonstrates motor activity that is considered “excessive” and “peculiar,” such as echolalia (mimicking sounds) or echopraxia (mimicking movements).

In this article, we look at the symptoms of schizophrenia with catatonia, its causes, diagnosis, and how it is treated.

Fast facts on schizophrenia with catatonia:

Here are some key points about schizophrenia with catatonia. More details and supporting information are in the main article:

- Catatonia only occurs in some individuals with schizophrenia.

- Symptoms can involve alternating hyperactivity and underactivity.

- Risk factors for schizophrenia with catatonia are the same as those for schizophrenia in general.

There are now a number of effective treatments for the symptoms of schizophrenia with catatonia.

Symptoms of schizophrenia with catatonia:

Schizophrenia with catatonia is much rarer than it used to be thanks to improved treatments.

Catatonic states are now more likely to be found in types of mental health conditions other than schizophrenia, such as neurodevelopmental conditions (conditions that affect children during the development of their nervous system), bipolar disorder psychosis, or depressive disorders.

Individuals with catatonia may flip between decreased and excessive motor activity.

With modern treatments, people with schizophrenia with catatonia can manage their symptoms more easily, making the likelihood of leading a happier and healthier life much greater.

The defining symptoms of catatonia are dominated by at least three of the following:

- Stupor: There is no psychomotor activity and no interaction with the environment.

- Catalepsy: The person may adopt unusual postures, such as a fixed one.

- Waxy flexibility: If the person’s arm is moved into a position, they will maintain this position until it is moved again.

- Mutism: This means having limited verbal responses.

- Negativism: The person may have little or no response to instructions or external stimuli.

- Posturing: This means the person actively holds a posture against gravity.

- Mannerism: The person carries out odd, exaggerated actions.

- Stereotypy: This means making repetitive movements without an apparent reason.

- Agitation: The person may have increased, restless movements for no known reason.

- Grimacing: The person expresses pain or disapproval in their face.

- Echolalia: This means mimicking another person’s speech.

- Echopraxia: This means mimicking another person’s movements.

Without proper treatment, an episode of catatonia can persist for days or weeks.

Causes and risk factors:

It is unclear what causes schizophrenia with catatonia.

Research indicates that brain dysfunction causes most forms of schizophrenia, but it is not known why that brain dysfunction occurs.

Most likely, a combination of genetics and environmental triggers, such as stress, causes this brain dysfunction.

Experts believe that an imbalance of dopamine, a neurotransmitter, is involved in the onset of schizophrenia.

They theorize this imbalance is most likely caused by genes that make someone susceptible to the condition.

Some researchers suggest the levels of other neurotransmitters, such as serotonin, might also be involved.

Other risk factors for schizophrenia with catatonia include:

- Genetics: Individuals with a family history of schizophrenia have a higher risk of developing it themselves.

- Viral infection: Some recent studies suggest that viral infections may predispose a child to the development of schizophrenia.

- Fetal malnutrition: If a fetus experiences malnutrition during pregnancy, there is a higher risk of developing schizophrenia.

- Stress: Severe stress early in life may contribute to the development of schizophrenia.

Stressful experiences often occur just before schizophrenia appears.

- Childhood abuse or trauma: Some researchTrusted Source suggests a link between childhood trauma or abuse and schizophrenia.

- Age of parents at birth: Older parents have a higher risk of having children who develop schizophrenia.

- Substance use: The use of substances that affect the mind during adolescence may increase the risk of developing schizophrenia

Diagnosis:

A doctor who suspects a person may have schizophrenia with catatonia will recommend a series of medical and psychological tests to help make a diagnosis"-- these tests might include:

Physical exam: The individual’s height, weight, heart rate, blood pressure, and temperature are checked as the doctor needs tonlisten to the heart and lungs and checks the abdomen.

MRI or CT scan: An MRI or CT scan is used to look for abnormalities in brain structure.
Electroencephalogram (EEG): An EEG can help check an individual’s brain function.

Psychological evaluation: A psychiatrist will ask the individual, if possible, about their thoughts, feelings, and behavior patterns.

They will discuss symptoms, when they started, how severe they are, and how they affect the person’s life.

They will also ask whether the individual has thoughts about harming themselves or others.

It can take a long time to accurately diagnose schizophrenia with catatonia.

Other conditions, such as mania, seizure disorders, substance use, and severe depression, share symptoms with schizophrenia with catatonia and must be ruled out first.

Treatment:

Schizophrenia is a condition that lasts throughout life, although catatonia symptoms may not persist. People with schizophrenia require lifelong treatment, even when symptoms seem to have disappeared and the person believes they are better. Treatment is essentially the same for all forms of schizophrenia.

Treatments vary depending on several factors, including the severity and types of primary symptoms during an episode, the individual’s health, and their age.

Medications:

Benzodiazepines: This class of drugs acts as tranquilizers and is most commonly used for schizophrenia with catatonia. The medication is fast-acting and may be administered intravenously (injected into a vein).

There is a risk of dependence if used for a long time sob the person may have to take this medication for several days or weeks.

Barbiturates: These medications are referred to as depressants or sedatives. They suppress the central nervous system.

Their effects range from mild sedation to full anesthesia -- Barbiturates rapidly relieve the symptoms of catatonia. If used for a long time, there is a risk of dependence.

This medication is used to treat schizophrenia with catatonia less often than barbiturates.

Antidepressants and mood-stabilizing drugs: People with schizophrenia with catatonia often have other mental health conditions, such as depression, that antidepressants can address.

Other treatments

Electroconvulsive therapy (ECT):

During this procedure, a healthcare professional sends an electric current through the brain to produce controlled seizures (convulsions).

ECT is used for catatonia that has not responded to medications or other treatments. Side effects can include short-term memory loss.

Hospitalization:

This may be necessary during severe episodes because in a hospital setting, individuals are safer and more likely to receive proper nutrition, sleep, hygiene, and treatment.

Psychotherapy:

For people with schizophrenia with catatonia, medications are the main part of treatment and whilst psychotherapy can be useful if symptoms are severe, it may not be appropriate.

Social and vocational skills training:

This may help the individual live independently, a vital part of recovery. The therapist can help them learn proper hygiene, how to prepare nutritious meals, and how to communicate better.

There may also be support in finding work, housing, and joining self-help groups.

Compliance (adherence):

Compliance or adherence means taking medication at the right times and in the right doses.

Lack of compliance can be an issue for people with schizophrenia because they can stop taking their medication for long periods, significantly interfering with their lives and the lives of their loved ones.

Complications:

Untreated schizophrenia with catatonia can cause problems of a health, financial, behavioral, and legal nature -- such problems may affect every part of the person’s life.

Complications can include:

- depression

- suicidal thoughts or behavior
malnutrition

- hygiene problems

- substance use

- inability to find or maintain employment

- prison

- serious family conflicts

- inability to study or attend school and other educational institutions

- being a victim or perpetrator of crime

- smoking-related diseases

Subscribe

Investigating Schizophrenia
Content created by Medical News Today and supported by advertising. Learn more
What is catatonic schizophrenia?
Medically reviewed by Andy Watkins-McCall, MD, MPH — Written by Yvette Brazier — Updated on November 13, 2024
Symptoms
Causes and risk factors
Diagnosis
Treatment
Complications
Outlook
Catatonia refers to a set of symptoms that might develop in some individuals with schizophrenia. It can include periods where the person moves very little and does not respond to instructions.

Periods of hyperactivity called catatonic excitement also occur. This is when the individual demonstrates motor activity that is considered “excessive” and “peculiar,” such as echolalia (mimicking sounds) or echopraxia (mimicking movements).

In this article, we look at the symptoms of schizophrenia with catatonia, its causes, diagnosis, and how it is treated.

Fast facts on schizophrenia with catatonia
Here are some key points about schizophrenia with catatonia. More details and supporting information are in the main article.

Catatonia only occurs in some individuals with schizophrenia.
Symptoms can involve alternating hyperactivity and underactivity.
Risk factors for schizophrenia with catatonia are the same as those for schizophrenia in general.
There are now a number of effective treatments for the symptoms of schizophrenia with catatonia.

Symptoms of schizophrenia with catatonia
Schizophrenia with catatonia is much rarer than it used to be thanks to improved treatments.

Catatonic states are now more likely to be found in types of mental health conditions other than schizophrenia, such as neurodevelopmental conditions (conditions that affect children during the development of their nervous system), bipolar disorder psychosis, or depressive disorders.

Individuals with catatonia may flip between decreased and excessive motor activity.

With modern treatments, people with schizophrenia with catatonia can manage their symptoms more easily, making the likelihood of leading a happier and healthier life much greater.

The defining symptoms of catatonia are dominated by at least three of the following:

Stupor: There is no psychomotor activity and no interaction with the environment.
Catalepsy: The person may adopt unusual postures, such as a fixed one.
Waxy flexibility: If the person’s arm is moved into a position, they will maintain this position until it is moved again.
Mutism: This means having limited verbal responses.
Negativism: The person may have little or no response to instructions or external stimuli.
Posturing: This means the person actively holds a posture against gravity.
Mannerism: The person carries out odd, exaggerated actions.
Stereotypy: This means making repetitive movements without an apparent reason.
Agitation: The person may have increased, restless movements for no known reason.
Grimacing: The person expresses pain or disapproval in their face.
Echolalia: This means mimicking another person’s speech.
Echopraxia: This means mimicking another person’s movements.
Without proper treatment, an episode of catatonia can persist for days or weeks.

Causes and risk factors
It is unclear what causes schizophrenia with catatonia. Research indicates that brain dysfunction causes most forms of schizophrenia, but it is not known why that brain dysfunction occurs. Most likely, a combination of genetics and environmental triggers, such as stress, causes this brain dysfunction.

Experts believe that an imbalance of dopamine, a neurotransmitter, is involved in the onset of schizophrenia. They theorize this imbalance is most likely caused by genes that make someone susceptible to the condition. Some researchers suggest the levels of other neurotransmitters, such as serotonin, might also be involved.

Other risk factors for schizophrenia with catatonia include:

Genetics: Individuals with a family history of schizophrenia have a higher risk of developing it themselves.
Viral infection: Some recent studies suggest that viral infections may predispose a child to the development of schizophrenia.
Fetal malnutrition: If a fetus experiences malnutrition during pregnancy, there is a higher risk of developing schizophrenia.
Stress: Severe stress early in life may contribute to the development of schizophrenia. Stressful experiences often occur just before schizophrenia appears.
Childhood abuse or trauma: Some researchTrusted Source suggests a link between childhood trauma or abuse and schizophrenia.
Age of parents at birth: Older parents have a higher risk of having children who develop schizophrenia.
Substance use: The use of substances that affect the mind during adolescence may increase the risk of developing schizophrenia.

Diagnosis
A doctor who suspects a person may have schizophrenia with catatonia will recommend a series of medical and psychological tests to help make a diagnosis. These tests might include:

Physical exam: The individual’s height, weight, heart rate, blood pressure, and temperature are checked. The doctor listens to the heart and lungs and checks the abdomen.
MRI or CT scan: An MRI or CT scan is used to look for abnormalities in brain structure.
Electroencephalogram (EEG): An EEG can help check an individual’s brain function.
Psychological evaluation: A psychiatrist will ask the individual, if possible, about their thoughts, feelings, and behavior patterns. They will discuss symptoms, when they started, how severe they are, and how they affect the person’s life. They will also ask whether the individual has thoughts about harming themselves or others.
It can take a long time to accurately diagnose schizophrenia with catatonia. Other conditions, such as mania, seizure disorders, substance use, and severe depression, share symptoms with schizophrenia with catatonia and must be ruled out first.

Treatment
Schizophrenia is a condition that lasts throughout life, although catatonia symptoms may not persist. People with schizophrenia require lifelong treatment, even when symptoms seem to have disappeared and the person believes they are better. Treatment is essentially the same for all forms of schizophrenia.

Treatments vary depending on several factors, including the severity and types of primary symptoms during an episode, the individual’s health, and their age.

Medication
Benzodiazepines: This class of drugs acts as tranquilizers and is most commonly used for schizophrenia with catatonia. The medication is fast-acting and may be administered intravenously (injected into a vein). There is a risk of dependence if used for a long time. The person may have to take this medication for several days or weeks.
Barbiturates: These medications are referred to as depressants or sedatives. They suppress the central nervous system. Their effects range from mild sedation to full anesthesia. Barbiturates rapidly relieve the symptoms of catatonia. If used for a long time, there is a risk of dependence. This medication is used to treat schizophrenia with catatonia less often than barbiturates.
Antidepressants and mood-stabilizing drugs: People with schizophrenia with catatonia often have other mental health conditions, such as depression, that antidepressants can address.
Other treatments
Electroconvulsive therapy (ECT)
During this procedure, a healthcare professional sends an electric current through the brain to produce controlled seizures (convulsions).

ECT is used for catatonia that has not responded to medications or other treatments. Side effects can include short-term memory loss.

Hospitalization
This may be necessary during severe episodes. In a hospital setting, individuals are safer and more likely to receive proper nutrition, sleep, hygiene, and treatment.

Psychotherapy
For people with schizophrenia with catatonia, medications are the main part of treatment. While psychotherapy can be useful, if symptoms are severe, it may not be appropriate.

Social and vocational skills training
This may help the individual live independently, a vital part of recovery. The therapist can help them learn proper hygiene, how to prepare nutritious meals, and how to communicate better. There may also be support in finding work, housing, and joining self-help groups.

Compliance (adherence)
Compliance or adherence means taking medication at the right times and in the right doses.

Lack of compliance can be an issue for people with schizophrenia. They can stop taking their medication for long periods, significantly interfering with their lives and the lives of their loved ones.

Complications
Untreated schizophrenia with catatonia can cause problems of a health, financial, behavioral, and legal nature. These problems may affect every part of the person’s life.

Complications can include:

depression
suicidal thoughts or behavior
malnutrition
hygiene problems
substance use
inability to find or maintain employment
prison
serious family conflicts
inability to study or attend school and other educational institutions
being a victim or perpetrator of crime
smoking-related diseases

Outlook:

Schizophrenia with catatonia is a serious condition as it often involves problems with motor activity, including repetitive movements, stupor, and rigidity.

It can affect a person’s ability to function in daily life and require specialized medical care.

Treatment typically includes medications, such as benzodiazepines and antidepressants, and, depending on the severity of symptoms, may also include electroconvulsive therapy (ECT) or psychotherapy.

While schizophrenia with catatonia presents significant challenges, early intervention and personalized individual treatment plans can help manage symptoms.
« Last Edit: January 19, 2025, 07:43:50 AM by Chip »
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