Catatonic schizophrenia is one of several types of schizophrenia, a chronic mental illness in which a person loses touch with reality (psychosis). Catatonic schizophrenia includes episodes of behavior at extreme opposite ends of the spectrum. You may seem like you're in coma-like daze — unable to speak, move or respond — or you may talk and behave in a bizarre, hyperactive way. Catatonic episodes may last for a month or longer without treatment.
Catatonic schizophrenia is rare today because of improved schizophrenia treatment. In fact, being in a state of catatonia is more likely to occur with certain other health problems, including both physical and mental illnesses. With effective treatment, you can manage the symptoms of catatonic schizophrenia and work toward leading a happier, healthier life.
Signs and symptoms of catatonic schizophrenia fall into several categories of catatonic behaviors, including:
Although you may appear to be without emotion during a catatonic episode, you may actually feel extreme anxiety.
Other signs and symptoms of catatonic schizophrenia
Catatonic episodes are likely to last at least a day and may last for longer than 30 days without effective treatment.
When to see a doctor
If you're not ready to seek treatment, try to work up the courage to confide in someone, whether it's a friend or loved one, a health care professional, a faith leader or someone else you trust. He or she can help you take the first steps to successful treatment.
Helping someone who may have catatonic schizophrenia
If your loved one poses a danger to himself or herself or to someone else, you may need to call the police or other emergency responders for help. In some cases, emergency hospitalization may be needed. Laws on involuntary commitment for mental health treatment vary by state.
Catatonic schizophrenia and other forms of schizophrenia are brain disorders. Genetics and environment likely both play a role in causing catatonic schizophrenia.
Catatonia is much more commonly associated with other conditions. Some of the health problems that can lead to catatonia include other mood disorders, such as depression and bipolar disorder, and medical conditions that affect the central nervous system.
Doctors don't know why some people with schizophrenia develop catatonic symptoms, but one or more underlying problems with the brain are likely responsible. For example, problems with certain naturally occurring brain chemicals called neurotransmitters appear to play a role. Imaging studies show differences in the brain structure of people with schizophrenia, but the significance of these changes is unclear.
Although the precise cause of catatonic schizophrenia isn't known, certain factors seem to increase the risk of developing or triggering catatonic schizophrenia, including:
Signs and symptoms of schizophrenia typically develop between the teenage years and the mid-30s.
Left untreated, catatonic schizophrenia can result in severe emotional, behavioral, health, and even legal and financial problems that affect every area of your life. Complications that catatonic schizophrenia may cause or be associated with include:
Preparing for your appointment
In some cases, a health care provider, family member, friend or another acquaintance may ask about your behavior, thoughts and mood or suggest that you be evaluated by a mental health provider. Or you may decide on your own to schedule an appointment with your family doctor or mental health provider to talk about your concerns. In some cases, you may be taken to a hospital for an emergency psychiatric evaluation.
What you can do
In addition to your prepared questions, don't hesitate to ask questions during your appointment if you don't understand something.
What to expect from your doctor
Tests and diagnosis
If your doctor or mental health provider believes you may have catatonic schizophrenia or another mental illness, he or she typically runs a series of medical and psychological tests and exams. These can help pinpoint a diagnosis, rule out other problems that could be causing your symptoms and check for any related complications.
These exams and tests generally include:
Diagnostic criteria for catatonic schizophrenia
Diagnostic criteria for catatonic schizophrenia include:
It can sometimes be difficult to diagnose catatonic schizophrenia because catatonic behavior is often a symptom of other conditions, including severe depression, mania, drug intoxication, autism and seizure disorders. Be sure to stick with it until you get an accurate diagnosis, though, so that you can get appropriate treatment.
Treatments and drugs
Catatonic schizophrenia is a chronic condition that requires lifelong treatment, even during periods when you feel better and your symptoms have lifted. You may feel as if you don't need treatment, and you may be tempted to ignore treatment recommendations. But effective treatment can help you take control of your condition and enjoy a happier and healthier life.
Treatment options are similar for all types of schizophrenia. But the specific treatment approach that's best for you depends on your particular situation and the severity of your symptoms.
The team involved in treatment of catatonic schizophrenia may include your:
Main treatment options
Medications for catatonic schizophrenia
Choosing a medication
If one medication doesn't work well for you or has intolerable side effects, your doctor may recommend combining medications, switching to a different medication or adjusting your dosage. Don't stop taking your medication without talking to your doctor, even if you're feeling better. You may have a relapse of psychotic symptoms if you stop taking your medication. In addition, some medications need to be tapered off, rather than stopped abruptly, to avoid withdrawal symptoms.
Electroconvulsive therapy (ECT) for catatonic schizophrenia
Together with benzodiazepine medications, ECT is the primary treatment for catatonic schizophrenia. Your doctor may recommend ECT after you finish a course of benzodiazepines, or you may be treated with both together.
Hospitalization for catatonic schizophrenia
Psychotherapy for catatonic schizophrenia
Social and vocational skills training for catatonic schizophrenia
Treatment challenges in catatonic schizophrenia
For one thing, you, like many others with schizophrenia, may find it hard to follow your treatment plan. You may believe that you don't need medications or other treatment. Also, if you're not thinking clearly, you may forget to take your medications or to go to therapy appointments. Talk to your doctors about tips to stick to your treatment plan, such as taking an antipsychotic medication that's available in a long-lasting injectable form. Even with good treatment, you may have a relapse. Have a plan in place to deal with a relapse.
Smoking, often heavy smoking, is common when you have schizophrenia. If you smoke, you may need a higher dose of antipsychotic medication because nicotine interferes with these medications. Be honest with your doctors about your smoking habits. And be sure you understand the serious health risks of smoking.
Using alcohol and drugs can make catatonic schizophrenia symptoms worse. If you have a problem with alcohol or substance abuse, you may benefit from treatment programs that include care for both schizophrenia and substance abuse.
Lifestyle and home remedies
Catatonic schizophrenia isn't an illness that you can treat on your own. But you can do some things for yourself that will build on your treatment plan:
Coping and support
Coping with catatonic schizophrenia can be challenging. Medications can have unwanted side effects, and you may feel angry or resentful about having a condition that requires lifelong treatment. During periods when you feel better, you may be tempted to stop treatment, which can trigger a relapse. Here are some ways to cope with catatonic schizophrenia:
There's no sure way to prevent catatonic schizophrenia. Some signs of schizophrenia may be present from early childhood or even infancy. Early identification and treatment for people at risk of schizophrenia, perhaps starting in childhood, may help get symptoms under control before serious complications develop and may help improve the long-term outlook. Also, sticking with your treatment plan can help prevent relapses or worsening of catatonic schizophrenia symptoms.
Last Updated: 2010-12-17
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