Catatonic schizophrenia: Symptoms, Diagnosis, and Treatment

Catatonic schizophrenia is a sub-type of schizophrenia. This type of schizophrenia is characterized by having a medium prognosis (between good and bad), placing it between the paranoid (good prognosis) and the disorganized (bad prognosis).

It is a disorder that is currently rare in developed countries. The person with catatonic schizophrenia usually has ambivalent and motor-focused symptoms.

Generally, the subject automatically obeys orders (or just the opposite can happen, showing extreme negativity and not obeying anyone’s orders or instructions). The individual also tends to act with great perseverance. On the other hand, catatonic schizophrenia usually also includes hallucinatory and delusional symptoms.

We are going to see in detail the characteristic symptoms of this sub-type of schizophrenia.

 

Symptoms:

1. Motor immobility:

Also called stupor, motor immobility makes the patient with catatonic schizophrenia unable to execute any type of movement. You can get “stuck” without moving or saying anything.

2. Excessive motor activity:

However, the opposite symptom to the previous one may occur, and that the patient presents excessive motor activity, showing himself unable to stay still, moving continuously, and with some agitation.

3. Extreme negativism:

Extreme negativism translates into a resistance, on the part of the subject, to follow any order that he receives from another person. This resistance is unmotivated. It may also include maintaining a rigid posture against attempts to move by others, as well as silence.

4. Peculiar voluntary movements:

The patient with catatonic schizophrenia may present peculiar movements voluntarily, such as mannerisms (or mannerisms), consisting of gestures “unique” to the individual, exaggerated (as if the person were acting), and which are usually repetitive and short. These gestures accompany normal activity and are simpler than stereotypes. They typically appear in schizophrenia.

5. Echolalia:

Echolalia consists of the repetition of the last thing the interlocutor has said (the last word, phrase…). These, in turn, can be immediate (occur instantly) or delayed (occur hours, days, or weeks after the individual has heard them).

Echolalia, in addition to being typical in catatonic schizophrenia, also appears very frequently in children with an autism spectrum disorder (ASD).

 

Diagnosis

There is no definitive diagnostic test for Catatonic schizophrenia. The psychiatrist makes the diagnosis based on an evaluation of the person’s history and symptoms.

To establish the diagnosis of schizophrenia, symptoms must last for at least six months and be associated with a significant deterioration in work, education, or social development. Information from family, friends, or teachers is important to establish when the illness started.

The physician must rule out the possibility that the patient’s psychotic symptoms are caused by an effective disorder. Laboratory tests are often performed to rule out substance abuse or an underlying endocrine or neurological disorder that may have some features of psychosis.

Examples of these types of disorders are brain tumors, temporal lobe epilepsy, autoimmune diseases, Huntington’s disease, liver diseases, and adverse drug reactions.

 

Treatment of Catatonic Schizophrenia

Treatment of catatonic schizophrenia should be directed towards the treatments used for the schizophrenia itself. Mainly, psycho-social treatment is chosen, which seeks the reintegration or insertion of the individual in society, through sheltered employment procedures, for example, and among others.

On the other hand, the psychological therapies used (which ideally will also include families), focus on social skills training (EHS), psycho-educational intervention (at the family level), cognitive rehabilitation, and belief modification therapies (focused on treating delusions and hallucinations).

Also, in psychological therapy, it is sought to enhance the patient’s coping strategies, as well as to promote their self-esteem, self-concept, and autonomy.

In the case of catatonic schizophrenia, also, drug treatment (which must always be regulated, regardless of the schizophrenia sub-type in question). It will be aimed at alleviating or softening the typical motor symptoms of this schizophrenia sub-type. That is why treatment adherence should always be worked on, through psycho-educational techniques and positive reinforcement, for example.