Serious Symptoms Of Catatonic Schizophrenia

October 10, 2023

Catatonic schizophrenia is one of the five schizophrenia subtypes. It tends to present with disturbances in movement, although other typical symptoms are present to a lesser extent. Unfortunately, it is not entirely clear as to what causes this condition. Evidence indicates that brain dysfunction is behind it, but experts do not know why this dysfunction occurs. Many believe that catatonic schizophrenia, and other types, is the result of environmental triggers, such as stress, and genetics. Some experts theorize that an imbalance of certain neurotransmitters, such as dopamine and serotonin, is involved as well.

Patients have a few options for catatonic schizophrenia treatment. Many individuals will take medication for schizophrenia, including benzodiazepines and antidepressants. Psychotherapy for schizophrenia is also common. Individuals may receive electroconvulsive therapy (ECT) for catatonic schizophrenia if they have not responded to other treatments. Of course, the best treatment for schizophrenia, starts with understanding the symptoms of catatonic schizophrenia. Learn about them now.

Cataplexy

Cataplexy is a movement abnormality that typically occurs in narcolepsy patients. It rarely occurs in those who do not have narcolepsy. However, there have been cases where narcolepsy presents alongside catatonic schizophrenia or vice-versa. The condition occurs when an individual experiences uncontrolled, sudden paralysis or muscle weakness. It occurs during the day and can often be triggered by strong emotions like laughter and excitement. There is typically very little warning before an individual loses their muscle tone. They may have total weakness throughout their body, buckled knees, broken speech, and a slack jaw.

When a patient experiences complete cataplexy, they are awake and aware of what is happening. However, they are unable to move. The episode will typically last one or two minutes, and some individuals fall asleep following them. The frequency of these episodes varies widely from case to case. Patients who have catatonic schizophrenia but not narcolepsy may never experience cataplexy. Some patients may avoid experiencing emotions that bring on cataplexy attacks. The lack of muscle tone occurs because an individual's sleep and wake cycles are not regulated, and the body suddenly believes it is asleep.

Mutism

Mutism is a condition that occurs when an individual is incapable of speech or unwilling to speak at least part of the time. This may occur in all circumstances, or they may be selectively mute, which means they only lose the ability to speak in certain situations. It can occur as part of various mental illnesses and neurological conditions. However, mutism is most commonly associated with catatonia. It can occur within catatonic schizophrenia, other forms of schizophrenia, bipolar disorder, and depression.

Before antipsychotic drugs, total mutism in non-catatonic schizophrenia was much more common than it currently is. Total mutism is rare in patients receiving advanced medical care. Mutism can sometimes be difficult to treat in catatonic schizophrenia patients. What makes treatment more difficult is the lack of patient input and communication. The ways mutism presents can be psychotic symptoms. In other cases, they can be adaptive behavioral strategies for individuals to deal with their environment.

Stupor

Stupor, one of the core signs of catatonic schizophrenia, occurs when a patient's reactions to their environment seriously decrease. They may stop reacting to spontaneous events or acknowledging someone speaking to them. They may not look up when a new person enters the room or a loud sound occurs. They may seem entirely detached from their surroundings. Individuals in a stupor may not move much independently at all. Rather than engaging in basic self-care tasks like eating, drinking, and using the bathroom, they may stay confined to one space and look in one direction.

When an individual is in a stupor, they will still respond to physical stimulation. Examples include having their chest rubbed or being prodded with a needle. This is a serious symptom whether it occurs in catatonic schizophrenia patients or not. Suppose it occurs in someone who does not have a history of schizophrenia or psychosis. In that case, it may be a sign of a potentially life-threatening condition that requires emergency medical treatment.

Delusions And Hallucinations

Catatonic schizophrenia tends to present with delusions and hallucinations. Although these are not the core symptoms, they are still necessary to make a definitive diagnosis of schizophrenia. There is a difference between a hallucination and a delusion. Both are forms of psychosis. This means they involve beliefs or experiences not grounded in reality. Hallucinations are experiences involving an individual's senses. They may see, hear, smell, or taste things that are not there.

One of the most common portrayals of schizophrenic hallucinations in media is hearing conversations or voices that have not occurred. Delusions are beliefs not grounded in reality. Even when an individual is presented with evidence that the delusion is not true, they may continue to believe it. In catatonic schizophrenia, the hallucinations and delusions accompany symptoms of catatonia and movement involvement. Experiencing psychosis is not always a sign of schizophrenia. However, when someone does have hallucinations or delusions, a doctor should evaluate them. This helps them see if the symptoms are being caused by an underlying physical or mental health condition.

Poor Emotional Expression

Schizophrenia can lead to poor emotional expression. This is especially true in catatonic schizophrenia, which presents with impaired motor functioning and overall movement. If an individual is excited, they may not express emotions appropriate to the situations around them. At the same time, if an individual is in a stupor or catatonic, they may not express emotions appropriately at all.

Schizophrenia can cause impairment in emotional functioning. It can be difficult to react to situations with the appropriate amount of feeling. Researchers are working on recognizing when emotional functioning is impaired and creating treatments to minimize the symptoms. Flat affect is the term for poor emotional expression. A patient exhibiting flat affect will have an unchanging and apathetic facial expression combined with very little change in their pitch, tone, or strength of voice as they speak.

Waxy Flexibility

Waxy flexibility is a significant symptom seen in catatonia and catatonic schizophrenia. It refers to individuals remaining in the same position for an extended period after someone places them there. For instance, a doctor can move a patient's arm and place it into a specific position. If the patient has waxy flexibility, including due to catatonic schizophrenia, they will often keep their arm in this position until the doctor moves it again. It is worth noting that waxy flexibility often means the patient will display slight resistance in the part of their body that the doctor or other person is trying to move.

Lack Of Motivation

Individuals with various forms of schizophrenia, including catatonic schizophrenia, will experience avolition as a symptom. Avolition, one of the negative symptoms of schizophrenia, is also referred to as a significant lack of motivation to do everyday tasks and activities. The activities that patients can lose their motivation to do even include cooking food and washing dishes. Essentially, an individual with catatonic schizophrenia who experiences a lack of motivation loses almost all of their drive. This means that the lack of motivation extends beyond a day or two of not feeling the desire to do much. For this to be a symptom of catatonic schizophrenia, this symptom must significantly impact an individual's life.

Stereotypy

Some individuals who have catatonic schizophrenia will deal with stereotypy as a symptom. This symptom refers to repetitive movements or postures that occur for no apparent reason. The movements that patients may perform include marching in place, crossing and uncrossing their legs, and rocking their body back and forth. Of course, this symptom alone is not enough for individuals to be diagnosed with catatonic schizophrenia, or another form of the disorder. This is, in part, because stereotypy is often seen in other conditions. Examples include autism spectrum disorder, intellectual disabilities, tardive dyskinesia, and some movement disorders.

Echolalia Or Echopraxia

Catatonic schizophrenia patients may experience echolalia or echopraxia as a symptom of their condition. These terms refer to mimicking another individual. Specifically, echolalia is the mimicking of another individual's speech. Echopraxia is mimicking their movements. However, it is important to note that this mimicking is not done as a way to make fun of the other individual. Patients will mimic and repeat others for seemingly no real reason or purpose. Some individuals with this form of schizophrenia will experience one of these two mimicking symptoms, or they may deal with both.

Posturing

Quite a few individuals with catatonic schizophrenia will deal with posturing as a symptom. Posturing refers to holding a specific posture that fights against gravity. Thus, the posture must not be a relaxed one where individuals do not need to think about holding it. In most cases, posturing in this condition is the active maintenance of the posture, meaning that individuals know they are doing it. It is also worth noting that posturing is one of the symptoms of catatonia. This means that it is not a classic symptom of schizophrenia that happens to also be present in catatonic schizophrenia.

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