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OverviewWhat is catatonic schizophrenia?“Catatonic schizophrenia” is a subtype of schizophrenia that includes catatonia as a key feature. Experts no longer recognize it as a diagnosis, making this name obsolete. Today, experts recognize schizophrenia as a specific disease and a spectrum of disorders. Healthcare providers regard catatonia as an important syndrome to consider and treat, especially when it happens with schizophrenia. The American Psychiatric Association removed catatonic schizophrenia from its list of official diagnoses when updating to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013. The World Health Organization (WHO) removed “catatonic schizophrenia” from the International Classification of Diseases when updating to the 11th edition (ICD-11) in 2019. What is catatonia?Catatonia is a syndrome — a collection of signs and symptoms — where your brain doesn’t manage muscle movement signals as it should and you behave abnormally. It happens with many other conditions, but schizophrenia is frequently associated with catatonia. Once thought to be the only condition associated with catatonia, it’s now known that bipolar disorder is more commonly associated with catatonia and that catatonia occurs alongside a number of medical and mental health conditions. There are three main forms of catatonia: excited, withdrawn and mixed.
What is the difference between catatonic schizophrenia and paranoid schizophrenia?Like “catatonic schizophrenia,” “paranoid schizophrenia” is an obsolete term for a diagnosis that no longer exists. Paranoid schizophrenia was the name for schizophrenia where experts regarded paranoia, delusions and hallucinations as key symptoms. Catatonic schizophrenia is the term for schizophrenia where catatonia is the most dominant feature. Who does it affect?Schizophrenia tends to happen earlier, between ages 15 and 25, for men and people assigned male at birth. It usually happens between ages 25 and 35 for women and people assigned female at birth. It happens at the same rates regardless of sex. Children can develop schizophrenia in rare cases, and their cases are usually more severe than those that appear in adults. In contrast to adults, catatonia in childhood is most commonly associated with schizophrenia. How common is this condition?Schizophrenia is a widely known condition, but it isn’t very common. About 85 people out of every 10,000 will develop it during their lifetime. Worldwide, healthcare providers diagnose about 2.77 million people per year with this condition. Catatonia happens in a small — but still noteworthy — percentage of people with schizophrenia. Researchers estimate it happens in between 10% and 25% of people with schizophrenia. How does this condition affect my body?Schizophrenia is a condition that disrupts how your brain works, especially the processes related to your thinking and focusing ability, memories, key senses and more. Schizophrenia that involves catatonia often stands out because it involves extremely high levels of movement or no movement at all, though most people have more subtle presentations in between these extremes. Symptoms and CausesWhat are the symptoms?Schizophrenia typically happens in three stages and has five key symptoms. The active stage of schizophrenia is when symptoms are at their worst. The key symptoms of schizophrenia can happen regardless of whether or not catatonia is also present. Those five symptoms are:
See our main Schizophrenia article for more about these symptoms and the stages during which they happen. Symptoms of catatoniaHistorically, experts have recognized up to 40 different symptoms that can happen with catatonia. The DSM-5 narrows that list to 12 symptoms.
While people who show signs of catatonia may not react to what’s happening around them, many of them are aware of what’s happening. Research shows that people who had catatonia symptoms often remember what happened to and around them, even though they showed little or no reaction to their surroundings. Shifts in activity levelWhile schizophrenia happens in phases, the involvement of catatonia often changes how the condition progresses. Most cases of schizophrenia with catatonia develop and get worse quickly. Catatonia can also involve different levels of activity. Some people with catatonia will stay nonresponsive to the world around them for a time, but then, will shift to a much higher level of activity. In some cases, these shifts in activity level include behavior that’s impulsive or even dangerous to the person themselves or to those around them. What causes the condition?Experts haven’t yet uncovered a confirmed cause of schizophrenia, but they suspect there are many factors that can play a role or contribute.
Experts believe there are several risk factors that can increase the chances that you’ll develop schizophrenia. Some examples of these include mutations you inherit from one or both parents, exposure to certain chemicals or substances, stress or complications that happened as you developed in your mother’s uterus and recreational drug use. None of these are confirmed causes, however. Is it contagious?Schizophrenia isn’t contagious and it doesn’t spread from person to person. Catatonia also isn’t contagious, but infectious diseases can sometimes cause it. Diagnosis and TestsHow is it diagnosed?Your healthcare provider diagnoses schizophrenia using a combination of methods and approaches. These include a physical examination, neurological examination, lab tests, imaging scans and more. There’s no one lab test, diagnostic test or imaging scan that can diagnose any form of schizophrenia. However, tests and imaging scans can still help your provider rule out other dangerous or life-threatening conditions. A diagnosis of schizophrenia requires that a person show at least two of that condition’s main symptoms. In addition, a person must also have at least three of the 12 catatonia signs for their provider to diagnose that as part of their schizophrenia. What tests will be done to diagnose this condition?The tests that can happen when your healthcare provider suspects schizophrenia include:
Management and TreatmentHow is it treated, and is there a cure?Schizophrenia is usually treatable, though not curable. Medications are usually the main form of treatment for schizophrenia. However, when this condition also involves catatonia, different treatments are required. There are two main ways to treat schizophrenia that’s currently causing catatonia:
Complications/side effects of the treatmentThe complications and side effects that are possible with treatments for schizophrenia depend on several factors, including the medications you take, any other health conditions you might have and more. Your healthcare provider is the best person to tell you what side effects are possible or likely because they can consider your specific case and tailor the information to your needs. How do I take care of myself or manage the symptoms?You should never try to diagnose schizophrenia in yourself or a loved one because it takes training and experience to diagnose it accurately. This condition also involves symptoms that can happen with other conditions or substance use. Lastly, the medications necessary to treat schizophrenia require a prescription from your healthcare provider. Because of all these factors, your healthcare provider should be the one to diagnose this condition and recommend treatments. How soon after treatment will I feel better?Your healthcare provider is the best source of information on when you should start to feel better and notice the effects of treatment. They can consider your specific case and all its details, providing you with information that’s the most accurate for your situation. PreventionHow can I reduce my risk or prevent this condition?Schizophrenia is a condition that happens unpredictably. That means it’s impossible to prevent it or reduce your risk of developing it. Outlook / PrognosisWhat can I expect if I have this condition?Schizophrenia is a condition that’s well-known partly because of how it disrupts a person’s ability to think and understand the world around them. Because it’s a condition that causes psychosis, which means a disconnection from reality, people who have this condition struggle to tell what’s real and what isn’t. They also may not recognize that they have a condition because their brain can’t process that fact. People who have catatonic schizophrenia may not respond to what’s happening around them, but they might be aware of it all the same. They may also cycle between not responding and periods of high activity, where they could act violently and pose a threat to themselves or others. When schizophrenia goes untreated, this condition can cause severe disruptions in a person’s life. They may struggle to hold a job, maintain friendships and relationships and more. Many try — consciously or unconsciously — to self-medicate, which can lead to alcohol and substance use disorders. With treatment, schizophrenia is often manageable. Many people who receive treatment find ways to manage their condition and follow the treatment plan can live happy, fulfilling lives. How long does schizophrenia last?Schizophrenia is a permanent condition. Some cases can go into remission, which means a person’s symptoms go away and don’t return. However, because the symptoms can return unpredictably, experts still consider this a lifelong condition. What’s the outlook for this condition?Schizophrenia with catatonia isn’t usually fatal on its own. However, it’s associated with increased risk of death from conditions that happen from not moving much, such as pulmonary embolism and pneumonia. There’s also one type of catatonia, malignant catatonia, that can be severe and even deadly. Malignant catatonia is dangerous because it can cause a very high fever and disrupt a person’s autonomic nervous system, which runs body systems without you thinking about them (such as breathing, blood pressure, etc.). Because malignant catatonia is potentially dangerous, ECT is usually a first-line treatment instead of medication. In general, schizophrenia with catatonia is a condition that responds well to treatment. The outcomes are usually fair to good, especially with faster diagnosis and treatment. However, catatonic schizophrenia is often more difficult to treat than catatonia occurring alongside other mental health conditions. Living WithHow do I take care of myself?It’s possible to manage schizophrenia and take care of yourself, even if you have a history of catatonia symptoms. Some steps you can take include:
When should I see my healthcare provider or seek care?Your healthcare provider will schedule appointments for you regularly, and it’s important for you to go to them. You should also see them if you notice a change in your symptoms or the effectiveness of your medication(s). When should I go to the ER?People who have schizophrenia symptoms now or who’ve had it in the past have an increased risk of self-harm and suicide. You should go to the ER or call 911 (or your local emergency services number) if you have thoughts about harming yourself, including thoughts of suicide, or about harming others. If you have thoughts like this, you can call any of the following:
Frequently Asked QuestionsWhat can I do if a loved one shows signs of schizophrenia or a similar condition?Because people with schizophrenia frequently can’t recognize their symptoms or condition, they often don’t believe they need medical care or treatment. That can be frustrating or frightening for both the person with the symptoms and those who care about them. Schizophrenia with catatonia can also cause you to feel worried or frightened if you have it, or if you have a loved one who has it. If you notice a loved one showing signs of schizophrenia, especially with symptoms like catatonia, it’s important to seek medical treatment for them. That’s because people with catatonia and schizophrenia may develop malignant catatonia, and are prone to agitation or dangerous behavior and other complications in some cases. How to help a loved one who has schizophreniaIf you notice a loved one showing signs of schizophrenia or a related condition, you can try to help them by doing the following:
A note from Cleveland Clinic “Catatonic schizophrenia” is an obsolete term for a subtype of schizophrenia. While experts don’t use this diagnosis any longer, catatonia is still a feature that happens commonly with schizophrenia. It’s also a symptom that stands out because it affects a person’s movements, behavior and ability to communicate. In some cases, catatonia can also turn into a deadly issue, so people with catatonia should receive medical care as quickly as possible. Fortunately, there are ways to treat catatonia and schizophrenia, and people who have schizophrenia can often manage their condition and live fulfilling, enjoyable lives. Who among the following is most likely to be diagnosed with generalized anxiety?Women are twice as likely to be affected. The disorder comes on gradually and can begin across the life cycle, though the risk is highest between childhood and middle age.
What is an extreme motor symptom of schizophrenia that involves being completely immobile?catatonic schizophrenia, rare severe mental disorder characterized by striking motor behaviour, typically involving either significant reductions in voluntary movement or hyperactivity and agitation. In some cases, the patient may remain in a state of almost complete immobility, often assuming statuesque positions.
Which of the following is an essential feature that characterizes borderline personality disorder BPD )?Patients with BPD are characterized by great emotional reactivity, high degrees of impulsivity, recurring self-destructive behaviors, inappropriate levels of anger, intense and unstable relationships with others, and a sense of emptiness and confusion about their own identities.
Which of the following way's might hallucinations be experienced in schizophrenia?[2] The most common hallucinations in schizophrenia are auditory, followed by visual. Tactile, olfactory and gustatory are reported less frequently [Table 1]. [3] Visual hallucinations in schizophrenia have a predominance of denatured people, parts of bodies, unidentifiable things and superimposed things.
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