What is Catatonic Schizophrenia: Symptoms, Causes & Treatment

Catatonic schizophrenia is a highly disruptive mental health concern that can have a profound negative impact on the substance and quality of a person’s life. But when someone with this disorder gets effective treatment, they can gain greater control of their thoughts and behaviors, and make sustained progress toward a more satisfying future.

Contact us today to learn more about outpatient programming in Tennessee. 

What Is Catatonic Schizophrenia?

As its name suggests, catatonic schizophrenia is a form of mental illness that includes the symptoms of two conditions:

• Schizophrenia is a complex mental health condition that can prevent a person from accurately perceiving their environment, organizing and communicating their thoughts, and adhering to societal behavior norms.
• Catatonia is a neuropsychiatric concern that can accompany several mental health disorders, including schizophrenia, schizoaffective disorder, major depressive disorder (MDD), bipolar disorder, and autism spectrum disorder (ASD).

The clinical term for someone who meets the criteria for both of these conditions is schizophrenia with catatonia specifier. It is commonly referred to as catatonic schizophrenia.

Schizophrenia symptoms

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identifies five types of schizophrenia symptoms. To be accurately diagnosed with this condition, a person must have at least two of the five (one of which must be delusions, hallucinations, or disorganized speech): 

1. Delusions – These are fixed beliefs that a person will hold onto even if they have no basis in reality or can be easily dispelled with evidence. Examples of delusions that can affect people with schizophrenia include believing they are in a relationship with a famous person that they’ve never met, that they are being sent coded messages via mass media, or that they have some form of incredible talent or magical power.
2. Hallucinations – Hallucinations involve perceptions of stimuli that don’t actually exist. The two most common types of hallucinations among people with schizophrenia are auditory (hearing voices or other sounds) and visual (seeing light patterns, people, or objects). 
3. Disorganized speech – This symptom is characterized by a person’s inability to organize and express their thoughts in a logical, understandable manner. It can manifest in many ways, including derailment (responding to a question by randomly jumping from one unrelated topic to the next), clanging (using words because of their sound or rhyme instead of their meaning), and incoherence (speaking in a way is incomprehensible to others).
4. Grossly disorganized or catatonic behavior – We will focus on this symptom in greater detail a bit later in today’s post. But, generally speaking, it can involve bizarre behaviors, decreased reactivity, stereotyped movements, and minimal verbal responsiveness.
5. Negative symptoms – Examples of negative symptoms include an absence of facial expressiveness, inability to maintain eye contact, speaking in a flat or monotone voice, difficulty experiencing joy or pleasure, and an apparent lack of interest in working or socializing.

Symptoms of Catatonic Schizophrenia

In addition to meeting the criteria established in the previous section, a person must also exhibit at least three of the following symptoms to be diagnosed with catatonic schizophrenia:

1. Stupor – Lack of movement or active interactions with their environment.
2. Catalepsy – Rigidly holding their body in odd positions.
3. Waxy flexibility – Similar to catalepsy, but the individual’s body can be moved into other positions by other people.
4. Mutism – Minimal or nonexistent use of speech.
5. Negativism – Either actively refusing to follow instructions or respond to stimuli, or simply offering no response whatsoever.
6. Posturing – Maintaining an odd posture against gravity (which rules out sitting or lying down). The main difference between posturing and catalepsy is that posturing involves an active choice by the individual, while catalepsy represents passive acceptance of a posture due to external influences.
7. Mannerism – The DSM-5 describes mannerisms as “odd, circumstantial caricature[s] of normal action.” Examples of this symptom include walking with a highly exaggerated gait or speaking with over-the-top formality or politeness. 
8. Stereotypy – Repetitive motions such as flapping their hands or arms, rocking back and forth, or spinning items. In people with autism spectrum disorder (ASD), stereotypies are often described as a type of stress response called “stimming.”
9. Agitation – The sudden onset of impulsive, restless movements that have no apparent external trigger.
10. Grimacing – Maintaining odd or inappropriate facial expressions such as sneering, clenching teeth, or smirking. As with agitation, grimacing is not a response to stress or other external stimuli.
11. Echolalia – This most commonly involves the repetition of words or phrases spoken by another person, but it can also include the mimicking of environmental sounds.
12. Echopraxia – Imitating another person’s gestures or movements.

What Causes Catatonic Schizophrenia?

A person’s risk of developing catatonic schizophrenia can be influenced by several factors, including:

• Certain genetic variations
• Complicated pregnancy and birth
• Vitamin D deficiency in infancy
• Advanced paternal age
• Infection with human endogenous retroviruses (HERVs)
• Brain chemical imbalance
• Prior struggles with other mental illnesses
• Abuse or neglect during childhood

How Is Catatonic Schizophrenia Treated?

Most patients with catatonic schizophrenia benefit from a combination of prescription medication, therapy, and ongoing support. 

Levels of care

Depending on the scope and severity of their symptoms, a person with catatonic schizophrenia may benefit from receiving care at one or more of the following levels:

• Inpatient treatment
• Residential care
• Partial hospitalization program (PHP)
• Intensive outpatient program (IOP)
• Outpatient therapy or counseling

Medication

The medication component of treatment for catatonic schizophrenia may include:

• Benzodiazepines (benzos)
• First-generation (typical) antipsychotics
• Second-generation (atypical) antipsychotics
• Mood stabilizers
• Other meds to address co-occurring conditions

Therapy

Patients with catatonic schizophrenia may benefit from an array of therapies and support services, including:

• Individual psychotherapy
• Group therapy sessions
• Family therapy and education
• Cognitive-behavioral therapy (CBT)
• Life skills education
• Nutritional counseling
• Meditation, yoga, and other holistic therapies
• Art and music therapy

Find Treatment for Catatonic Schizophrenia in Tennessee

Time Wellness Tennessee offers a full continuum of customized services for adults who have catatonic schizophrenia, other mental health concerns, and co-occurring addictions.

Treatment options at our center in Chattanooga, TN, include a residential inpatient program, partial hospitalization program (PHP), intensive outpatient program (IOP), outpatient program (OP), and virtual (online) rehab. In each environment, you can expect to receive close personal attention and comprehensive support from a team of skilled and compassionate professionals.

To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Admissions page or call us today.