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Catatonic schizophrenia: symptoms and treatment

Catatonic schizophrenia is a type of chronic mental disorder, where a person loses touch with reality. This psychiatric disorder is very severe and is usually a life-long mental illness that affects all areas of patients’ lives. However, this subtype of schizophrenia is especially rare. It is best recognized by severe disturbances in motor behavior. Patients with catatonic schizophrenia may show extreme immobility and stay in the same position for hours, days, weeks or longer. The patients usually appear to be unaware of surroundings. The psychiatrist Karl Ludwig Kahlbaum first described catatonic schizophrenia in 1874 as a disorder characterized by unusual motor symptoms.

Symptoms of catatonic schizophrenia

The symptoms of catatonic schizophrenia are closely related to disturbances in motor activity. Sometimes, extremely depressed persons show similar symptoms of their mental state. The symptoms usually include physical inability, accompanied with lack of movement and speech. The patient may remain in a rigid position and fall into the so called catatonic stupor - a condition in which it seems like being unaware of the environment. If an observer moves a hand or limb of the catatonic person's body, he or she may maintain the new position.

Another, quite opposite symptom of the same disease is excessive immobility. The patient may move in an excited manner that appears to have no purpose. Patients may, for example, turn in circles for hours or make extremely loud noises.

Patients may also have very inappropriate and unusual movements, or mimic other people’s speech or movement. They seem to repeatedly copy a word or gesture just expressed by someone else.

Other symptoms may be similar to the general symptoms of schizophrenia and include visual and auditory hallucinations, incoherent speech, neglect of personal hygiene, lack of emotions or emotions inappropriate to the situation, general trouble functioning, having delusions, angry outbursts, and social isolation.

Catatonic episodes are likely to last at least a day and may last for longer than 30 days without treatment.

Causes and treatment of catatonic schizophrenia

The exact cause of schizophrenia is still unknown. Scientists believe it is a brain disorder in which both genetics and environment play a significant role in development. During the past decade, research has discovered abnormalities in the structure or function of certain areas of the brain, including the limbic system, the frontal cortex and the basal ganglia. The dysfunction in one area may also cause problems in another area. Today scientists believe the limbic is a potential site of pathology in at least some, if not most schizophrenic patients.

The main treatments for catatonic schizophrenia are: medications, electro-convulsive therapy (ECT), hospitalization, psychotherapy and vocational skills training.

Medications, used together with electro-convulsive therapy are the basis of the treatment. Benozdiazepines or anti-anxiety medications are the most commonly used prescribed drugs. These are sedatives and may help if a patient has anxiety along with catatonic schizophrenia. Some patients will also receive antidepressants or anti-psychotic medications.

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