Catatonic schizophrenia is a subtype of schizophrenia that experts now consider obsolete. Experts no longer recognize it as a specific condition, and instead, attach catatonia as an additional feature when diagnosing schizophrenia. Catatonia is sometimes dangerous, but is usually very treatable with medication or other methods.
“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.
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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There are three main forms of catatonia: excited, withdrawn and mixed.
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.
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.
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.
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.
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.
Historically, 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.
While 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.
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.
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.
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.
The tests that can happen when your healthcare provider suspects schizophrenia include:
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:
The 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.
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.
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.
Schizophrenia is a condition that happens unpredictably. That means it’s impossible to prevent it or reduce your risk of developing it.
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.
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.
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.
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:
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).
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:
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.
If 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.
Last reviewed by a Cleveland Clinic medical professional on 07/18/2022.
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