Catatonic schizophrenia is one of the different forms of schizophrenia. This leads to psychomotor disorders.
What is catatonic schizophrenia?
It is not uncommon for other typical symptoms of schizophrenia to occur. These can include disturbances in thinking, hearing voices, and anxiety. See AbbreviationFinder for abbreviations related to Catatonic Schizophrenia.
Catatonic schizophrenia is a rare type of schizophrenia. In this variant, those affected suffer from psychomotor disorders. Typical manifestations are disorders of posture and movements. But there are also other symptoms of schizophrenia.
The first description of catatonic schizophrenia was in 1874 by the German psychiatrist Karl Ludwig Kahlbaum (1828-1899). In later years, the neurologist Karl Leonhard (1904-1988) carried out more detailed studies of the disease. Nowadays, catatonic schizophrenia is only found in rare cases.
Causes
As with schizophrenia in general, the causes of the catatonic form are still unclear. Doctors suspect that genetic, psychodynamic and environmental influences play a role in their onset and influence each other. The mental illness develops from a paranoid course.
Like all other forms of schizophrenia, catatonic schizophrenia is viewed by the Wernicke-Kleist-Leonhard psychopathological school as a heterogeneous group of diseases. Karl Leonhard represented the view of genetic triggers for the sub-form of periodic catatonia, which progresses in phases. As a rule, schizophrenic disorders only become apparent after puberty. In about two percent of all those affected, however, they already appear in childhood.
Symptoms, Ailments & Signs
A typical feature of catatonic schizophrenia is motor disorders. These are noticeable by movements of the arms, hands and legs that seem strange. Stereotypical movement patterns or strange postures are also possible, which can last for hours. Patients enter a completely rigid state accompanied by hallucinations or delusions. Most patients can no longer be addressed in this condition. Sometimes the state of rigidity changes abruptly into a violent state of excitement. In the worst case, the sufferers even carry out physical attacks on other people.
It is not uncommon for other typical symptoms of schizophrenia to occur. These can include disturbances in thinking, hearing voices, and anxiety. There are a number of other possible side effects of catatonic schizophrenia such as automatic command, persistence, negativism, muteness (mutism), catalepsy, echolalia, proskinesia, ambivalence and mannerisms. In particular, negativism and automatic command are considered typical of catatonic schizophrenia.
While in the case of command automatism the patient carries out every instruction that is demanded of him without resistance, exactly the opposite is the case with negativism. If the state of rigidity (stupor) occurs together with fever, the catatonia is malignant, pernicious or febrile. In earlier times, this form of the disease was often fatal.
However, thanks to modern treatments and medicines, very few deaths from them occur today. Since the patient’s body temperature increases in most cases during catatonic schizophrenia, clinical measurement is essential. The same applies to the CK value. An increase in both parameters is to be feared, which must be treated.
Diagnosis & course of disease
Catatonic schizophrenia is diagnosed based on the typical symptoms. The patient must suffer from catatonia (slackening), catalepsy (remaining in a rigid posture) and flexibilitis cerea (waxy flexibility). Basically, if you suspect schizophrenia, you should consult a specialist or a specialist clinic. Some therapy centers specialize in the early detection and treatment of catatonic schizophrenia.
The doctor makes the diagnosis after extensive discussions with the patient, following strictly defined criteria. Special questionnaires are also used in Germany. Bizarre postures, hallucinations, or delusions must be present for at least a month to confirm the diagnosis.
The differential diagnosis also plays an important role. The doctor excludes other causes that could be responsible for the occurrence of the symptoms. These include neurological disorders, brain tumors and drug or drug abuse. For this reason, various neurological and physical examinations are generally carried out when catatonic schizophrenia is suspected.
The course of catatonic schizophrenia can vary greatly from person to person. For this reason, it is not possible to create a general forecast. However, for most sufferers, the symptoms lessen over time. In principle, all forms of schizophrenia require lifelong therapy.
Complications
This type of schizophrenia mainly leads to motor and psychological disorders in the patient. These have a very negative effect on the life and everyday life of those affected and can significantly reduce their quality of life. Those affected suffer primarily from severe thought disorders and perception disorders. Hallucinations are also not uncommon.
Patients also have strong negative attitudes towards various things and people. A strong fever occurs, which is accompanied by a state of rigidity. In the worst case, the patient may die. It can also lead to slight aggression or irritability on the part of the patient.
In many cases, treatment in a closed clinic is therefore necessary if the patient poses a danger to himself or to other people. The person concerned may also depend on the help of other people in everyday life. In many cases, taking medication leads to side effects such as tiredness or exhaustion. Not every treatment leads to a positive course of the disease.
When should you go to the doctor?
Catatonic schizophrenia is a serious medical condition that requires 24-hour care and treatment by medically trained professionals. If people suffer from delusions and hallucinations, they need a doctor. If catalepsy or catatonia occurs, a doctor must be alerted as soon as possible. Muscle stiffness throughout the body is a red flag that should be acted upon immediately. Disorders and abnormalities in behavior and personality must be assessed by a specialist. In catatonic schizophrenia, the person affected is unable to go about their daily activities independently.
Sudden attacks on other people, fisticuffs and an uncontrolled appearance must be presented to a doctor. If instructions are generally reacted to in the opposite way, there is a pathological distrust that needs to be investigated. If you are paranoid or have a strong attitude of denial towards everyone, see a doctor. If echolalia or mannerisms occur, a doctor’s visit must be made. The patient is to be accommodated in the psychiatric ward so that he can be adequately cared for and does not pose a danger to himself or other people. Since there is often a lack of insight into the illness, in severe cases a medical officer is required to assess the state of health of the person concerned and take further measures.
Treatment & Therapy
To treat catatonic schizophrenia effectively, the patient is usually given medications such as benzodiazepines. With these means such as lorazepram, a breakthrough in catalepsy can often be achieved. The typical states of anxiety can also be alleviated by the preparations. As with the other types of schizophrenia, neuroleptics are also used in catatonic schizophrenia.
The gift of mood stabilizers is also considered useful. These include primarily lithium, olanzapine, carbamazepine, valproic acid and lamotrigine. If treatment with benzodiazepines does not lead to the desired success, therapy with amantadine, which is one of the NMDA receptors, and dopamine agonists is an alternative.
In some cases, special electroconvulsive therapy (ECT) is used to treat catatonia. It has the advantage of being effective and fast acting. It is carried out when benzodiazepine therapy is unsuccessful. If the state of rigidity lasts for a long time, physiotherapy can be useful under certain circumstances.
Outlook & Forecast
Catatonic schizophrenia has an unfavorable prognosis. It is a psychosomatic illness associated with numerous serious symptoms. Without optimal and sufficient medical care, there is a risk of self-harm and the possibility of endangering the lives of others.
Patients experience violent states of excitement. In these there are often assaults and attacks on other people. Treatment is therefore absolutely necessary and, thanks to modern possibilities, is increasingly leading to improved results. The cure of catatonic schizophrenia is still less the goal of therapy. The focus of psychotherapeutic and drug treatment is on alleviating existing symptoms and reducing aggressive behavioral tendencies. At the same time, fears and delusions should be reduced. These often lead to situations in which the environment and those affected are overwhelmed. The overall quality of life should be improved through the interaction of different therapeutic approaches, so that dealing with other people is possible.
A stable social environment is essential to improve prognosis. Despite all the problems, relatives should be aware of this. A clinical stay with the patient is nevertheless necessary. Coping with everyday life cannot take place without daily care. In addition, there is an increased risk of suffering sequelae with this disease. These can be physical or psychological.
Prevention
Since the causes of catatonic schizophrenia are largely unknown and genetic triggers are suspected, no effective preventive measures can be taken against the mental illness.
Aftercare
Catatonic schizophrenia is treated as a psychosomatic illness with the help of a team of doctors. This therapy often lasts for a long time and thus also includes aftercare and prevention. Medical and psychotherapeutic care can reduce the subsequent symptoms.
Nevertheless, the sick people can suffer from strong states of excitement. In doing so, they endanger themselves and their environment. For this reason, comprehensive treatment is necessary, which leads to good results through the use of modern measures. A cure is hardly possible, but the aggressive behavior can be combated.
At the same time, illness-related fears and associated delusions are reduced. The families of those affected receive noticeable relief through a suitable therapeutic approach. In a stable environment, patients feel relatively safe, which clearly supports the positive prognosis.
Nevertheless, daily care during a clinical stay is recommended. This reduces the risk of side effects that are of a psychological nature or can manifest themselves in physical symptoms. Relatives should therefore work closely with therapists and doctors during aftercare, because those affected often do not have the opportunity to become active themselves due to their illness.
You can do that yourself
In the case of catatonic schizophrenia, the person affected has no means of making everyday life more pleasant on their own or to take advantage of tips for self-help. Physically, the disease does not allow any self-initiated changes due to the disturbances in movement processes. In addition, it is part of the clinical picture of schizophrenia that the mental disorder does not allow insight into measures for positive changes. Only small things to be checked individually can be done to improve the general well-being.
For the reasons described, the person concerned is almost completely dependent on the support of relatives and comprehensive medical care. Due to the severity of the disease, people from the social environment are urgently advised to obtain detailed information about the disease, its course and the symptoms. This makes it easier to deal with the sick person and promotes the necessary understanding of the behavior shown in everyday life. The cognitive possibilities of a person suffering from schizophrenia are not comparable to those of a healthy person. The relatives should prepare and prepare for this.
Close cooperation between the relatives and a team of doctors and therapists is recommended. This ensures the best possible medical care and relieves family members immensely. In addition, therapeutic measures can be taken to prevent further complaints and improve well-being.
