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Catatonic Schizophrenia: In Depth Analysis Liz Gutierrez Valencia College

Catatonic Schizophrenia: In Depth Analysis Catatonic Schizophrenia: In Depth Report Schizophrenia, previously called split personality disorder, is defined by the MerriamWebster dictionary as a type of psychotic disorder characterized by loss of contact with the environment, by noticeable deterioration in the level of functioning in everyday life, and by disintegration of personality expressed as disorder of feeling, thought (as delusions), perception

(as hallucinations), and behavior. By psychotic it is meant that one is out of touch with reality or the person is unable to separate real from unreal experiences. According to the National Institute of Mental Health, the prevalence rate for schizophrenia is approximately 1.1% of the population over the age of 18, which could be as many as 51 million people worldwide suffering from schizophrenia, in the United States alone there could be more than 2 million people suffering from it. There are five different types of schizophrenia, the paranoid-type schizophrenia, disorganized-type schizophrenia, catatonic-type schizophrenia, undifferentiated-type schizophrenia and lastly residual-type schizophrenia. The focus of this paper is catatonic schizophrenia, which according to WebMD, is characterized by disturbances of movement in which people with the disorder may remain completely immobile or move all over the place. The person affected by the disorder, may be silent for hours, not uttering a word or they may constantly repeat anything you say or do senselessly. Either way, the behavior is putting these people at high risk because it impairs their ability to take care of themselves. There is no known single cause of schizophrenia but it is considered to be the result of a complex group of genetic, psychological and environmental factors. The paper will focus on the history of schizophrenia, in general, and its causes, the common symptoms and signs will be discussed, as well as how to get a diagnosis, find available treatments, how they work, and the side effects of each treatment.

Catatonic Schizophrenia: In Depth Analysis There will also be further information discussed such as the prognosis, current research in regards to catatonic schizophrenia and where information can be found regarding this psychotic disorder. The history of catatonic schizophrenia is not easy to coin down however it all

began with Eugen Bleuler (April 30, 1857 July 15, 1939). Bleuler was a Swiss psychiatrist who developed the word schizophrenia in 1911 with the intention to describe the split of function between personality, thinking, memory and perception. It is believed that the disease has always existed and merely discovered during the 20th century. However, schizophrenia is also claimed to be a culturally determined clustering of mental symptoms. Despite that relatively recent history, schizophrenia has been described numerous times throughout written history. Ancient Egyptian, Hindu, Chinese, Greek, Roman writings have been found containing the described symptoms very similar to those of the symptoms of schizophrenia, which will be later discussed in the paper. During medieval times, schizophrenia like many other illnesses was often mistakenly attributed to the supernatural, evidence of possession of spirits or evil. The disease has been explored in contemporary movies that have exposed the life of individuals with schizophrenia, and the challenges faced by them. An example of these films would be The Soloist, which explores the challenges faced by Juilliard-trained musician Nathaniel Ayers as a result of schizophrenia. In life nothing is certain apart from death, such can be said about the causes of catatonic schizophrenia. It is frequently attributed to heredity however, schizophrenia, like most other mental disorders, arent directly passed from one generation to another genetically, and there is no single cause for this illness. Schizophrenia then becomes a complex group of genetic,

Catatonic Schizophrenia: In Depth Analysis psychological and environmental factors. In relations to genes, schizophrenia and bipolar disorder have the same number of risk genes. In relations to the environment, the risk of schizophrenia is increased in individuals who had certain infections during pregnancy. Also

associated with the development of the illness are traumatic life circumstances during childhood. The Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders. Included in the DSM is schizophrenia. Schizophrenia symptoms can be positive or negative, positive are the more overtly psychotic symptoms, and negative are the potentially less overtly psychotic symptoms. Positive symptoms of catatonic schizophrenia included but are not limited to: beliefs that have no basis in reality (delusions), hearing, seeing, feeling, smelling, or tasting things that have no basis in reality (hallucinations), disorganized speech, disorganized behaviors and catatonic behaviors. The negative symptoms of catatonic schizophrenia include: inhibition of facial expression, lack of speech and lack of motivation. The signs of catatonic schizophrenia fall into different categories of catatonic behaviors, which include physical immobility. The sufferer of the disease may be completely unable to move or speak. Catatonic stupor is when the patient is unaware of their surroundings and holds their body in a rigid position. Waxy flexibility is the form of immobility where the persons arm is moved into a certain position it will stay that way for hours. Another sign of catatonic schizophrenia is excessive mobility, rather than being unable to move, the person can move in an excited manner that appears to have no purpose. Pacing in frenzy, turning in circles, flailing arms and making loud noises are also signs of excessive mobility. There is also extreme resistance where the person is unable to respond to instructions and can resist any attempt to be

Catatonic Schizophrenia: In Depth Analysis

moved even not speaking at all. Peculiar movements are also conspicuous, such as inappropriate or unusual postures use of strange mannerisms, and following a routine or always arranging objects exactly the same way. Lastly, mimicking speech or movement, repeating speech or action is very common and although a person may seem emotionless during a catatonic episode however the person may actually experience extreme anxiety. Catatonic episodes are likely to last at least a day and may last for longer than 30 days without effective treatment. According to Oregon Health and Science University the measures of preventing schizophrenia are unavailable and unknown at the time however, early identification and early intervention can improve the quality of life that is experienced by people who suffer from schizophrenia (Oregon Health & Science University, 2011). The treatment is much more successful if the symptoms of the disease are promptly and properly diagnosed. Diagnosing schizophrenia can be quite difficult, as true with much mental-health diagnosis; there is no one test that indicates without a doubt that a patient may be suffering from schizophrenia. The doctors must then gather comprehensive medical, family and mental-health information. The patient will be asked to fill out a self-test that the health-care practitioner will review if the person being evaluated is able to complete it. After diagnosing catatonic schizophrenia, the medical practitioner will provide the patient with the options available to help treat the disease. These treatments can either be medications or psychosocial interventions. Medication seem to be the cornerstone of treatments for people with schizophrenia, these medicines are often referred to as antipsychotic because they help decrease the intensity of psychotic symptoms. The health-care practitioners will prescribe these medicines sometimes in combination of one or more other psychiatric medications in order to maximize the

Catatonic Schizophrenia: In Depth Analysis

benefit for the person with schizophrenia. The most effective medications in treating the positive symptoms of catatonic schizophrenia include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify), paliperidone (Invega), asenapine (Saphis), lurasidone (Latuda), and lloperidone (Fanapt)(Dryden-Edwards, 2009). These are considered the newer group of antipsychotic medications and are known to have the ability to work quickly in treating the symptoms. These medications have common side effects, which often include: sleepiness, dizziness, and increased appetite. Depression may also accompany schizophrenia in that case the doctors will prescribe antidepressants like Prozac, Zoloft, Paxil and Celexa. Medications arent the only way of treating catatonic schizophrenia, psychosocial interventions are also done to treat the psychotic disorder, and these include: family education, assertive community treatment (ACT) and substance abuse treatment. Family education refers to educating the family members about the symptoms, course and treatments, when this type of intervention is consistently provided for at least several months, it results in decreasing the relapse rate for the schizophrenic individuals and help improve the persons social and emotional outcomes. ACT involves a treatment team of a psychiatrist, nurse and case manager meeting with that individual on a daily basis in community settings to help reduce the hospitalization of the patient or the possibility of the patient becoming homeless. There is also substance abuse treatment that helps individuals understand, control and prevent substance abuse since according to Roxanne Dryden-Edwards, a medical practitioner, almost 50% of individuals with schizophrenia suffer from some kind of substance abuse or dependence. Another option is CBT, or cognitive behavioral therapy in which the intervention focuses on helping the client

Catatonic Schizophrenia: In Depth Analysis understand the changes and the challenges that they will encounter throughout the course of the diseases, it helps individuals decrease schizophrenic symptoms and improve their ability to function socially. Individuals with schizophrenia should be aware of the prognosis, or the likely course of the ailment. These individuals death rate is double than those with out the disorder and almost

have of them will suffer from substance abuse during their life. If however the individuals family is involve and support the sufferer of the ailment, the quality of life improves. As schizophrenia is relatively new and still very complex of a disease, there is a lot of research being done in order to understand the disease more and improve the treatments that are being delivered (Riley, 2010). There is an experimental treatment known as cognitive remediation, which addresses cognitive problems that are related to schizophrenia such as memory problems and learning problems. This treatment has shown promise in improved functioning but the research still hasnt concluded and is still being investigated and studied further. Catatonic schizophrenia is a complex psychotic disorder that has no single cause, but a group of different factors increase the likely hood of developing schizophrenia the onset of the symptoms normally occurs in young adulthood. Even though the cause can be pinpointed there are genetics and environmental factors that contribute to develop the disease. The primary treatment is with antipsychotic medications, which work by suppressing dopamine receptor activity in the bran. Psychosocial interventions, or psychotherapy also aid the treating of the ailment, and if worse comes to worse the person may be involuntarily hospitalized if he is proven to be a danger to himself and others. This disorder seems affects cognition and does contribute to problems with behavior and emotions; common behaviors displayed by catatonic schizophrenics

Catatonic Schizophrenia: In Depth Analysis include hallucinations, delusions excessive mobility or sometimes complete immobility or disorganized speech. People who suffer from the disease have a shorter life expectancy, likelihood to have substance abuse problems, increased physical health problems and a higher suicide rate, which is about five percent. However the treatments prove to be effective and the education of this type of schizophrenia is being brought forth and shared much more than it was before. References O r e g o n H e a l t h & S c i e n c e U n i v e r s i t y. ( 2 0 1 1 ) . S c h i z o p h r e n i a . R e t r i e v e d f r o m h t t p : / / w w w. o h s u . e d u / x d / h e a l t h / h e a l t h information/topic-by-id.cfm? C o n t e n t Ty p e I d = 8 5 & C o n t e n t I d = P 0 0 7 6 2 Dryden-Edwards, R. (2009). Schizophrenia. Retrieved from h t t p : / / w w w. m e d i c i n e n e t . c o m / s c h i z o p h r e n i a / p a g e 2 . h t m Veague, E. B., & Levitt, P. (2007). Schizophrenia. Chelsea House Pub. R i l e y, J . S . ( 2 0 1 0 , S e p t e m b e r ) . S c h i z o p h r e n i a . R e t r i e v e d f r o m http://psych.med.nyu.edu/conditions-wetreat/conditions/schizophrenia Castle, D. J., & Buckley, P. F. (2008). Schizophrenia. Oxford: Oxford University Press. Veague, H. B. (2007). Schizophrenia. New York, NY: Chelsea House Publishers. DeLisi, L. E. (2006). 100 questions & answers about schizophrenia: painful minds. Sudbury: Jones and Bartlett Publishers Freedman, R. (2007). Neuronal dysfunction and schizophrenia symptoms. American Psychi atri c Assoc iation , DOI: 10.1176

Catatonic Schizophrenia: In Depth Analysis

Catatonic Schizophrenia: In Depth Analysis

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