CATATONIC DISORDERS

5% – 9 % of all psychiatric inpatients according to

DSM-IV
25%-50% mood disorders
10% - 15% schizophrenia
Other mental disorders
 Catatonic Disorders
 Indicated by abnormal disturbances in muscular
movement (Catatonia)
 Caused by psychological or physiological factors
 Characterized by immobility - the body is rigid
for an extended period of time, although the
converse may be true, with the demonstration of
purposeless movements unrelated to the
environmental stimuli
 Types of Catatonic Disorders
 Catatonic Schizophrenia (rare)- marked by
problems w/ interpersonal rltnshps, extreme
immobility for weeks or longer or may be
extremely active but bizarre &
purposeless/unconnected
 Waxy flexibility – can be moved and will hold
new position
 Stupor – extremely slowed motor activity to the
point of being motionless & unaware of
surroundings
 Depression w/ Catatonic
Features
 Extreme negativism
 Choose not to speak (elective mutism)
 Echolalia – mimic others speech
 Echopraxia – mimic others movements
 Emotional pain linked w/ body movements
 Symptoms ease in correlation w/
depression
 Causes of Depression W/
Catatonic Features
 Irregularities in production of
neurotransmitters within the brain
(neurotransmitters are chemicals that
conduct impulses along a nerve from one
nerve cell to another)
 Most impt. transmitters associated with
depression: norepinephrine & serotonin
 Catatonia due to General Medical
Condition
 Caused by physiological (and not mental)
factors
 Neurological diseases: encephalitis (swelling of
the brain) may be temporary or permanent
 Demonstration of greater insight/awareness into
their illness/symptoms – will have periods of
clear thinking with appropriate affect (emotional
response)
 Catatonic Schizophrenia
 Thought disorder
 Inappropriate affect
 History of peculiar behavior &
dysfunctional rltnshps
 Medical testing or determination of cause
by infectious disease, metabolic
abnormalities, or neurological conditions
 Patient must be asked about prescribed
and/or illicit drugs
 Catatonic Schizophrenia
Treatment
 Treatment depends on underlying cause
 Hospitalization (protection/safety)
 Psychotherapy
 Family education
 Support services – special ed.
 Medications – lithium, valproic acid
(depakote)
 ECT (extreme cases)
Catatonic Schizophrenia Prognosis
 Usually a life-long , debilitating illness
 TRIGGERS: social & environmental
stressors (leaving for college/military
service), death of close friend/relative, use
of illicit drug
 Vulnerable to stress for a life-time
 20% eventually resume previous level of
functioning; relapse w/n 5 yrs.
 Prevention of Catatonia
 No specific preventions
 Must be able to prevent infectious disease
 Suspend illicit drug use