Catatonic Symptoms in Schizophrenia and Other Conditions

Table of ContentsView AllTable of ContentsCharacteristicsDiagnosisCausesTreatmentCoping

Table of ContentsView All

View All

Table of Contents

Characteristics

Diagnosis

Causes

Treatment

Coping

Although you may have heard the term “catatonic schizophrenia,” this diagnosis no longer officially exists in the current “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR). It was previously one of the subtypes of schizophrenia.

Currently, it is used to describe someone who isdiagnosed with schizophreniaand who also meets the diagnostic criteria for catatonia. Catatonia can also occur in other conditions.

While these symptoms can be scary and extremely debilitating, knowing more about them (and what treatments are available) can help you better manage them or help a loved one.

At a GlanceCatatonic schizophrenia is no longer an officially recognized diagnosis, but catatonic behavior can still occur in schizophrenia as well as in other mental health conditions. Signs of catatonia often include an inability to move or speak. People experiencing it may appear rigid, repeat words, or perform strange movements. They may also display other signs of schizophrenia, including hallucinations, problems with thinking, difficulty expressing emotions, and social withdrawal. If a person is experiencing catatonia, seeing a doctor for a diagnosis and treatment recommendations is important. Schizophrenia is typically treated with medications, but electroconvulsive therapy is also sometimes recommended.

At a Glance

Catatonic schizophrenia is no longer an officially recognized diagnosis, but catatonic behavior can still occur in schizophrenia as well as in other mental health conditions. Signs of catatonia often include an inability to move or speak. People experiencing it may appear rigid, repeat words, or perform strange movements. They may also display other signs of schizophrenia, including hallucinations, problems with thinking, difficulty expressing emotions, and social withdrawal. If a person is experiencing catatonia, seeing a doctor for a diagnosis and treatment recommendations is important. Schizophrenia is typically treated with medications, but electroconvulsive therapy is also sometimes recommended.

Characteristics of Catatonic Behavior

Someone with this condition might experience rigidity or stupor, or be unable to speak, respond, or even move. This can last for hours or even days if left untreated.

Catatonia can also cause a person to perform strange movements. They may also experience catatonic posturing where they stay in uncomfortable-looking positions without attempting to shift into more comfortable or natural ones.

In addition to a lack of mobility, erratic and extreme movement is possible in catatonic behavior. For example, a person might pace in a repeated pattern and make loud exclamations for no reason (i.e., not in response to an environmental stimulus or event). Parrot-like repetition or echoing of words, known as echolalia, is also a common catatonic behavior.

While a person who is catatonic may not be able to speak or move, they are still conscious and aware. A person in a catatonic state may also experience intense emotions and feelings of anxiety but not be able to express what they are experiencing.

Common Schizophrenia SymptomsPeople with this disorder may also display signs of schizophrenia, including:Cognitive problemsDecreased ability to express emotionsDelusionsDisorganizationHallucinationsPoor self-careSocial difficultiesSocial withdrawal

Common Schizophrenia Symptoms

People with this disorder may also display signs of schizophrenia, including:Cognitive problemsDecreased ability to express emotionsDelusionsDisorganizationHallucinationsPoor self-careSocial difficultiesSocial withdrawal

People with this disorder may also display signs of schizophrenia, including:

Signs and Symptoms of Schizophrenia

How Is Catatonic Behavior Diagnosed?

There are no labs or tests to diagnose catatonic symptoms. Catatonic behavior can also occur in conditions such asautismand mood disorders, so a doctor will evaluate symptoms to determine what is causing them.

A doctor will perform a series of medical exams and psychological evaluations to assess the individual’s physical and mental health, as well as rule out other conditions.

Depending on the results, a doctor may order a magnetic resonance imaging (MRI) scan or an electroencephalogram (EEG) to check for any lesions or unusual brain wave patterns.A test may also be given to check for drugs and alcohol.

During the psychiatric evaluation, the individual will be asked questions about their thoughts and behaviors. A psychiatrist will attempt to discover how long they have been experiencing the symptoms in question.

If a patient is in a catatonic stupor and unable to talk, their family may be called in to provide information about the catatonic behavior.

What Causes Catatonic Behavior?

Causes of Catatonic Behavior

Catatonic symptoms like facial contortions, strange limb movements, or unusual body positions can lead to a misdiagnosis oftardive dyskinesiaor other movement disorders. Similarly,Tourette’s syndromemay be confused for catatonia due to some of the vocalizations that can be part of the syndrome.

Causes of Schizophrenia

While the exactcauses of schizophreniaare not fully understood, it is believed that a combination of genetic and environmental influences may play a role. Genetics appear to make people more vulnerable to the condition, but other factors, including viral infections, exposure to toxins, neurochemical irregularities, stress, andtrauma, can also play a role.

Estimates suggest that between 9% and 17% of people with acute psychiatric illness experience catatonia.

Treatment of Catatonic Symptoms

Treatments for catatonic behavior can vary depending on the individual’s needs and diagnosis. Schizophrenia is a lifelong, chronic condition, which means people must take steps to stay ahead of and manage their catatonic behaviors and schizophrenia.

While there’s no cure, there are treatment methods that can help people better manage their symptoms.

The Best Online Therapy ProgramsWe’ve tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.

Medication

Benzodiazepineslike Ativan (lorazepam) are perhaps the most common approach to treatment.These drugs act as depressants on thecentral nervous system, which is why they are often used to treat anxiety.

Because these drugs are fast-acting, they can often relieve catatonic symptoms quite quickly. However, they can be habit-forming when used as a long-term treatment.

There is some debate around the use of antipsychotics in catatonia. In some cases, antipsychotics can worsen catatonia and are often discontinued in its acute management.However, they are generally reintroduced to treat and prevent the symptoms of schizophrenia.

How Schizophrenia Is Treated

Electroconvulsive Therapy (ECT)

ECT, formerly known as electroshock therapy, is increasingly used to effectively treat catatonia in schizophrenia and other psychiatric conditions. Research has shown that ECT has an 80% to 100% efficacy rate in treating catatonia.

Despite the high efficacy rates, access is often limited due tostigmaand other factors, so it is often only utilized when people have not responded to benzodiazepines.

Coping With Catatonic Behavior

Witnessing someone experience catatonic behavior with schizophrenia is certainly scary. Steps people can take to help cope:

Stay Informed

Perhaps the best thing friends and family members can do is to stay educated about diagnosis, symptoms, and effective treatment. By staying informed, loved ones can get help immediately if they notice any signs of catatonia like rigidity or stupor, or erratic extreme movements.

Be Prepared to Describe Symptoms

Depending on the severity and type of symptoms, people may need to step in to describe the catatonic behaviors to their loved one’s doctor.

Offer Encouragement and Support

Care for Yourself

Self-care is also essential for sustaining the mental energy required to support someone with a mental illness.Caregiversshould try to get ample sleep, eat right, exercise, and make time for relaxation and fun.

Living With Schizophrenia

Takeaways

Getting a proper diagnosis and complying with treatment is key to coping with catatonic behavior. While schizophrenia is a lifelong disease, catatonia can be controlled. With appropriate treatment, people suffering from catatonic symptoms as part of schizophrenia and other psychiatric conditions can find significant relief from their symptoms.

13 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Csihi L, Ungvari GS, Caroff SN, Gazdag G.First 150 years of catatonia: Looking back at its complicated history and forward to the road ahead.World J Psychiatry. 2024;14(5):600-606. doi:10.5498/wjp.v14.i5.600American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Dawkins E, Cruden-Smith L, Carter B, et al.Catatonia psychopathology and phenomenology in a large dataset.Front Psychiatry. 2022;13:886662. doi:10.3389/fpsyt.2022.886662National Institute of Mental Health.Schizophrenia.Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry.2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391Haroche A, Rogers J, Plaze M, Gaillard R, Williams SC, Thomas P, Amad A.Brain imaging in catatonia: systematic review and directions for future research.Psychol Med. 2020;50(10):1585-1597. doi:10.1017/S0033291720001853Walther S, Strik W.Catatonia.CNS Spectr. 2016;21(4):341-348. doi:10.1017/S1092852916000274Carroll BT, Anfinson TJ, Kennedy JC, Yendrek R, Boutros M, Bilon A.Catatonic disorder due to general medical conditions.J Neuropsychiatry Clin Neurosci. 1994;6(2):122-33. doi: 10.1176/jnp.6.2.122Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry. 2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391Rahman T, Lauriello J.Schizophrenia: An overview.Focus (Am Psychiatr Publ). 2016;14(3):300-307. doi:10.1176/appi.focus.20160006Drug Enforcement Administration (DEA).Benzodiazepines. In:Drugs of Abuse: A DEA Resource Guide. 2017 ed.Huang MW, Gibson RC, Jayaram MB, Caroff SN.Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms.Cochrane Database Syst Rev. 2022;7(7):CD013100. doi:10.1002/14651858.CD013100.pub2Lloyd JR, Silverman ER, Kugler JL, Cooper JJ.Electroconvulsive therapy for patients with catatonia: Current perspectives.Neuropsychiatr Dis Treat. 2020;16:2191-2208. doi:10.2147/NDT.S231573

13 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Csihi L, Ungvari GS, Caroff SN, Gazdag G.First 150 years of catatonia: Looking back at its complicated history and forward to the road ahead.World J Psychiatry. 2024;14(5):600-606. doi:10.5498/wjp.v14.i5.600American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Dawkins E, Cruden-Smith L, Carter B, et al.Catatonia psychopathology and phenomenology in a large dataset.Front Psychiatry. 2022;13:886662. doi:10.3389/fpsyt.2022.886662National Institute of Mental Health.Schizophrenia.Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry.2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391Haroche A, Rogers J, Plaze M, Gaillard R, Williams SC, Thomas P, Amad A.Brain imaging in catatonia: systematic review and directions for future research.Psychol Med. 2020;50(10):1585-1597. doi:10.1017/S0033291720001853Walther S, Strik W.Catatonia.CNS Spectr. 2016;21(4):341-348. doi:10.1017/S1092852916000274Carroll BT, Anfinson TJ, Kennedy JC, Yendrek R, Boutros M, Bilon A.Catatonic disorder due to general medical conditions.J Neuropsychiatry Clin Neurosci. 1994;6(2):122-33. doi: 10.1176/jnp.6.2.122Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry. 2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391Rahman T, Lauriello J.Schizophrenia: An overview.Focus (Am Psychiatr Publ). 2016;14(3):300-307. doi:10.1176/appi.focus.20160006Drug Enforcement Administration (DEA).Benzodiazepines. In:Drugs of Abuse: A DEA Resource Guide. 2017 ed.Huang MW, Gibson RC, Jayaram MB, Caroff SN.Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms.Cochrane Database Syst Rev. 2022;7(7):CD013100. doi:10.1002/14651858.CD013100.pub2Lloyd JR, Silverman ER, Kugler JL, Cooper JJ.Electroconvulsive therapy for patients with catatonia: Current perspectives.Neuropsychiatr Dis Treat. 2020;16:2191-2208. doi:10.2147/NDT.S231573

Csihi L, Ungvari GS, Caroff SN, Gazdag G.First 150 years of catatonia: Looking back at its complicated history and forward to the road ahead.World J Psychiatry. 2024;14(5):600-606. doi:10.5498/wjp.v14.i5.600American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Dawkins E, Cruden-Smith L, Carter B, et al.Catatonia psychopathology and phenomenology in a large dataset.Front Psychiatry. 2022;13:886662. doi:10.3389/fpsyt.2022.886662National Institute of Mental Health.Schizophrenia.Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry.2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391Haroche A, Rogers J, Plaze M, Gaillard R, Williams SC, Thomas P, Amad A.Brain imaging in catatonia: systematic review and directions for future research.Psychol Med. 2020;50(10):1585-1597. doi:10.1017/S0033291720001853Walther S, Strik W.Catatonia.CNS Spectr. 2016;21(4):341-348. doi:10.1017/S1092852916000274Carroll BT, Anfinson TJ, Kennedy JC, Yendrek R, Boutros M, Bilon A.Catatonic disorder due to general medical conditions.J Neuropsychiatry Clin Neurosci. 1994;6(2):122-33. doi: 10.1176/jnp.6.2.122Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry. 2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391Rahman T, Lauriello J.Schizophrenia: An overview.Focus (Am Psychiatr Publ). 2016;14(3):300-307. doi:10.1176/appi.focus.20160006Drug Enforcement Administration (DEA).Benzodiazepines. In:Drugs of Abuse: A DEA Resource Guide. 2017 ed.Huang MW, Gibson RC, Jayaram MB, Caroff SN.Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms.Cochrane Database Syst Rev. 2022;7(7):CD013100. doi:10.1002/14651858.CD013100.pub2Lloyd JR, Silverman ER, Kugler JL, Cooper JJ.Electroconvulsive therapy for patients with catatonia: Current perspectives.Neuropsychiatr Dis Treat. 2020;16:2191-2208. doi:10.2147/NDT.S231573

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

Dawkins E, Cruden-Smith L, Carter B, et al.Catatonia psychopathology and phenomenology in a large dataset.Front Psychiatry. 2022;13:886662. doi:10.3389/fpsyt.2022.886662

National Institute of Mental Health.Schizophrenia.

Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry.2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391

Haroche A, Rogers J, Plaze M, Gaillard R, Williams SC, Thomas P, Amad A.Brain imaging in catatonia: systematic review and directions for future research.Psychol Med. 2020;50(10):1585-1597. doi:10.1017/S0033291720001853

Walther S, Strik W.Catatonia.CNS Spectr. 2016;21(4):341-348. doi:10.1017/S1092852916000274

Carroll BT, Anfinson TJ, Kennedy JC, Yendrek R, Boutros M, Bilon A.Catatonic disorder due to general medical conditions.J Neuropsychiatry Clin Neurosci. 1994;6(2):122-33. doi: 10.1176/jnp.6.2.122

Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry. 2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391

Rahman T, Lauriello J.Schizophrenia: An overview.Focus (Am Psychiatr Publ). 2016;14(3):300-307. doi:10.1176/appi.focus.20160006

Drug Enforcement Administration (DEA).Benzodiazepines. In:Drugs of Abuse: A DEA Resource Guide. 2017 ed.

Huang MW, Gibson RC, Jayaram MB, Caroff SN.Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms.Cochrane Database Syst Rev. 2022;7(7):CD013100. doi:10.1002/14651858.CD013100.pub2

Lloyd JR, Silverman ER, Kugler JL, Cooper JJ.Electroconvulsive therapy for patients with catatonia: Current perspectives.Neuropsychiatr Dis Treat. 2020;16:2191-2208. doi:10.2147/NDT.S231573

Meet Our Review Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?HelpfulReport an ErrorOtherSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?HelpfulReport an ErrorOtherSubmit

What is your feedback?

At a Glance#

Characteristics of Catatonic Behavior#

Common Schizophrenia Symptoms#

How Is Catatonic Behavior Diagnosed?#

What Causes Catatonic Behavior?#

Causes of Catatonic Behavior#

Causes of Schizophrenia#

Treatment of Catatonic Symptoms#

Medication#

Electroconvulsive Therapy (ECT)#

Coping With Catatonic Behavior#

Stay Informed#

Be Prepared to Describe Symptoms#

Offer Encouragement and Support#

Care for Yourself#

Takeaways#