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Catatonic Schizophrenia Symptoms, Causes, Risk Factors & Treatment

Catatonic Schizophrenia: What Is Schizophrenia?

According to the National Institute of Mental Health, schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which causes significant distress for the individual, their family members, and friends. If left untreated, the symptoms of schizophrenia can be persistent and disabling. However, effective schizophrenia treatments are available. When delivered in a timely, coordinated, and sustained manner, treatment can help affected individuals to engage in school or work, achieve independence, and enjoy personal relationships.

Schizophrenia is a mental disorder characterized by disruptions in thought processes, perceptions, emotional responsiveness, and social interactions. Although the course of schizophrenia varies among individuals, schizophrenia is typically persistent and can be both severe and disabling.

Symptoms of schizophrenia include psychotic symptoms such as hallucinations, delusions, and thought disorder (unusual ways of thinking), as well as reduced expression of emotions, reduced motivation to accomplish goals, difficulty in social relationships, motor impairment, and cognitive impairment. Although symptoms typically start in late adolescence or early adulthood, schizophrenia is often viewed from a developmental perspective. 

Cognitive impairment and unusual behaviors sometimes appear in childhood, and the persistent presence of multiple symptoms represents a later stage of the disorder. This pattern may reflect disruptions in brain development as well as environmental factors such as prenatal or early life stress. This perspective fuels the hope that early interventions will improve the course of schizophrenia which is often severely disabling when left untreated.

Catatonic Schizophrenia
Catatonic Schizophrenia: People with schizophrenia may seem like they have lost touch with reality, which causes significant distress for the individual, their family members, and friends.

Schizophrenia Onset and Symptoms

Schizophrenia is typically diagnosed in the late teen years to the early thirties and tends to emerge earlier in males (late adolescence – early twenties) than females (early twenties – early thirties). A diagnosis of schizophrenia often follows the first episode of psychosis, when individuals first display symptoms of schizophrenia. Gradual changes in thinking, mood and social functioning often begin before the first episode of psychosis, usually starting in mid-adolescence. Schizophrenia can occur in younger children, but it is rare for it to occur before late adolescence. The symptoms of schizophrenia generally fall into the following three categories:

Psychotic symptoms 

Include altered perceptions (e.g., changes in vision, hearing, smell, touch, and taste), abnormal thinking, and odd behaviors. People with psychotic symptoms may lose a shared sense of reality and experience themselves and the world in a distorted way. Specifically, individuals typically experience:

  • Delusions, which are firmly held beliefs not supported by objective facts (e.g., paranoia – irrational fears that others are “out to get you” or believing that the television, radio, or internet are broadcasting special messages that require some response)
  • Hallucinations, such as hearing voices or seeing things that aren’t there
  • Thought disorder, which includes unusual thinking or disorganized speech

Negative symptoms 

Include loss of motivation, disinterest or lack of enjoyment in daily activities, social withdrawal, difficulty showing emotions, and difficulty functioning normally. Specifically, individuals typically have:

  • Reduced motivation and difficulty planning, beginning, and sustaining activities
  • Diminished feelings of pleasure in everyday life
  • “Flat affect,” or reduced expression of emotions via facial expression or voice tone
  • Reduced speaking

Cognitive symptoms 

Include problems in attention, concentration, and memory. For some individuals, the cognitive symptoms of schizophrenia are subtle, but for others, they are more prominent and interfere with activities like following conversations, learning new things, or remembering appointments. Specifically, individuals typically experience:

  • Problems using information immediately after learning it
  • Trouble focusing or paying attention
  • Difficulty processing information to make decisions

What Is Catatonic Schizophrenia?

In the past, catatonia was considered to be a subtype of schizophrenia. It’s understood now that catatonia can occur in a broad spectrum of psychiatric and medical conditions. Although catatonia and schizophrenia can exist as separate conditions, they are closely tied to one another. The first medical acknowledgment of catatonic behavior involved people with schizophrenia.

Catatonic Schizophrenia Symptoms

People with catatonic symptoms in schizophrenia exhibit unusual styles and levels of physical movement. For example, such a person may move their body erratically or not at all. This state may continue for minutes, hours, even days.

Symptoms of catatonic schizophrenia may include:

  • Stupor (a state close to unconsciousness)
  • Catalepsy (trance seizure with rigid body)
  • Waxy flexibility (limbs stay in the position another person puts them in)
  • Mutism (lack of verbal response)
Catatonic Schizophrenia
Catatonic Schizophrenia: a person may move their body erratically or not at all. This state may continue for minutes, hours, even days.
  • Negativism (lack of response stimuli or instruction)
  • Posturing (holding a posture that fights gravity)
  • Mannerism (odd and exaggerated movements)
  • Echopraxia (meaningless repetition of another person’s movements)
  • Stereotypy (repetitive movements for no reason)
  • Agitation (not influenced by external stimuli)
  • Grimacing (contorted facial movements)
  • Echolalia (meaningless repetition of another person’s word)

The catatonic state may be punctuated by times of polar opposite behaviors. For example, someone with catatonia may experience brief episodes of unexplained excitability and defiance. 

What Causes Catatonic Schizophrenia?

Just because a person has catatonic symptoms doesn’t mean that person has schizophrenia.

Causes of catatonia

The causes of catatonic disorders vary from person to person, but researchers believe irregularities in the dopamine, gamma-aminobutyric acid (GABA), and glutamate neurotransmitter systems are the primary cause. It isn’t unusual for catatonia to be accompanied by other neurological, psychiatric, or physical conditions.

Causes of schizophrenia

While causes of schizophrenia are unknown, researchers believe that a combination of factors contributes to its development, including genetics, brain chemistry, and environment.

Catatonic Schizophrenia
Researchers believe irregularities in dopamine, gamma-aminobutyric acid (GABA), and glutamate neurotransmitter systems are the primary cause of catatonic disorders.

Risk Factors For Catatonic Schizophrenia

Family history is a risk factor for this condition. However, a person’s lifestyle and behavior may also be related. Catatonic schizophrenic episodes have been linked to substance misuse. For example, a person who already has a predisposition to the disorder may experience a full episode after a night of engaging in drug use. This is because mind-altering substances also contribute to changes in brain chemistry. When combined with existing chemical imbalances in a person’s brain, the impact of drugs and alcohol can be strong.

When To See A Doctor For Catatonic Schizophrenia?

If you or someone you love is experiencing any symptoms of catatonic schizophrenia, you should see your doctor as soon as possible. If you believe that someone is having a catatonic episode, seek medical help immediately.

Diagnosis Of Catatonic Schizophrenia

Only a medical doctor can diagnose catatonic schizophrenia. In order to do so, a doctor may perform some or all of the following tests:

  • EEG (electroencephalogram)
  • MRI scan
  • CT scan
  • Physical examination
  • Psychiatric examination (performed by a psychiatrist)

Catatonic Schizophrenia Treatment


Typically, the first step in treating catatonic schizophrenia is medication. Your doctor might prescribe lorazepam (Ativan) — a benzodiazepine — injected either intramuscularly (IM) or intravenously (IV). Other benzodiazepines include:

  • Alprazolam (Xanax)
  • Diazepam (Valium)
  • Clorazepate (Tranxene)


Sometimes psychotherapy is combined with medication to teach coping skills and how to deal with stressful situations. This treatment also aims to help people who have mental health issues associated with catatonia learn how to collaborate with their doctor to manage their condition better.

Reclaim Your Life From Catatonic Schizophrenia 

Catatonic Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. This should not be taken lightly. We Level Up Treatment Center can provide you, or someone you love, Catatonic Schizophrenia Treatments with professional and safe care. Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.