Catatonia is a disorder that disrupts a person's awareness of the world around them. People with this condition sometimes react very little or not at all to their surroundings, or might behave in ways that are unusual, unexpected or unsafe to themselves or others.
People who've experienced catatonia often describe a stuck or trapped feeling. When you have catatonia, you may remain aware of your surroundings but are unable to move your body or respond when spoken to. Some people believe they're about to die.
People with catatonia often express intense anxiety and say they feel overwhelmed with feelings. It's not that people with catatonia have no thoughts - it might be that they have too many.
Catatonia, a neuropsychiatric syndrome characterized by abnormal movements, behaviors, and withdrawal, is a condition that is most often seen in mood disorders but can also be seen in psychotic, medical, neurologic, and other disorders.
Catatonia can last anywhere from a few hours to weeks, months or even years. Some people have reoccuring episodes. I've spoken to doctors, nurses, academics, patients and carers about this condition. One question comes up more than any other: what are people with catatonia thinking?
Catatonia is often treated with a medication called lorazepam. Lorazepam is a benzodiazepine, which is a type of sedative medication. This means that it helps to slow down the body and brain and relax the muscles.
Catatonia is often associated with brain imaging abnormalities (in more than 75% of cases). The majority of the case reports show diffuse lesions of white matter, in a wide range of brain regions.
A controlled study using different motor tasks (idle status, self-initiated movements, and movements on request) showed a decreased activity of the prefrontal cortex, the parietal cortex, and the supplementary motor area in catatonic patients compared to controls (31). These changes persisted even after remission.
It has also been noted that people with past depression who experience trauma are prone to catatonic depression. For example, a traumatic event or losing a loved one can cause mental trauma. As an outcome, the individual encounters extreme emotional stress, which causes him or her to enter a catatonic state.
Other case studies have discussed catatonia in association with conversion disorder, but not with purposeful feigning of catatonia [6–8]. Catatonia is difficult to malinger, and extended observation during hospitalization will usually reveal the patient to have inconsistencies in their behaviors [9].
Catatonia is often a presentation of extreme anxiety and depression. Missing the diagnosis of catatonia would lead to improper treatment, which could be life-threatening.
Catatonia is most often seen in adults, though it sometimes occurs in children. The syndrome commonly is associated with mood disorders, toxic neural conditions (such as those caused by medications), and infections; in some instances, it appears to develop on its own, in the absence of known risk factors.
Catatonic symptoms can happen not only with schizophrenia, but in mood disorders, autism, and other conditions. But it most often shows up with schizophrenia. Your doctor may tell you that you have catatonia, or catatonic schizophrenia, if you have at least three of these 12 features.
If catatonia is left unrecognized and untreated it becomes chronic, and patients may die from complications of malnutrition, immobility, and/or dangerous behavior.
Historically, catatonia is related to schizophrenia and other mental illnesses, such as severe depression, bipolar disorder, and psychosis. 4 However, the causes of catatonia are numerous, ranging from psychiatric to medical illnesses.
A loved one may need to call an inpatient psychiatric center or seek emergency medical attention to help the person get treatment as soon as possible. If a person suspects their loved one is in a catatonic state, they should contact their primary care physician or seek emergency medical attention.
The state of catatonia is conscious and has neural reflexes. Also, the patient's pupils remain unchanged. However, coma is the loss of consciousness with nerve reflex. Patients may become unresponsive or lose their ability to respond to external stimulation, and the patient's pupils may have variable changes.
Catatonia is an important neuropsychiatric disorder that was described in print in 1868 by Karl Kahlbaum. It is a psychiatric emergency and requires prompt recognition and treatment.
DSM-5 classification
The DSM-5 does not classify catatonia as an independent disorder, but rather it classifies it as catatonia associated with another mental disorder, due to another medical condition, or as unspecified catatonia.
Someone with catatonia may not speak (mutism), move (immobility), or appear rigid. Depressive episodes last at least 2 weeks but can be ongoing. Catatonic episodes are usually considered “acute,” meaning they last just hours or days. But in some cases, catatonia can become chronic, lasting weeks to years.
Because of the risk of serious complications of catatonia, admission to an ICU is the treatment of choice for a patient with this condition.
Catatonic stupor predisposes patients to pneumonia because of failure to clear respiratory secretions and aspiration of stomach content. Not only catatonic stupor, but also the catatonic excitement may prove fatal.