What Is Catatonia?

Catatonia is a group of symptoms that usually involve a lack of movement and communication, and also can include agitation, confusion, and restlessness.

Until recently, it was thought of as a type of schizophrenia. But doctors now understand that other mental illnesses and some conditions that throw off your body’s metabolism also can make you catatonic. About 1 person in 10 who has a severe mental illness will have catatonia at some point.

Catatonia can be treated, but if it’s not, it can lead to life-threatening problems.

Symptoms and Diagnosis

Doctors can diagnose someone as catatonic if they have any three of these signs:

  • Not responding to other people or their environment
  • Not speaking
  • Holding their body in an unusual position
  • Resisting people who try to adjust their body
  • Agitation
  • Repetitive, seemingly meaningless movement
  • Mimicking someone else’s speech
  • Mimicking someone else’s movements

Types

There are three types of catatonia:

  • Akinetic catatonia. This is the most common. Someone with akinetic catatonia often stares blankly and won’t respond when you speak to them. If they do respond, it may only be to repeat what you said. Sometimes they sit or lie in an unusual position and won’t move.
  • Excited catatonia. With this type, the person may move around, but their movement seems pointless and impulsive. They may seem agitated, combative, or delirious, or they may mimic the movements of someone who’s trying to help them.
  • Malignant catatonia. This type happens when the symptoms lead to other health problems, like dangerous changes in blood pressure, body temperature, or breathing or heart rate. Someone who’s catatonic for a long time may be more likely to have problems like dehydration, blood clots, or kidney failure as a result of the symptoms.

Causes

Doctors aren’t sure exactly what makes someone become catatonic. It happens most often with people who have mood disorders or psychotic disorders, like depression, bipolar disorder, and schizophrenia. About a third of people who are catatonic also have bipolar disorder.

Several physical conditions can lead to catatonia in people who don’t have a mental illness. These include:

  • Conditions that affect your body chemistry, like kidney problems, diabetes, and thyroid conditions
  • Parkinson’s disease, which attacks your body’s nervous system
  • Encephalitis, an infection that affects your brain

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Treatment

Doctors usually treat catatonia with a kind of sedative called a benzodiazepine that’s often used to ease anxiety.

Another treatment option is electroconvulsive therapy (ECT). It sends electrical impulses to the person’s brain through electrodes placed on their head. (They’re given medicine to sleep through the procedure.) It might be recommended if:

  • Sedatives don’t work.
  • The catatonia is severe.
  • The person has had catatonia before.
  • Quick action is needed to save someone’s life.
WebMD Medical Reference Reviewed by Smitha Bhandari, MD on January 24, 2019

Sources

SOURCES:

Catatonia Information Center, Penn State University.

Psychosomatic Medicine: “Catatonic Stupor in Schizophrenic Disorders and Subsequent Medical Complications and Mortality.”

Psychiatry: “Clinical Manifestations, Diagnosis, and Empirical Treatments for Catatonia.”

The Journal of Psychiatry and Clinical Neuroscience: “Catatonia in Psychotic Patients: Clinical Features and Treatment Response.”

World Journal of Psychiatry: “Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.”

Wolters-Kluwer / Up To Date: “Catatonia: Treatment and prognosis.”

Primary Care Companion to the Journal of Clinical Psychiatry: “Dread Complications of Catatonia: A Case Discussion and Review of the Literature.”

Schizophrenia Research: “Catatonia in DSM-V.”

Behavioral Sciences: “The Syndrome of Catatonia.”

Journal of Psychopathology: “Catatonia from the first descriptions to DSM-5.”

Journal of Clinical Psychopharmacology: “Recurrent Catatonia in Parkinson’s Disease.”

BMJ Journal of Neurology, Neurosurgery and Psychiatry: “Malignant catatonia secondary to sporadic encephalitis lethargica.”

National Institute on Drug Abuse: “Benzodiazepines and Opioids.”

American Psychiatric Association: “What is electroconvulsive therapy?”

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