265 Schizophrenia, Catatonic Type (295.20)
DSM-IV-TR criteria
- A type of Schizophrenia where the clinical picture is dominated by two of the following:
- Motor immobility as evidenced by catalepsy (including waxy flexibility) or stupor.
- Excessive motor activity that is purposeless and not influenced by external stimuli.
- Extreme negativism or mutism.
- Peculiarities of voluntary movement as evidenced by posturing (voluntary assumption of inappropriate or bizarre postures), stereotyped movements, prominent mannerisms, or prominent grimacing.
- Echolalia or echopraxia
Associated features
- Those diagnosed with the Catatonic subtype of schizophrenia are characterized by extreme psychomotor dysfunctions. They experience physical immobility; this occurs when they are completely unable to move or speak.
- They also may go into a catatonic stupor, which includes a form of waxy flexibility. Waxy flexibility occurs when a patients arm is moved into a position and remains in that position for hours.
- A catatonic Schizophrenic may also experience fits of excessive movement or mobility. These movements seem to have no purpose; it could include pacing, turning in circles, flailing of the arms, or making loud noises.
- Another feature of catatonic Schizophrenia is extreme negativism or mutism. This is when the person exhibits extreme resistance to instructions or help. They will resist any attempt to be moved and may refuse to speak.
- Peculiar postures or movements are also common with Catatonic Schizophrenia. This includes things such as posturing, which is sitting odd or bizarre postures for long periods of time. This could also include grimacing or the adoption of odd mannerisms.
- Along with fore mentioned symptoms, stereotyped behaviors are common, such as repeating words, following a routine obsessively, or constantly arranging objects the same way.
- Catatonic Schizophrenics will often suffer from echolalia, which causes them to involuntarily repeat things that they hear. They also suffer from echopraxia, which is the involuntary copy of movements or gestures made by someone else.
- Some other symptoms along with the catatonic behaviors could include delusions, hallucinations, incoherent speech, angry outbursts, neglect of personal hygiene, social isolation, and clumsy, uncoordinated movements.
- Other associated symptoms would include cognitive deficits, such as difficulty with the processing of visual stimuli because they can only focus on one object, poor verbal and spatial memory, abstract reasoning, poor psycho motor speed, and very poor planning ability.
- Social and emotional deficits are also seen. There is an impaired ability to solve or understand social problems and issues. They have an impaired ability to recognize emotion expressed in others and also have an abnormal expression of emotions. For example, they do not always respond with the correct emotion, such as being happy when they should be sad.
- There are high rates of substance