According to the American Psychiatric Association, schizophrenia is a rare illness affecting between 0.5 and 1.5 percent of adults. There are several schizophrenic subtypes, meaning that the criteria for schizophrenia has been met, but the particular symptoms warrant a more specific diagnosis. One of these subtypes is the catatonic type, which requires at least two catatonic symptoms to dominate the schizophrenic presentation. Symptoms of catatonia are not exclusive to schizophrenia and can occur in other disorders. Regardless of the primary diagnosis, catatonic behavior indicates serious underlying mental illness and should be taken seriously so that proper care and treatment can be implemented.
Complete Immobility or Posturing
Individuals in a catatonic state can become completely fixed in a certain position and may hold that position for hours or even days. People in this state appear like models in a wax museum, and can hold their arms or legs steady regardless of how uncomfortable or awkward it may seem. In addition, if the body is repositioned, the catatonic individual will often hold the new position. This is called "waxy flexibility." Posturing occurs when the individual voluntarily assumes a bizarre or inappropriate position which remains fixed until the individual voluntarily adopts a new position.
Extreme Resistance and Mutism
Another type of catatonia is called extreme negativism, where individuals will resist all instructions and may refuse to change a rigid body position if another person tries to physically reposition them. For example, a caretaker looking after a catatonic individual may tell him to roll over so things like bedsores can be avoided, but the catatonic individual will refuse to roll over despite explanations, rewards or other incentives for them to do so. This symptom can also include mutism, meaning the person refuses to talk.
Excessive Purposeless Movement and Language Peculiarities
Another type of catatonia is repetitive and purposeless movement. This can include things like unusual facial expressions, arm or leg movements, and head movements. Echopraxia refers to a state in which the individual repetitively imitates the movements of another person. Echolalia refers to the mimicking or repetition of everything another person says. Both Echopraxia and echolalia have a senseless "parrot-like" quality, and can be quite unnerving, irritating and scary to those who are not aware of the symptoms of catatonia.
References
- "Diagnostic and statistical manual of mental disorders (4th ed. text revision)"; American Psychiatric Association; 2000
