CATATONIC DISORDERS

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CATATONIC DISORDERS

• 5 9 of all psychiatric inpatients according
  to DSM-IV
• 25-50 mood disorders
• 10 - 15 schizophrenia
• Other mental disorders

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Catatonic Disorders

• Indicated by abnormal disturbances in muscular
  movement (Catatonia)
• Caused by psychological or physiological factors
• Characterized by immobility - the body is rigid
  for an extended period of time, although the
  converse may be true, with the demonstration of
  purposeless movements unrelated to the
  environmental stimuli

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Types of Catatonic Disorders

• Catatonic Schizophrenia (rare)- marked by
  problems w/ interpersonal rltnshps, extreme
  immobility for weeks or longer or may be
  extremely active but bizarre purposeless/unconne
  cted
• Waxy flexibility can be moved and will hold new
  position
• Stupor extremely slowed motor activity to the
  point of being motionless unaware of
  surroundings

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Depression w/ Catatonic Features

• Extreme negativism
• Choose not to speak (elective mutism)
• Echolalia mimic others speech
• Echopraxia mimic others movements
• Emotional pain linked w/ body movements
• Symptoms ease in correlation w/ depression

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Causes of Depression W/ Catatonic Features

• Irregularities in production of neurotransmitters
  within the brain (neurotransmitters are chemicals
  that conduct impulses along a nerve from one
  nerve cell to another)
• Most impt. transmitters associated with
  depression norepinephrine serotonin

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Catatonia due to General Medical Condition

• Caused by physiological (and not mental) factors
• Neurological diseases encephalitis (swelling of
  the brain) may be temporary or permanent
• Demonstration of greater insight/awareness into
  their illness/symptoms will have periods of
  clear thinking with appropriate affect (emotional
  response)

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Catatonic Schizophrenia

• Thought disorder
• Inappropriate affect
• History of peculiar behavior dysfunctional
  rltnshps
• Medical testing or determination of cause by
  infectious disease, metabolic abnormalities, or
  neurological conditions
• Patient must be asked about prescribed and/or
  illicit drugs

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Catatonic SchizophreniaTreatment

• Treatment depends on underlying cause
• Hospitalization (protection/safety)
• Psychotherapy
• Family education
• Support services special ed.
• Medications lithium, valproic acid (depakote)
• ECT (extreme cases)

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Catatonic Schizophrenia Prognosis

• Usually a life-long , debilitating illness
• TRIGGERS social environmental stressors
  (leaving for college/military service), death of
  close friend/relative, use of illicit drug
• Vulnerable to stress for a life-time
• 20 eventually resume previous level of
  functioning relapse w/n 5 yrs.

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Prevention of Catatonia

• No specific preventions
• Must be able to prevent infectious disease
• Suspend illicit drug use