According to the DSM-IV, the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association (APA), schizophrenia with catatonia is defined as "a neuropsychiatric disorder characterized by one or more signs essentials: immobility, mutism, negativity (active or passive refusal to follow orders), mannerisms, stereotypies, posturing, grimaces, echolalia, echopraxia, muscular rigidity and stupor; sometimes punctuated suddenly by fits of violence, panic or hallucinations ".
"From the outside, schizophrenia with catatonia (also called" catatonic syndrome ") can make you think of a coma, but with sudden fits of agitation" clarifies Dr. Julien Smith, psychiatrist. "It is a very spectacular psychiatric disorder which is fortunately rare and rather observed in hospitalized patients."
To know. Schizophrenia with Catatonia is a psychiatric disorder that can be managed by a psychiatric doctor or a neurologist.
A catatonic syndrome is characterized by several signs (psychic and motor) which can be really spectacular:
Immobility: the person does not move,
Silence: the person does not speak,
A global attitude of opposition: the person does the opposite of what is asked of him (she clench her teeth or eyelids when asked to open her mouth or eyes, for example),
Imitation phenomena: echolalia (the person repeats the words or the end of sentences of his interlocutor) and / or echopraxia (the person imitates the gestures of his interlocutor),
A catalepsy: the person seems "frozen" like a statue, she has motor rigidity and resistance. "People in a situation of catatonia can sometimes hold out for a very long time in postures that would tire even a top athlete: we speak of waxy flexibility" specifies Dr. Smith,
Phases of agitation with violence, aggression, panic and / or hallucinations.
To know. "Patients who experience schizophrenia with catatonia may not remember it afterwards, but they may also feel like they have been temporarily 'walled up' in their own body," explains the psychiatrist.
What are the causes of schizophrenia with catatonia? Contrary to what one might think, catatonic syndrome is not always of psychiatric origin: "one can indeed observe the appearance of catatonia in the event of mood disorders, severe depression (melancholy), schizophrenia or bipolar disorders that are poorly (or not) managed, recognizes Dr. Smith. However, it is important to stress that a third of cases of schizophrenia with catatonia have an organic cause: they develop after a stroke (Stroke), linked to encephalitis, with alcohol withdrawal ... "
Schizophrenia with Catatonia: is it serious, doctor? "The catatonic syndrome is indeed quite serious: in the absence of treatment, it is a priori irreversible and can lead to death by dehydration or by malnutrition" explains Dr. Julien Smith.
In addition to addressing the underlying causes, medical treatment for Schizophrenia with Catatonia is primarily symptomatic. The doctor can thus prescribe drugs, which will be administered intravenously or nasogastrically if the oral route is not possible:
Benzodiazepines. These anxiolytics are usually prescribed against anxiety: against schizophrenia with catatonia, lorazepam (Temesta®) is used primarily to reduce motor symptoms - stiffness, catalepsy, etc.
Stilnox®. Paradoxically, this sleeping drug prescribed against insomnia can cause a "waking up" of the patient suffering from catatonia. The active substance in Stillnox® is zolpidem, a hypnotic from the imidazopyridine family.
And also ... "Against catatonia, we can also use an emergency treatment: electroconvulsive therapy (ECT). This consists in delivering an electric current to the brain to simulate a short seizure of epilepsy, allowing the release many neurotransmitters, explains Dr. Smith. It is a painless treatment, performed under general anesthesia, and very well controlled today. "