Catatonia, a condition that impairs the function of the brain, is often associated with neuropsychiatric and psychiatric disorders. It often occurs as a symptom of psychiatric disorders such as schizophrenia, bipolar disorder or major depression. In this condition, the person is unable to react appropriately to what is happening around them and often exhibits abnormal behavior. Symptoms such as communication disorders, lack of movement and bizarre postures are among the characteristics that define a catatonic state.
Catatonia is a condition that can seriously affect an individual's quality of life. With early diagnosis and effective treatment, it is possible for people to manage the condition and return to their normal lives. However, every case is different, so it is important to consult a specialist.
What Causes Catatonia?
Catatonia is a neuropsychiatric condition that affects an individual's emotional, mental and physical states. The underlying causes can be complex and vary from individual to individual. Some factors that cause catatonia include:
Schizophrenia: Catatonia is often associated with schizophrenia spectrum disorders. Schizophrenia can cause disturbances in perception of reality, thought processes and emotional responses.
Bipolar Disorder: Bipolar disorder is a condition that fluctuates between manic episodes and depressive episodes. Catatonia can occur during the depressive phases of bipolar disorder.
Major Depression: In cases of severe depression, symptoms of catatonia may be observed. In this case, the individual's energy decreases, their movements are restricted and problems in communication may occur.
Neurological Disorders: Some neurological diseases or lesions can also lead to catatonia. This can be caused by organic causes that affect brain function.
Medications: Some psychotropic drugs can cause catatonia-like symptoms. Catatonia can develop if the dose of these medications is incorrectly adjusted or if they are used for a long period of time.
Intense Stress and Trauma: Extreme stress, traumatic events or bad experiences in childhood can trigger catatonic symptoms.
Somatic Diseases: Some serious somatic diseases, especially neurological and systemic diseases, can lead to catatonic symptoms.
What are the Types of Catatonia?
Catatonia is a condition characterized by a variety of symptoms, and these symptoms can be based on different underlying causes. Here are some of the main types of catatonic symptoms:
Catatonia-type schizophrenia: This condition occurs as part of the schizophrenia spectrum. Catatonic symptoms, such as lack of movement, strange postures, lack of speech, are often observed in individuals diagnosed with schizophrenia.
Depression with catatonia: Associated with major depression, catatonia can occur in cases of severe depression. Individuals may struggle with symptoms such as extreme immobility, lack of speech and decreased emotional responses.
Bipolar disorder with catatonia: Catatonia can occur during the depressive phases of bipolar disorder or as an accompanying condition to manic episodes. This can cause marked fluctuations in energy levels.
Catatonia of neurological origin: This includes catatonic symptoms that occur as a result of certain neurological diseases, lesions or brain injuries. These conditions are usually due to organic causes.
Medication-induced catatonia: A type of catatonia that can occur as a side effect of certain psychotropic drugs. It can develop if the dose of the medication is incorrectly adjusted or if it is used for a long period of time.
Catatonia due to somatic diseases: Serious systemic or neurological diseases can cause catatonic symptoms. This condition usually occurs due to underlying somatic health problems.
What are the Symptoms of Catatonia?
Catatonia is a condition associated with various neuropsychiatric and psychiatric disorders. Symptoms of catatonia can vary from individual to individual, but are usually outlined as follows:
Lack of Movement (Akinesia): Catatonic individuals often exhibit prolonged immobility. There may be minimal or no movement while sitting, lying down or standing.
Abnormal Postures: Strange or abnormal body postures are common. The individual may involuntarily assume strange postures.
Repetitive and meaningless movements: Some catatonic individuals may make repetitive, meaningless and automatic movements. This can take the form of waving hands, turning the head or moving in a certain rhythm.
Speech Disorders: Lack of speech or gibberish is also a symptom of catatonia. The individual may show a marked decrease in the ability to speak.
Unresponsiveness to Environmental Stimuli: Catatonic individuals may have difficulty responding appropriately to environmental stimuli. They may become desensitized to the outside world.
Over-adaptation or Stubbornness: Catatonic individuals may tend to over-adapt to a situation or show excessive resistance.
Lack of Emotional Expression: A marked decrease in emotional expressions may be observed. Individuals may have difficulty showing their emotional reactions.
Interesting or Absurd Behavior: Individuals with a catatonic condition may exhibit unusual or absurd behavior, which can often be difficult to understand by those around them.
How is Catatonia Diagnosed?
Catatonia is usually diagnosed after a detailed evaluation by a specialist psychiatrist or neurologist. The diagnostic process takes into account the onset, severity, frequency and other characteristics of the symptoms. Here are some of the methods used to diagnose catatonia:
Clinical Assessment: A qualified health professional assesses the general health of the individual showing symptoms of catatonia. This includes factors such as the onset, duration and severity of symptoms.
Mental State Examination: A psychiatric examination provides information about the individual's thought processes, perceptions, emotional state and other cognitive functions.
Medical History and Physical Examination: A medical history and physical examination is performed to rule out organic factors that may be the cause of catatonic symptoms. Neurologic examination is aimed at evaluating neurologic disorders or brain lesions.
Laboratory Tests: Blood tests and other laboratory investigations may be used to evaluate thyroid function, electrolyte balance and other potential physical health problems.
Imaging Tests: Brain imaging techniques, especially magnetic resonance imaging (MRI) or computed tomography (CT) scans, can be used to identify neurological causes.
Psychiatric Evaluation: The specialist psychiatrist will assess the individual's psychiatric history and other psychiatric disorders. This is aimed at understanding the underlying root causes of the catatonia symptoms.
Evaluation According to DSM-5 Criteria: The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria prepared by the American Psychiatric Association are used to diagnose catatonia.
How is catatonia treated?
Catatonia treatment may vary depending on the individual's symptoms and underlying causes. Treatment usually requires a multidisciplinary approach and should be directed by a specialist psychiatrist or neurologist.
Treatment of the Underlying Cause
If catatonia is a symptom of a psychiatric disorder, treatment of this underlying disorder is the first priority. Conditions such as schizophrenia, bipolar disorder or depression are treated with appropriate medication.
Medication Therapy
Antipsychotic drugs are commonly used to treat catatonic symptoms. Medication may vary depending on the patient's specific condition and the type and dosage of medication should be determined by a specialist psychiatrist or neurologist.
Electroconvulsive Therapy (ECT)
It is an option used to manage emergencies or conditions that do not respond to medication. It is particularly applicable for severe depression and severe catatonic states.
Supportive Care
Supportive therapies can be used to increase the individual's participation in activities of daily living and improve social skills. It is also important to provide care and keep the individual safe.
Therapy
Individual therapy, group therapy or family therapy can help strengthen the catatonic individual's emotional and social skills. These therapies can be effective in addressing underlying psychosocial factors.
Hospitalization
Hospitalization may be considered when catatonia is severe or when urgent intervention is required. This may be necessary to ensure the individual's safety and to begin effective treatment.
Physical Rehabilitation
If muscle weakness has developed due to lack of movement, physical therapy and rehabilitation programs can help improve an individual's physical health and activity.