A: As a 2009 review in the Archives of General Psychiatry aptly put it, catatonia may be forgotten but it's certainly not gone. Long associated with schizophrenia ("catatonic type"), the latest research indicates that catatonia is its own syndrome.
People with catatonia lose the ability to control their movements. Some patients freeze or become rigid, while others cannot stop repeating movements, even when they might injure themselves as a result. Other typical symptoms of catatonia are inability to speak (mutism), resistance to simple commands, apparent refusal to eat or drink, persistent staring, stupor, and lack of response to painful stimuli. These symptoms indicate that catatonia has more in common with movement disorders like Parkinson's disease than psychotic disorders like schizophrenia.
Catatonia has many possible causes—psychiatric, neurological, or medical. It does frequently appear in people with severe psychiatric disorders, but not just schizophrenia. It can also affect those who suffer with depression or bipolar disorder. It can also occur in patients with infections, autoimmune disorders such as lupus, and other types of general medical conditions.
Once they recognize catatonia, doctors can look for and treat any underlying medical cause. They can also provide one of two effective treatments, depending on circumstances. Patients whose movements are rigid or restricted may respond to the antianxiety medication, lorazepam. Those who are agitated, who are suffering delirium, or who don't respond to lorazepam may benefit from electroconvulsive therapy. Both treatments benefit at least 80 percent of patients with catatonia, and some studies suggest the success rate may be even higher.
This means that in many if not most cases, catatonia can be both remembered and gone.
(Michael Craig Miller, M.D., is editor-in-chief of the Harvard Mental Health Letter. He is an Assistant Professor of Psychiatry at Harvard Medical School and an associate physician at Beth Israel Deaconess Medical Center in Boston, Mass.)
For additional consumer health information, please visit www.health.harvard.edu.)