Schizophrenia is one of the topics related to psychology that most attracts attention to the general public. Maybe it's because of some kind of halo of mysticism that has been created around it. Undoubtedly, it is a subject that raises curiosity. In this case, we will go into a specific type of schizophrenia, the catatonic type schizophrenia.
Throughout the article, we will discuss what schizophrenia is about to create a contextual framework. Subsequently, the characteristics of catatonic schizophrenia and differential etiological diagnosis will be fully entered. Finally, the treatment will be exposed. In this way, there will be a tour of this type of pathology that, without a doubt, leaves no one indifferent.
- 1 Schizophrenia
- 2 Catatonic Schizophrenia
- 3 Differential etiological diagnosis
- 4 Treatment
- 5 Conclusion
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), schizophrenia is characterized by at least two of the following symptoms during the minimum period of one month:
- Delusional ideas.
- Talk disorganized.
- Very disorganized or catatonic behavior.
- Negative symptoms such as flat effect, praise or abulia.
On the other hand, these symptoms must influence and alter the socio-labor functioning of the individual. That is, it must interfere with your social, work, family relationships, preventing you from leading a normal life. The above symptoms must be present for at least six months.
"Schizophrenia has its paradises, in the same way as its hells and its purgatories."
The exclusion of the diagnosis of schizoaffective disorder and affective disorder should be taken into account. Secondary alterations due to the use of substances or medical conditions should also be excluded. If there is autism and another developmental disorder in history, an additional diagnosis of schizophrenia is only made if delusions or hallucinations are present for at least one month.
Schizophrenia Catatonic Type
Catatonic type schizophrenia is a subtype of schizophrenia. In this case, two characteristic reactions similar to those observed in bipolar disorders are manifested. In fact, some authors believe that both disorders could be equivalent. Features are alternate periods of stupor and catatonic agitation..
The state of catatonic stupor is that the individual remains completely apathetic and immobile. This state extends to primary behaviors such as food, grooming, etc. It can also include absolute mutism and motor immobility, that is, staying in the same position for hours.
On the other hand, the state of catatonic agitation is that the individual has a very increased motor and verbal activity. Sometimes it can be quite aggressive and destructive. Negativism is also observed, consisting of active or passive resistance to all kinds of instructions given.
This negativism can come in two forms. On one side, the person can refuse to do what he has been told, and on the other, he does just the opposite. When the subject is paralyzed, it can be accompanied by waxy flexibility. You can remain in the same posture for hours. Only between 20 and 30% of patients show catalepsy. No intellectual impairment is detected. The onset of a catatonic reaction happens much faster than other types of schizophrenia.
Differential etiological diagnosis
Catatonia can not only occur in schizophrenia, so it is so important to know the etiology of it to be able to treat it properly. According to the team of Nora Orazabal (2010) in her article "Catatonia: about a case", catatonia can occur due to the following factors:
- Psychiatric disorders: bipolar affective disorder (manic or mixed episodes), major depression, paranoid schizophrenia and catatonic schizophrenia.
- Drugs and toxic: Deprivation (BZD, l-dopa and gabapentin) and overdose (LSD, cocaine, amphetamine, disulfiram, levetiracetam).
- Neurological disorders: Epilepsy, stroke, multiple sclerosis, encephalitis.
- Medical disorders: endocrine pathology, infections, electrolyte abnormalities, paraneoplastic syndrome.
As the Orazabal team affirms "The patient's clinical condition usually hinders the correct history and the syndrome may be due to several causes that act concomitantly". In addition, they talk about the importance of the patient's psychiatric history, noting that "it is very useful to establish an etiological hypothesis of the picture ".
The treatment is, above all, pharmacological. As Germán Abeleira (2012) states in his article "Schizophrenia", it is convenient to consider the starting hypothesis before choosing the drug. In the case of schizophrenia, according to Abeleira, "It is played with the dopaminergic hypothesis, which says that schizophrenic subjects have an above-normal dopaminergic activity, which is thought to be the cause of the onset of schizophrenia".
Abeleira speaks that "first generation" treatments such as chlorpromazine provided good results, however, the side effects were very numerous. For this reason, "second generation" antipsychotics such as clozapine appeared. Its objective was, among other things, to reduce the extrapyramidal effects of the first medications. Even so, it is still evolving with this type of drugs.
"Modern science has not yet produced a tranquilizer as effective as a few kind words."
As Abeleira points out, due to continuous research to improve treatments, "third generation" are appearing in this way, which generally focus more on regulating the capacity of neurotransmitters and thereby modulate the impact they have on neuronal receptors. "
In this way, it is observed that the treatment for catatonic type schizophrenia is still in full swing. Despite the great advances in science, the human brain is still a great mystery. Little by little, we are approaching increasingly effective treatments, but without a doubt, it is essential to know exactly the mechanisms that produce each pathology in order to be treated as successfully as possible.
It is therefore essential to support scientific research, so that, in this way, all those who suffer from any type of disease, have the best remedies. In fact, human brain research has been carried out in scientific laboratories for just over a hundred years. Therefore, little by little and with patience, and with increasingly modern material, they will end up finding better treatments for the best quality of life of people.
- Abeleira, G. (2012). Schizophrenia. Notebooks of Tomás, 4, 151-172.
- American Psychiatric Association (2013).DSM-V Diagnostic and statistical manual of mental disorders. Pan American Medical Editorial.
- Crespo, M. and Pérez, V. (2005). Catatonia: a neuropsychiatric syndrome. Colombian Journal of Psychiatry, 34, (2), 251-266.
- Olazabal, N., Bustamante, S., Solano, G., Radmani, R., Erkoreka, L. and González-Torres M. (2011). Catatonia: about a case. Journal of the Spanish Association of Neuropsychiatry, 31, (109), 111-119.
- Depression test
- Goldberg depression test
- Self-knowledge test
- how do others see you?
- Sensitivity test (PAS)
- Character test