obsolete catatonic type schizophrenia chronic state

Catatonic Schizophrenia: An Obsolete Diagnosis

Catatonic schizophrenia was a subtype of schizophrenia that was once recognized as a distinct diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM). However, it is no longer considered a standalone condition due to emerging research and updates to psychiatric classifications.

Characteristics of Catatonic Schizophrenia

Individuals with catatonic schizophrenia exhibited unusual physical movements, such as rigidity, repetitive behaviors, or erratic movements. They may also experience an inability to move or speak, and in some cases, appear unresponsive or comatose-like. These symptoms were often associated with a broader spectrum of mental health conditions, including mood disorders, autism, and other psychiatric illnesses.

Reclassification and Current Understanding

The American Psychiatric Association (APA) removed catatonic schizophrenia from its list of official diagnoses when updating to the fifth edition of the DSM in 2013. The World Health Organization (WHO) followed suit by removing "catatonic schizophrenia" from the International Classification of Diseases (ICD-11) in 2019.

Today, catatonia is recognized as a symptom that can occur across various mental health conditions, rather than a standalone diagnosis. Research has shown that catatonic symptoms are more frequently associated with mood disorders and other psychiatric conditions than with schizophrenia itself.

Key Points

• Catatonic schizophrenia was once considered a subtype of schizophrenia but is no longer an officially recognized diagnosis.
• Catatonia can occur across various mental health conditions, including mood disorders, autism, and other psychiatric illnesses.
• Individuals with catatonic symptoms may exhibit unusual physical movements, such as rigidity or repetitive behaviors.

References:

[1] The American Psychiatric Association removed catatonic schizophrenia from its list of official diagnoses when updating to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2013. [2] The World Health Organization (WHO) removed “catatonic schizophrenia” from the International Classification of Diseases (ICD-11) in 2019. [3] Emerging research has convinced modern psychiatry to reconsider catatonia as a symptom of schizophrenia rather than a standalone condition. [4] Catatonic symptoms can occur across various mental health conditions, including mood disorders, autism, and other psychiatric illnesses. [5]

Catatonic Schizophrenia: A Review of Signs and Symptoms

Catatonic schizophrenia, although no longer an officially recognized diagnosis, can still manifest in individuals with schizophrenia as well as other mental health conditions. The signs and symptoms of this subtype are varied and can be broadly classified into two categories: hypokinetic (withdrawn) and hyperkinetic.

Hypokinetic Symptoms

• Inability to move or speak
• Withdrawal from social interactions and activities
• Reduced motor activity, such as decreased movement or rigidity

These symptoms are often associated with a withdrawn state, where the individual may appear catatonic or unresponsive. [1][2]

Hyperkinetic Symptoms

• Erratic or excessive physical movement
• Automatic movements, such as repetitive gestures or postures
• Bizarre postures or mannerisms

In contrast to hypokinetic symptoms, hyperkinetic symptoms are characterized by an increase in motor activity, often accompanied by bizarre or automatic movements. [3][4]

Other Symptoms

• Stereotypies: repetitive and unchanging patterns of behavior or movement
• Mannerisms: unusual or exaggerated physical movements
• Bizarre postures: unusual or awkward positions of the body

These symptoms can occur in individuals with schizophrenia, bipolar disorder, or other mental illnesses. [5][6]

Important Note

It's essential to note that catatonic schizophrenia is no longer an officially recognized diagnosis and has been removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-11). However, symptoms of catatonia can still occur in individuals with these conditions. [7][8]

References:

[1] Catatonic schizophrenia is no longer an officially recognized diagnosis, but catatonic behavior can still occur in schizophrenia as well as in other mental health conditions. Signs of catatonia often include an inability to move or speak.

[2] Once thought to be a subtype of schizophrenia, catatonia is now recognized to occur with a broad spectrum of medical and psychiatric illnesses, particularly ...

[3] Undifferentiated schizophrenia is a subtype of schizophrenia. Symptoms may include signs of psychosis, such as delusions and hallucinations, or drastic changes in behavior.

[4] Catatonic schizophrenia refers to a subtype of schizophrenia characterized by stereotypies, mannerisms, automatic movements, and bizarre postures.

[5] If you're experiencing symptoms of catatonia alongside schizophrenia, bipolar disorder, or any other mental illness, we can carry out tests to evaluate your ...

[6] Catatonia is a complex syndrome, most commonly seen in people with underlying mood (eg major depressive disorder) or psychotic disorders (eg schizophrenia).

[7] The American Psychiatric Association removed catatonic schizophrenia from its list of official diagnoses when updating to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (), published in 2013.

[8] The World Health Organization (WHO) removed “catatonic schizophrenia” from the International Classification of Diseases when updating to the 11th edition (ICD-11) in 2019.

Diagnostic Tests for Catatonic Schizophrenia (Obsolete Type)

Catatonic schizophrenia, a subtype of schizophrenia that is no longer recognized as a distinct diagnosis, can be challenging to diagnose accurately. However, various tests and assessments can help identify the condition.

• Lab tests: Blood tests, urine tests, and cerebrospinal fluid tests may be conducted to rule out other conditions and find chemicals in the system that could indicate schizophrenia [10].
• Imaging scans: MRI scans, CT scans, and PET scans may provide a good view of the brain structure and help identify any abnormalities [8][9].
• EEG/MEG: Electroencephalogram (EEG) or magnetoencephalogram (MEG) tests can measure electrical activity in the brain, which may be abnormal in individuals with schizophrenia [7].
• Complete blood count (CBC): A CBC test measures various components of the blood, such as red and white blood cell counts, to rule out other conditions [9].
• Comprehensive metabolic panel (CMP): A CMP test evaluates various bodily functions, including electrolyte levels, kidney function, and liver function [9].

It's essential to note that these tests are not specific to catatonic schizophrenia and can be used to diagnose other conditions as well. A medical doctor must interpret the results in conjunction with clinical experience and assessment techniques to make an accurate diagnosis.

References:

[7] by SA Rasmussen · 2016 · Cited by 319 — Laboratory investigations should include a complete blood count, blood urea nitrogen, creatinine, muscle and hepatic enzymes, thyroid function tests, ...

[8] An MRI scan—in which magnetic fields and sound waves are used to create two- or three-dimensional images—may provide a good view of the structure of the brain ...

[9] May 4, 2023 — Complete blood count (CBC) · Comprehensive metabolic panel (CMP) · Urine and drug screening tests · Brain MRI · Brain CT · PET Scan · EEG/MEG.

[10] Blood tests for schizophrenia. There is no blood test that can diagnose schizophrenia. But blood tests, along with urine tests and cerebrospinal fluid test, can find chemicals in your system that ...

Based on the provided context, it appears that catatonic schizophrenia has been removed from official diagnoses in both the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the World Health Organization's International Classification of Diseases (ICD-11).

Regarding drug treatment for this condition, there is limited information available. However, some studies suggest that benzodiazepines are ineffective in treating chronic catatonic schizophrenia [1]. On the other hand, a combination of electroconvulsive therapy (ECT) and clozapine has been found to be effective in some patients with chronic catatonia in schizophrenia [2].

Clozapine is another option that may be available for patients with schizophrenia who experience catatonia [3]. However, it's essential to note that the treatment guidelines for catatonic schizophrenia are not separate from those for other forms of schizophrenia.

Here are some key points regarding drug treatment for obsolete catatonic type schizophrenia:

• Benzodiazepines are ineffective in treating chronic catatonic schizophrenia [1].
• A combination of ECT and clozapine may be effective in some patients with chronic catatonia in schizophrenia [2].
• Clozapine is another option that may be available for patients with schizophrenia who experience catatonia [3].

References:

[1] Beckmann et al. (2014) - found benzodiazepines ineffective in treating chronic catatonic schizophrenia. [2] Sienaert et al. (2014) - found a combination of ECT and clozapine effective in some patients with chronic catatonia in schizophrenia. [3] Edinoff et al. (2021) - mentioned clozapine as an option for patients with schizophrenia who experience catatonia.

Please note that these references are based on the provided context, which includes search results from various sources. The information may not be comprehensive or up-to-date, and it's essential to consult a medical professional for accurate and personalized advice.

Based on the provided context, it appears that catatonic schizophrenia was previously considered a subtype of schizophrenia with a chronic state. However, this diagnosis is no longer officially recognized.

Possible Differential Diagnoses:

• Catatonia: A syndrome characterized by immobility, mutism, and rigidity, which can occur in various medical and psychiatric conditions (Rasmussen, 2016) [12].
• Malignant Catatonia: A toxic response that occurs in a dose-related fashion, often associated with antipsychotic medication use (Edinoff, 2021) [13].
• Periodic Catatonia: A rare heritable subtype of catatonic schizophrenia with a chronic degenerating course (Edinoff, 2021) [13].
• NMS (Neuroleptic Malignant Syndrome): An idiosyncratic reaction to antipsychotic medication, characterized by fever, muscle rigidity, and altered mental status (Edinoff, 2021) [13].

Other Considerations:

• Pulmonary Embolism: A medical condition that can present with atypical symptoms in elderly patients, including those with schizophrenia (Hu, 2013) [11].
• Viral Encephalitis: An infection of the brain that can cause catatonic-like symptoms, such as mutism and rigidity (Rasmussen, 2016) [12].

Key Points:

• Catatonic schizophrenia is no longer an officially recognized diagnosis.
• Catatonia can occur in various medical and psychiatric conditions.
• Differential diagnoses for a chronic state with catatonic features should consider the above options.

References:

[11] Hu, H. C. (2013). Delayed diagnosis of pulmonary embolism with atypical presentation in an elderly schizophrenia male patient. [Context result 11]

[12] Rasmussen, S. A. (2016). Catatonia: a syndrome of immobility and mutism. [Context result 12]

[13] Edinoff, A. N. (2021). Catatonia in psychiatric and medical conditions. [Context result 13]