Catatonic Schizophrenia and Addiction
Catatonic Schizophrenia and Addiction
Table of Contents
For individuals with schizophrenia, substance use disorders are common. Studies often link the two, and it’s important to explore the commonalities and possible causes as to why these comorbidities occur. In rare cases, an individual with a substance use disorder can also develop catatonic schizophrenia.
But what exactly is catatonic schizophrenia, and how does it relate to addiction? Read on to explore the symptoms and risk factors of both catatonic schizophrenia and addiction alongside the recommended modalities for treating co-occurring catatonic schizophrenia and addiction.
What is Catatonic Schizophrenia?
Catatonic schizophrenia, a subtype of schizophrenia, is a rare but extremely severe disorder that is typically characterized by unique motor behavior. These behaviors include a significant decrease in voluntary motor movement or an increase in highly erratic bodily movements.
An individual with catatonic schizophrenia may remain in a motionless, rigid state for extended periods ranging from hours to even days.
What is Catatonic Schizophrenia’s Connection to Addiction?
There are parallels between catatonic schizophrenia and addiction, and the two are frequently linked. An estimated 50% of individuals diagnosed with schizophrenia are also reported to have a co-occurring substance use disorder. Why are the two so commonly co-occurring? The link between substance abuse and the development of psychoses has attracted much attention and garnered a great deal of research to determine the possible causes, including potential links through genetic vulnerability, medication side effects, psychosocial factors, and neurobiological factors.1Symptoms of Catatonic Schizophrenia
Stupor - a state similar to unconsciousness characterized by a lack of psychomotor activity and a lack of interaction with the environment.
Catalepsy - a trance seizure state characterized by a rigid body or adopting unusual postures.
Waxy flexibility - a symptom characterized by limbs that stay in whatever position they are placed in by another individual until they are moved again.
Mutism - a lack of any verbal response.
Negativism - a lack of any response to external stimuli.
Posturing - holding a posture or position that goes against gravity.
Mannerism - carrying out odd and exaggerated movements.
Stereotypy - the occurrence of repetitive movements or actions without an apparent reason.
Agitation - the presence of agitation that is not influenced by any external stimuli.
Grimacing - the presence of grimacing or other contorted facial movements.
Echolalia - mimicking or repeating another person’s speech.
Echopraxia - mimicking or repeating another person’s movements.
Symptoms of Addiction
For any kind of addiction, the defining symptom is a problematic pattern of substance use. For individuals with substance use disorders, their addiction is characterized by strong cravings and an inability to stop using the addictive substance.
Symptoms of addiction, however, can range in severity and vary greatly from one person to the next. Symptoms can also vary based on the substance they are using, as well as other factors like family history and personal circumstances. When exploring the common symptoms of addiction, these can include psychological symptoms, social symptoms, and physical symptoms.
Psychological symptoms:
- The inability to stop using the addictive substance.
- Continued substance use even in the presence of health concerns.
- An increase in risk-taking behavior, such as using the substance and driving.
- Utilizing the substance to cope with problems.
Social symptoms:
- Giving up hobbies and activities that were once enjoyable.
- Turning down social gatherings because it will not involve the addictive substance (i.e. turning down an invite to a party or gathering because there will not be alcohol).
- Financial difficulties or changes in financial status without a reason.
- Increased solitude and behavior involving secrecy.
- Legal issues due to impaired judgment or risk-taking behavior, or due to the purchase or use of illicit substances.
Physical symptoms:
- A change in appearance, including a disregard for outward appearance or personal hygiene.
- Marked changes in appetite (can be a decrease or an increase, depending on the addictive substance).
- Sleeplessness and insomnia.
- Increased tolerance for the substance.
- Withdrawal symptoms, including cravings, trembling, seizures, sweating, constipation, and diarrhea.
While these are the symptoms most commonly associated with substance use disorders and addiction, substance abuse can have drastically different effects from one individual to another.
Risk Factors for Catatonic Schizophrenia
While research suggests that catatonic schizophrenia happens due to a dysfunction in the brain, it is not known exactly why this dysfunction occurs. However, there are several risk factors believed to link to the onset of catatonic schizophrenia. These risk factors are the same as with other subtypes of schizophrenia.
The risk factors for catatonic schizophrenia include:
Genetics: Studies show that individuals with a family history of schizophrenia are at higher risk for developing the disorder.
Drug use: Certain drugs that affect the brain during adolescence are suggested to be linked to the onset of schizophrenia.
Parental age at birth: The children of individuals who gave birth at an older age are at a higher risk of developing schizophrenia.
Stress or trauma in childhood: Stress during early life, such as childhood abuse or other childhood trauma, can contribute to the development of childhood schizophrenia.
Fetal malnutrition: The risk for developing schizophrenia increases for individuals who suffered from malnutrition in the womb.
Viral infections: Certain viral infections are linked to instances of childhood schizophrenia.
Risk Factors for Addiction
- Genetics: The connection between genetics and addiction is heavily studied. According to the National Institute on Drug Abuse, research suggests that as much as half of a person’s risk of becoming addicted to substances like alcohol, nicotine, or other drugs, is due to their genetic makeup.3
- Environment: In early life, environmental factors such as a lack of parental involvement or abuse can increase the risk of addiction. Adverse environments lead to a higher likelihood of risk-taking behaviors and experimentation with drugs and alcohol.
- An early use: Using drugs or alcohol earlier on in life can increase the risk of addiction.
- Dual diagnoses and existing dependencies: Individuals with a mental health disorder are at a higher risk of developing a substance use disorder. Additionally, those with alcohol addiction are at a significantly higher risk of developing a drug use disorder and vice-versa.4
Diagnosing Catatonic Schizophrenia
EEG (electroencephalogram)
MRI (magnetic resonance imaging) scan
CT (computed tomography) scan
physical examination
psychiatric examination
Treating Catatonic Schizophrenia During Addiction Treatment
Due to the high likelihood of dual diagnoses, catatonic schizophrenia and addiction are often treated as comorbidities. Having schizophrenia puts individuals at a higher risk of drug and alcohol abuse. However, with the proper diagnosis and treatments, it is possible for those dealing with one or both disorders to receive treatment and lead healthier lives.
Dual Diagnosis
A dual diagnosis of schizophrenia, including catatonic schizophrenia, is common. Studies show that an individual with schizophrenia is over four times more likely to be diagnosed with a substance use disorder than individuals without it.5 This factor is why it’s paramount to treat both disorders together; treating one without the other is more likely to lead to relapses in substance use or less effective mental health treatment recovery.
Treatments
Treatments for drug and alcohol abuse and addiction, including co-occurring schizophrenia, typically begin with a detox period. Detox involves going through a period of withdrawal in which the individual can be properly and safely treated for any withdrawal symptoms.
Once the detox period is complete, treatments can include cognitive behavioral therapy, along with possible family therapy, medication management, and other work to learn skills like substance refusal techniques and daily life skills to live a healthier day-to-day life.
Therapies
There are several effective therapy options for someone struggling with a dual diagnosis of catatonic schizophrenia and addiction. Through effective therapy and treatment by professionals in the medical, mental health, and addiction treatment spaces, it is possible to treat and manage these co-occurring disorders.
Therapies can include the following:
- Cognitive behavioral therapy
- Individual therapy
- Group therapy
- Family therapy
- Inpatient or outpatient substance abuse therapy
- EMDR therapy
