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.1

Symptoms of Catatonic Schizophrenia

Thanks to improved treatments, catatonic schizophrenia is much less common. The symptoms, however, are still severe. Catatonic schizophrenia symptoms include:

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:

Social symptoms:

Physical symptoms:

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.

Some research suggests that catatonic schizophrenia is linked to imbalances in the brain, particularly dopamine and serotonin.2

Risk Factors for Addiction

While risk factors can vary from one person to another, some common risk factors identified with addiction include:

Diagnosing Catatonic Schizophrenia

The diagnosis of catatonic schizophrenia can only be made by a medical doctor. To diagnose catatonic schizophrenia, the following schizophrenia tests and scans may be performed:

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 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.


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



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