A picture for your mind 🧊
A patient sits completely still. You ask them to stand — no response. You ask their name — no response. You gently lift their arm into an odd position, and they hold it there. That striking sign should make you think: catatonia.
The simple idea
Catatonia is a major disturbance of movement, behaviour, and responsiveness. It can look like either extreme:
- Frozen: silent (mutism), barely responsive (stupor), holding strange postures, keeping a position you place them in (this "bendable and holds" quality is called waxy flexibility).
- Or over‑active: intensely agitated and moving without purpose.
Other signs include repeating your words (echolalia) or copying your movements (echopraxia).
| Two faces of catatonia | What you see |
|---|---|
| Frozen | mutism, stupor, odd postures, waxy flexibility |
| Over‑active | intense, purposeless agitation |
| Either | echolalia (repeats words), echopraxia (copies moves) |
Why it's dangerous 🚨
A person who stays frozen can develop dehydration, poor nutrition, blood clots, infections, and dangerous swings in their body's automatic functions. So catatonia is not just "the patient won't talk" — it can become a medical emergency.
The hopeful part
Catatonia often responds well to a specific calming medicine (a benzodiazepine, usually lorazepam), and to ECT when it's severe. Importantly, it isn't only linked to schizophrenia — it can appear with mood disorders and medical illnesses too.
Quick check ✅
- What does "waxy flexibility" describe?
- Why is a silent, motionless patient a reason for concern, not annoyance?
Remember this 🌟
Where we're going next → We now turn from psychosis to the world of mood — starting with depression (Part 3).