Psychiatry

Name :- Jitendra saini

Group :- 18
Semester:- 9
Campus. :- Central
Topic :- Catastrophic
schizophrenia
 Catastrophic schizophrenia
In psychiatry, catastrophic schizophrenia or schizocaria is an
obsolete term for a rare and acute form of schizophrenia
leading directly to a severe and unremitting chronic
psychosi (the long term occurrence of psychosis) and
deterioration of the personality. Catastrophic schizophrenia
was thought to be the most severe subtype of
schizophrenia, as it had "an acute onset and rapid decline
into a chronic state without remission". Catastrophic
schizophrenia was also referred to as schizocaria, which
was defined by Gerhard Mauz as a psychosis that caused
the absolute destruction of the core of one's being
 Symptoms
Stupor – no psychomotor activity, no interaction with the
environment
Catalepsy – includes adopting unusual postures
Waxy flexibility – if an examiner places the patient’s arm
in a position, they will maintain this position until it is
moved again
Mutism – limited verbal responses
Negativism – little or no response to instructions or
external stimuli
Posturing – actively holding a posture against gravity
Mannerism – carrying out odd, exaggerated actions
Stereotypy – repetitive movements without an apparent reason
Agitation – for no known reason
Grimacing
Echolalia – mimicking another person’s speech
Echopraxia – mimicking another person’s movements.Delusions – The
patient may believe they are being persecuted. Alternatively, they
may think they have extraordinary powers and gifts.
Hallucinations – particularly hearing voices (auditory hallucination),
but hallucinations can include visual (seeing things that aren’t there)
or hallucinations involving any other sensory system.
Thought disorder – when speaking, the person can jump from one
subject to another for no logical reason. The patient’s speech might
be muddled and impossible to understand.
Lack of motivation (avolition) – the patient loses their drive. They give
up on everyday activities, such as washing and cooking.
 Cause
Genetics – individuals with a family history of schizophrenia have .
a higher risk of developing it themselves.
Viral infection – some recent studies suggest that viral infections may
predispose the child to development of schizophrenia.
Fetal malnutrition – if the fetus suffers from malnutrition during
pregnancy, there is a higher risk of developing schizophrenia.
Stress during early life – severe stress early in life may contribute to the
development of schizophrenia. Stressful experiences often occur just
before schizophrenia appears.
Childhood abuse or trauma.
Age of parents at birth – older parents have a higher risk of having
children who develop schizophrenia.
Drugs – the use of drugs that affect the mind during adolescence may
increase the risk of developing schizophrenia.
 Diagnosis
Physical exam – the patient’s height, weight, heart rate, blood
pressure, and temperature are checked. The doctor will listen to the
heart and lungs and check the abdomen.
CBC (complete blood count) – to check for alcohol and drugs, as well
as thyroid function.
MRI or CT scan – the aim is to look for any abnormalities in brain
structure.
EEG (electroencephalogram) – to check for brain function.
Psychological evaluation – a psychiatrist will ask the patient (if
possible) about their thoughts, feelings, and behavior patterns. They
will discuss symptoms, when they started, how severe they are, and
how they affect the patient’s life. They will also ask whether the
patient has thoughts about harming themselves or others.
 Treatment
Medication
Benzodiazepines – this class of drugs act as tranquilizers and are most
commonly used for catatonic schizophrenia. The drug is fast acting
and may be administered intravenously (injected into a vein). There is
a risk of dependency if used for a long time. The patient may have to
take this medication for several days or weeks.
Barbiturates – these drugs are referred to as depressants or
sedatives. They suppress the central nervous system. Their effects
range from mild sedation to total anesthesia. Barbiturates rapidly
relieve the symptoms of catatonia. If used for a long time, there is a
risk of dependency. This drug is used to treat catatonic schizophrenia
less often than barbiturates.
Antidepressants and mood-stabilizing drugs – people with catatonic
schizophrenia often have other mental health problems, such as
depression.
ECT (electroconvulsive therapy) – this is a procedure in which an
electric current is sent through the brain to produce controlled
seizures (convulsions). ECT is used for catatonic patients who have
not responded to medications or other treatments. Side effects can
include short-term memory loss.

Hospitalization – this may be necessary during severe episodes.

Patients are safer in a hospital setting; they are more likely to get
proper nutrition, sleep, and hygiene, as well as the right treatment.

Psychotherapy – for patients with catatonic schizophrenia,

medications are the main part of treatment; however, psychotherapy
can be useful, but if symptoms are severe, psychotherapy may not be
appropriate.
 Complications
Depression, suicidal thoughts, suicidal behavior – a significant
number of patients with schizophrenia have periods of
depression.
Malnutrition.
Hygiene problems.
Substance abuse – which may include alcohol, prescription
medications, and illegal drugs.
Inability to find or maintain employment, resulting in poverty
and homelessness.
Prison.
Serious family conflicts.
Inability to study or attend school and other educational
institutions.
Being a victim or perpetrator of crime.
Smoking-related diseases.