Catatonia is a medical emergency if severe (especially if the person stops eating or drinking).
See a Psychiatrist and or a Neurologist for more information.
Catatonia isn’t just one single state, it’s a syndrome with several forms that can appear in different psychiatric, neurological, or medical conditions.
Here are the main types of catatonia, based on presentation and underlying features:
1. Retarded (Stuporous) Catatonia
This is the most common type and involves decreased movement and responsiveness.
Key features:
- Mutism (not speaking)
- Stupor (immobile, unresponsive but awake)
- Waxy flexibility (limbs stay in positions placed by others)
- Negativism (resistance to movement or instruction)
- Posturing (holding odd positions for long periods)
- Echolalia or echopraxia (repeating words or movements)
Often seen in major depression, schizophrenia, or medical illnesses (e.g., encephalitis, metabolic disorders).
2. Excited (Agitated) Catatonia
Characterized by excessive, purposeless, or frenzied motor activity.
Key features:
- Hyperactivity or agitation
- Verbigeration (repetition of meaningless words/phrases)
- Impulsivity or combativeness
- Stereotyped movements (repetitive gestures)
- Sudden emotional outbursts
This type can rapidly switch between agitation and stupor and may be seen in mania, psychotic states, or toxic/metabolic conditions.
3. Malignant (Lethal) Catatonia
A life-threatening form with autonomic instability.
Key features:
- Fever
- Delirium or confusion
- Elevated blood pressure, pulse, and respiration
- Rigidity
- Rapid progression to stupor or coma
Closely resembles neuroleptic malignant syndrome (NMS) and requires emergency treatment.
4. Periodic or Recurrent Catatonia
- Episodes of catatonia that recur intermittently over months or years.
- Often linked to mood disorders or genetic susceptibility.
5. Atypical or Mixed Catatonia
- Patients show a combination of retarded and excited features or shift between them.
- Sometimes seen in bipolar disorder or schizoaffective states.
Shervan K Shahhian
LIBERTY PSYCHOLOGICAL ASSOCIATION 