The predominant clinical features seen in the catatonic subtype of schizophrenia involve disturbances in a person’s movement. Affected people may exhibit a dramatic reduction in activity, to the point that voluntary movement stops, as in catatonic stupor. Alternatively, activity can dramatically increase, a state known as catatonic excitement.

Other disturbances of movement can be present with this subtype. Actions that appear relatively purposeless but are repetitively performed, also known as stereotypic behavior, may occur, often to the exclusion of involvement in any productive activity.

Some people get stuck in a body like it’s suddenly leased to a universe that forgot to pay the rent. They resist being moved, holding a pose exactly as someone else sets it, sometimes for what feels like forever. Psychiatrists call it waxy flexibility, but the name doesn’t capture the weird tension in it: these bodies can push back with surprising strength, all while looking awkward, uncomfortable, almost statuesque in their defiance. It’s a kind of stubbornness that isn’t willful, exactly—it’s more like physics meeting psychology in a room with no exit.

And it doesn’t stop at posture. Limbs twist into angles that make you blink twice, faces contort like they’re auditioning for some silent, bizarre theater. Observers might mistake the display for tardive dyskinesia, another disorder with twitchy, repetitive movements—but the vibe here is different. This isn’t random; it’s deliberate in its own alien rhythm, a choreography that seems to obey rules we don’t yet understand.

Then there’s the echo: words and gestures bouncing back like thrown stones. Echolalia, repeating someone else’s speech like a parrot possessed, or echopraxia, mimicking movements with eerie precision. Seen in Tourette’s too, sure, but in catatonia, it has a different edge—less comic, more unsettling, like the body itself is a conduit for some other logic. Immobility, mimicry, contorted postures—all stitched together in a human form that feels almost like a living mirror of chaos, and yet, stubbornly, unyielding.

How Is Catatonic Schizophrenic Diagnosed?

The general criteria for a diagnosis of schizophrenia must be satisfied. Temporary and isolated catatonic symptoms may occur in the context of any other subtype of schizophrenia, but for a diagnosis of catatonic schizophrenia one or more of the following behaviors should dominate the clinical picture: a. stupor (marked decrease in reactivity to the environment and in spontaneous movements and activity) or mutism;

b. excitement (apparently purposeless motor activity, not influenced by external stimuli);

c. posturing (voluntary assumption and maintenance of inappropriate or bizarre postures);

d. negativism (an apparently motiveless resistance to all instructions or attempts to be moved, or movement in the opposite direction); e. rigidity (maintenance of a rigid posture against efforts to be moved); f. waxy flexibility (maintenance of limbs and body in externally imposed positions)

Interviewer: “What’s wrong with you?”

Patient: “I tell the truth”

 

Ref: psychcentral.com