North Carolina Neurological Foundation (NCNF)

Catatonia Associated With Another Mental Disorder

Catatonia associated with another mental disorder is characterized by a cluster of psychomotor disturbances, including stupor, mutism, posturing, negativism, and stereotyped movements, occurring in the context of an underlying psychiatric condition such as mood disorders or schizophrenia. Etiology involves dysregulation of GABAergic, dopaminergic, and glutamatergic neurotransmission, as well as structural and functional abnormalities in frontal-subcortical circuits. Clinically, patients present with marked motor immobility or excessive purposeless activity, echolalia, echopraxia, or extreme negativism, often causing significant functional impairment. Diagnosis requires careful psychiatric evaluation, exclusion of medical causes, and recognition of catatonic features using standardized rating scales. Management includes benzodiazepines (primarily lorazepam), electroconvulsive therapy for severe or refractory cases, and treatment of the underlying psychiatric disorder. Prognosis depends on rapid recognition and treatment, with outcomes generally favorable when intervention is timely.