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MindOfOrderedChaos
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21 Jan 2006, 8:22 am

Can people who know about this condition tell me some more about it. i have read some information on the internet. About it but I don't find the information very clear.

http://www.healthatoz.com/healthatoz/At ... atonia.jsp

I am wondering weither I am being a hypercondriatc or not.


Im really not sure what it is at all and not sure how close if at all i fit into it. Im just wanting some more knowledge about it. Plus if I did have it and got dignosed would my licence be taken off me? And are there really any effective treatments or is it better to just live with life the way I am?

As I said before im not sure about this at all. Probably don't fit into it but just incase im asking.



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21 Jan 2006, 9:54 am

I read that catatonia is fairly common in autism and AS.

I read a small research project that said that autism, AS, OCD and catatonic schizophrenia are caused by the same underlying biological cause. And that catatonic schizophrenia is not related to schizophrenia.

If you exhibit features of catatonic features, it does not mean you have schizophrenia. Schizophrenia is an old "dumping ground" for odd mental disorders. Remember, Autism used to be called childhood schizophrenia.

Here is the paper:
Bejerot S, Nylander L., Low prevalence of smoking in patients with autism spectrum disorders. Psychiatry Res. 2003 Jul 15;119(1-2):177-82.

Psychiatric patients are significantly more often smokers than the general population, the only known exception being obsessive-compulsive disorder (OCD) and catatonic schizophrenia. We have investigated nicotine use in subjects with autism spectrum disorders (ASD).

Ninety-five subjects (25 females and 70 males) consecutively diagnosed with any ASD and of normal intelligence were included in the study. Only 12.6% were smokers, compared with 19% in the general population and 47% in a control group of 161 outpatients diagnosed with schizophrenia or a schizophreniform disorder.

The results suggest that smoking is rare among subjects with ASD, while the opposite was shown for schizophrenia. If replicated, this finding could suggest biological differences between non-catatonic schizophrenia and ASD, and support the theory of a biological link between ASD and a subtype of OCD, and between ASD and catatonic schizophrenia.



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21 Jan 2006, 3:34 pm

I'd like to mention that a correlation of cigarette smoking might only be coincidental between Catatonic Schizophrenia and ASDs. If someone were continually catatonic or in a state of frenzied mania, it would indeed be very hard to smoke a cigarette. As for ASDs, many of us with our Sensory Processing Disorder are more sensitive to cigarette smoke (though not all) and might be less likely to ever pick up a cigarette or to even bear being around smoking individuals.

I'm not saying catatonia doesn't occur in ASDs. I've read that it does. But there are Catatonic Schizophrenic individuals who exhibit psychotic symptoms as well beyond their grossly disorganized behavior. The only reason the group of Schizophrenias are still "grouped" is because nobody's been able to sort them out-- not that they haven't tried. The labels aren't very clean nor even succinct for an individual over their lifetime. And it still remains that, despite the label, many Schizophrenics of all ranges share symptoms and can even change in their symptom picture over their life to a completely different type of Schizophrenia.

Catatonia:
Mainly, catatonia can be widely defined as a motor disturbance either causing hypo- or hyper-activity. But don't confuse it with Bipolar manias and depressive episodes. A classic example of hypoactivity would be the statue-like figure of a Schizophrenic who remains in a set position, sometimes even for hours. The individual may even show a certain waxy flexibility where an onlooker can reposition them into another position. Hyperactivity is the complete opposite where the individual cannot sit still, constantly moving, often gross motor movements are seen.

I'm not saying you don't have catatonia, Mind. If you suspect it, it can't hurt to have it checked out. First you might want to study yourself whenever these episodes occur. If you mind is moving equally as fast or as slow, that might be more indicative of a mood disorder rather than catatonia. But nevertheless, it's always good to err on the safe side and get it checked out.

As for treatments, I'm not too up to date on that but I would suspect they treat you with an antipsychotic if anything. Though, other than sedating the person, I don't know how effective antipsychotics are on catatonia. My guess is not very effective at all.

But do keep in mind that if you bring it up to a professional, the classic stereotype of a Catatonic Schizophrenic is probably going to be foremost on their minds and the fact that you are aware enough to bring up the subject might make them less likely to believe you because it shows you having a good amount of awareness of yourself-- or they might be inclined also to think, as you suggested, that you're a bit of a hypochondriac whose read the DSM online a little too much.

I think what might be your best bet is to seek out someone who has experience with catatonia specifically in the Autistic Spectrum. Hope that helps a little, Mind. It's hard to describe catatonia accurately enough with seeing a good example of it in action.

A movie example which might be a little helpful is Awakenings. Robert Deniro plays a patient, Leonard, who experienced-- along with many other people of his day-- encephalitis which caused brain damage and put many into a sort of "sleeping sickness". The encephalitis was the cause of the patients' catatonia. Robin Williams plays the doctor (Oliver Sacks' character) and tries giving them large doses of L-Dopa which was just then starting to be used for Parkinson's patients. It worked to some extent but eventually the patients begin experiencing many side effects. Deniro does a good example of a hypoactive catatonic before the medication as well as a good example of mild catatonic hyperactivity later in the movie (you'll have to ignore the motor tics he displays in the movie though-- which aren't really part of catatonia-- so just picture catatonic mild frenzy without the tics). I think that's about the best example I can come up with. Statues. And the later heightened activity, aggressiveness. Deniro even showed paranoia, though not every case exhibits as paranoid. And of course he more closely resembled hyperactive catatonia in Schizophrenia with that paranoid component.


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Last edited by Sophist on 22 Jan 2006, 10:38 am, edited 1 time in total.

MindOfOrderedChaos
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21 Jan 2006, 10:05 pm

Thanks for the help. I don't think I have it. Just being a hypercondricatic :lol:



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22 Jan 2006, 10:40 am

Mind, can you explain why you suspected you might have catatonia? You are probably experiencing something, only it might have a different cause/label to it.


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anbuend
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23 Jan 2006, 12:22 pm

A link on the subject:

http://bjp.rcpsych.org/cgi/content/full/176/4/357

Catatonia is not just "sitting still". It's a complex set of motor things, the criteria for which overlap very much with the criteria for autism. The above link is about autistic people who seem to have gotten more that way with time. But most autistic people would meet the criteria for catatonia.

As one thing notes:

Quote:
Family members can confirm the presence of typical primary features of catatonia including immobility, stupor, posturing, rigidity, staring, grimacing, and withdrawal. A history of behavioral responses to others usually includes the presence of mutism, negativism, echopraxia, echolalia, waxy flexibility, and withdrawal. A history of stereotypies, mannerisms, and verbigeration is often elicited from people who are close to the patient.

The alternative presentation of catatonia is an excited state possibly with impulsivity, combativeness, and autonomic instability. While a history of an excited state should be sought from the family of a person with catatonia, it is often denied by the family. When present, excited episodes are short-lived and may precipitate collapse with exhaustion.


As someone officially diagnosed with catatonia, though, I have to mention that "stupor" is not a good word for the state of immobility, since it's possible to be completely immobilized and unresponsive yet perfectly functional cognitively and perceptually. That's not always the case, but it's indistinguishable from the outside which one is which.


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23 Jan 2006, 10:38 pm

anbuend, wherein lies the line between typical autty behavior and that which delves into "catatonia"? I, myself, have staring episodes (many times these are "lost in thought" episodes or if there is a lack of thought then I am usually cognitively worn out or tired) for long stretches of time. I have stims and occasional rigid posturing particularly of the hands which is usually triggered by anxiety.

Since you are so personally familiar with catatonia, yourself, where does that line lie, if anywhere?


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anbuend
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23 Jan 2006, 10:55 pm

I don't think the line does lie anywhere.

Catatonia is a set of traits related to observed body movements and lack thereof, observed at one point in time, and attributed to a number of different hypothesized internal traits (emotions, sensory perception, sense of time, ability to think, etc) over time. That seem to usually cluster together.

Autism is a set of traits, observed at a totally different point in time, by a totally different set of people. That seem to usually cluster together.

There's considerable overlap between the two "things". Obviously if you've got someone who developed traits of catatonia only after a certain age, they're not going to be classified as autistic, because autism is defined as happening before a certain age. Most autistic people are probably going to have catatonic traits (just as most people with certain forms of encephalitis are probably going to have catatonic traits, but those forms of encephalitis are not identical to "catatonia").

So I wouldn't say there's a hard and fast line, because they're descriptions that overlap in some areas and don't in others.


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24 Jan 2006, 11:37 pm

So, essentially mild catatonia is part and parcel of the Autistic Spectrum with no needs of separating the two, kind of like... Obsessive-Compulsive Personality Disorder could technically be diagnosed but it's one piece of the larger disorder known as "Autism", so it isn't?

And then "catatonia" is only diagnosed in an autistic individual such as yourself if it's extreme enough to become unusual and problematic even for an autistic person?

Is this Autistic Catatonia different in nature to Schizophrenic Catatonia-- or is it only different in nature because Schizophrenics tend to show it more to its extreme when they do present? (I have only seen a few Schizophrenics present with Catatonic symptoms and these were always the milder types so I don't have a large range of personal experience with it.) Or does Schizophrenia often present with mild catatonic symptoms, like Autism, but it-- like Autism-- is only considered "catatonia" if the case is extreme enough to be abnormal amongst "noncatatonic" Schizophrenics?


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anbuend
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25 Jan 2006, 12:23 pm

I don't believe in schizophrenia as a meaningful concept, so you're asking the wrong person there.

But....

Note that the diagnosis of childhood schizophrenia has gone far down with time since it was invented. That's largely because autism (the kind we talk about on this board, not Bleuler's definition of it) was removed from the category of schizophrenia (despite the fact that, without the criteria excluding autism, most autistics would meet criteria for one form of schizophrenia or another).

Note that the diagnosis of catatonic schizophrenia has gone far down with time since it was invented. That's partly because of autism, I'm sure, and also partly because lots of the genuine causes for catatonia have been unearthed. (Remember that the whole notion of schizophrenia all being one thing is because Bleuler et al. thought that it was a specific mental process underlying all the different "types", not because Bleuler knew that, because he didn't, because he was wrong.)

All that catatonic schizophrenia necessarily means is "idiopathic adult-onset catatonia". Anyone who has catatonia for no other known reason can get thrown into that category, and once you're thrown into the category of schizophrenia, it's easy enough to come up with other "symptoms" of schizophrenia even if in someone else they'd be considered normal (because this isn't science, that they practice here). You can -- if you notice by looking at the criteria -- be diagnosed with catatonic schizophrenia in the absence of hallucinations or delusions (this is one reason they have to be so explicit about excluding autism, because then most autistics would have childhood schizophrenia diagnoses).

It's being discovered that, for instance, people with a diagnosis of catatonic schizophrenia don't react at all the same to certain drugs the way that people with diagnoses of other kinds of schizophrenia do. For that matter, neuroleptic drugs (the ones used to "treat" "schizophrenia" these days) can cause catatonia on their own. So everything's gotten very muddled and few people are willing to acknowledge how muddled all their definitions are.

The reason that I have the additional diagnosis of catatonia is because that aspect of things has gotten more prominent with time and because it's useful when getting certain kinds of assistance, and for that matter when explaining why neuroleptics are so dangerous to me (they're dangerous to most people with catatonia, which is being reluctantly discovered these days). If this aspect of autism had been this obvious and stable from my early childhood, I wouldn't have an additional diagnosis of catatonia, I'd have just been regarded as "lower functioning" than I was regarded as in early childhood. (As it is, I've just had to contend with "regression" being used to describe me a lot more often than I'm comfortable with.)

And of course catatonia is just an outward description of the motor actions, I think there's (in my case) a perceptual aspect and that "weird sense of time" aspect as well. I've seen one guy who was diagnosed with schizophrenia (following a belief that he'd turned into a molecule he was, as a scientist, studying, or something like that) who described his own "catatonia" as being too terrified to move, which doesn't generally factor into mine. I have heard of depression causing "catatonia" and I have heard of many different neurological diseases causing "catatonia". My suspicion is that "catatonia" is just a word for what happens when movement is only happening (if at all) in a certain specific set of ways, which can result from any of a number of things depending on what (if anything) is "blocking" more typical movement (and in some people, more typical movement may just not be there in the first place).

And yes, in autistic people catatonia is generally only diagnosed in people who are experiencing more of that than before, although the reasons for that may range from drugs we are given to increased overload with time to unnecessary levels of pressure to all kinds of other things. Because otherwise it's just, yeah, like diagnosing "schizoid personality disorder" in an autistic person, not something that would make a lot of sense unless there was a change to warrant it or a certain way things need to be coded.

In my case, the diagnosis means that I have a wheelchair to reduce the necessary amount of movement to get around, which in turn means I freeze less, but when I do freeze people don't need to pry me off whatever surface I'm on to move me. Also means access to services as "autistic with associated movement disorder" that are allocated in a weird split way by the agencies in my town (one agency does "developmental", another does "physical", and autism is considered "developmental" and catatonia is considered "physical" and they each do different aspects of assistance so I need to be split up like that I guess), despite the fact that I don't really split myself into "autism" and "catatonia" and so forth in such an artificial way.


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25 Jan 2006, 11:02 pm

Yeah, I was thinking about how a lot of disruption in various mood disorders could also be considered catatonic... Really, come to think of it, the whole label is just as broad as you say as are the Schizophrenias. It's losing it's practicality as a generalization.

Psychiatry knows so little. I hope eventually this changes (for the better).


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anbuend
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26 Jan 2006, 10:02 pm

Actually, I suspect that the things called "catatonia" are not all that broad in what the manifestation is. They're more broad in terms of causes. To use a medical analogy, fever exists, and is defined pretty definitely, but it has many causes. I think catatonia is kind of like that.

The problem I see with the schizophrenias on the other hand is that they are many things with many seemingly unrelated causes, rather than one obvious thing with many possible causes or many manifestations with one general cause. ("Many manifestations with one general cause" is what Bleuler was aiming at but I don't believe him.)


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