Catatonia: Reduced Movement

Reduced movement in catatonia can range from unusual stillness to stupor, in which the person shows very little spontaneous activity or response to the environment. Someone may remain in one position for a long time or appear unable to initiate movement. This differs from ordinary tiredness, choosing to rest or the slowed movement seen in some other conditions.

Catatonia is a syndrome involving marked changes in movement, speech and responsiveness. It can occur with mood disorders, psychotic disorders and medical or neurological illnesses. It is not simply a severe negative symptom, and the presence of catatonic signs requires careful clinical assessment.

Clinicians look for a cluster of catatonic signs and investigate possible psychiatric, neurological and medical causes. The person’s awareness may not be obvious from their outward behaviour, so respectful communication remains important. Prolonged immobility can lead to pressure injuries, blood clots, muscle problems and difficulties maintaining hydration or nutrition. These risks make prompt assessment essential. Management includes physical care as well as specific treatment for catatonia. It is unsafe to assume that an unresponsive person is merely refusing to cooperate or to treat reduced movement as a routine feature of schizophrenia without further evaluation.

Physical care is a central part of managing marked immobility. Clinicians monitor nutrition, hydration, skin integrity and complications of remaining still, while assessing the cause of the syndrome. The person should continue to receive explanations and respectful contact. Outward unresponsiveness does not reliably reveal the degree of awareness or emotional experience occurring during the episode.

Further reading: Research record 37039129; Research record 40368005.