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Tests and diagnosis
By Mayo Clinic staffIf your doctor or mental health provider believes you may have catatonic schizophrenia or another mental illness, he or she typically runs a series of medical and psychological tests and exams. These can help pinpoint a diagnosis, rule out other problems that could be causing your symptoms and check for any related complications.
These exams and tests generally include:
- Physical exam. This may include measuring height and weight, checking vital signs, such as heart rate, blood pressure and temperature, listening to your heart and lungs, and examining your abdomen.
- Laboratory tests. These may include a complete blood count (CBC), screening for alcohol and drugs, and a check of your thyroid function.
- Psychological evaluation. A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns, if this is possible. He or she will ask about your symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar episodes in the past. You'll also discuss any thoughts you may have of suicide, self-harm or harming others. Your doctor may also want to talk to family or friends, if possible. If you're unresponsive or your behavior seems inappropriate, your doctor will check for catatonic symptoms.
Diagnostic criteria for catatonic schizophrenia
To be diagnosed with catatonic schizophrenia, you must meet certain symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
Diagnostic criteria for catatonic schizophrenia include:
- Being unable to move
- Being unable to speak
- Remaining in the same position for long periods
- Excessive or overly excited behavior with no clear purpose
- Resisting instructions or attempts to move you
- Peculiar movements, such as grimacing or unusual postures
- Mimicking words and movements of others
It can sometimes be difficult to diagnose catatonic schizophrenia because catatonic behavior is often a symptom of other conditions, including severe depression, mania, drug intoxication, autism and seizure disorders. Be sure to stick with it until you get an accurate diagnosis, though, so that you can get appropriate treatment.
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- Minzenberg MJ, et al. Schizophrenia. In: Hales RE, et al, eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Publishing Inc.; 2008. www.psychiatryonline.com. Accessed Oct. 7, 2008.
- Schizophrenia. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/schizophrenia/complete-publication.shtml. Accessed Oct. 27, 2008.
- Jibson MD, et al. Schizophrenia and related disorders. http://www.uptodate.com/home/index.html. Accessed Oct. 1, 2008.
- Schizophrenia and other psychotic disorders: Schizophrenia. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Oct. 30, 2008.
- Dyer JG, et al. Update on early intervention in schizophrenia. Journal of Psychosocial Nursing. 2008;46:19.
- Turkington D, et al. Cognitive behavior therapy for schizophrenia. American Journal of Psychiatry. 2006;163:365.
- Treating schizophrenia. A quick reference guide. Arlington, Va.: American Psychiatric Association. http://www.psychiatryonline.com. Accessed Dec. 9, 2008.
- Schultz SH, et al. Schizophrenia: A review. American Family Physician. 2007;75:1821.
- Fink M, et al. Editorial: Catatonia: Subtype or syndrome in DSM? American Journal of Psychiatry. 2006;163:1876.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 10, 2008.
- Treatment of patients with schizophrenia, 2nd ed. Arlington, Va.: American Psychiatric Association. http://www.psychiatryonline.com. Accessed Dec. 9, 2008.
