Catatonic Schizophrenia Diagnostic Criteria

The formal ICD diagnosis of catatonic schizophrenia rests on these symptoms, which can be evaluated by psychiatrists and other mental health professionals.

ICD-10 Criteria for Catatonic Schizophrenia

The following information is reproduced verbatim from the ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization, Geneva, 1992. (Since the WHO updates the overall ICD on a regular basis, individual classifications within it may or may not change from year to year; therefore, you should always check directly with the WHO to be sure of obtaining the latest revision for any particular individual classification.)

F20.2 Catatonic Schizophrenia

Prominent psychomotor disturbances are essential and dominant features and may alternate between extremes such as hyperkinesis and stupor, or automatic obedience and negativism. Constrained attitudes and postures may be maintained for long periods. Episodes of violent excitement may be a striking feature of the condition.

For reasons that are poorly understood, catatonic schizophrenia is now rarely seen in industrial countries, though it remains common elsewhere. These catatonic phenomena may be combined with a dream-like (oneiroid) state with vivid scenic hallucinations.

Diagnostic Guidelines

The general criteria for a diagnosis of schizophrenia (see introduction to F20 above) must be satisfied. Transitory 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 behaviours should dominate the clinical picture:

  1. stupor (marked decrease in reactivity to the environment and in spontaneous movements and activity) or mutism;
  2. excitement (apparently purposeless motor activity, not influenced by external stimuli);
  3. posturing (voluntary assumption and maintenance of inappropriate or bizarre postures);
  4. negativism (an apparently motiveless resistance to all instructions or attempts to be moved, or movement in the opposite direction);
  5. rigidity (maintenance of a rigid posture against efforts to be moved);
  6. waxy flexibility (maintenance of limbs and body in externally imposed positions); and
  7. other symptoms such as command automatism (automatic compliance with instructions), and perseveration of words and phrases.

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In uncommunicative patients with behavioural manifestations of catatonic disorder, the diagnosis of schizophrenia may have to be provisional until adequate evidence of the presence of other symptoms is obtained. It is also vital to appreciate that catatonic symptoms are not diagnostic of schizophrenia. A catatonic symptom or symptoms may also be provoked by brain disease, metabolic disturbances, or alcohol and drugs, and may also occur in mood disorders.

Includes:

  • catatonic stupor
  • schizophrenic catalepsy
  • schizophrenic catatonia
  • schizophrenic flexibilitas cerea

All clinical material on this site is peer reviewed by one or more qualified mental health professionals. This specific article was originally published by on and was last reviewed or updated by Dr Greg Mulhauser, Managing Editor on .

Our material is not intended as a substitute for direct consultation with a qualified mental health professional. Please seek professional advice if you are experiencing any mental health concern.

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