Catatonia is one of those conditions that sounds mysterious until you really understand it. If you’ve ever wondered what is catatonia, its symptoms, or why it happens, exploring the causes of catatonia can give you clarity.
By understanding catatonia better, we can see how this complex state affects both the body and mind, and why timely recognition is so important.
KEY POINTS
- The exact prevalence of catatonia is unknown.
- Catatonia can be caused by a variety of neurological and psychiatric factors.
- Medications and electro-convulsant therapy have been utilized to successfully treat catatonia.
- Awareness and better understanding around catatonia is needed even in mental health professionals.
Catatonia is an experience associated with a person taking a rigid or mute stance. Aspects of catatonia can also include unusual posturing, repetitive movements, repeating speech, and agitation. It is most associated with psychosis.
I had not encountered someone experiencing the phenomenon until just a few years ago. I needed to learn more about it, yet the more I searched, the more questions I had.
What follows are five things I discovered in the process.
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5 Things to Know About Catatonia
1. Catatonia Is a Mysterious Phenomena Affecting an Unknown Number of People Each Year
My first query was, how common is catatonia? I quickly found that estimates of prevalence varied widely.
As catatonia can be a feature of several conditions, including schizophrenia, autism, and encephalitis, in addition to appearing on its own, statistics on the prevalence of catatonia are not readily available.
Nonetheless, it is believed to be rare, though estimates vary on how rare it is.
One study suggested that the condition affects 5 percent to 18 percent of individuals in psychiatric inpatient units (Hirjak et al., 2022), while another estimated that only 4 in every 100,000 people in the general population are touched each year (Luccarelli et al., 2025).
Adding to the mystery, in part due to the inaccessibility of participants, almost all research on catatonia involves individual case studies, as opposed to more robust studies with large sample sizes.
2. It Can Be Neurological or Psychiatric
Although catatonia was once listed as a subtype of schizophrenia, it is now known that catatonia often exists outside of schizophrenia. Ruling out potential neurological and medical causes would be the first step in addressing catatonia.
Catatonia can have many neurological causes, including anti-NMDA encephalitis, an autoimmune disorder wherein the body’s antibodies attack NMDA receptors in the brain, leading to a wide range of neurological symptoms (Wu et al., 2023).
Catatonia has also been observed in both depression and mania (Edinoff et al., 2021).
3. It Can Be Temporary or Longer-Term
While most cases of catatonia resolve within hours or days (even if episodes are recurrent), long-term cases of catatonia have also been reported.
Treatments for catatonia include benzodiazepines, electro-convulsant therapy, and specific antipsychotics (Hirjak et al., 2024); more recently, NMDA-antagonist medications (Lee et al., 2024) have been utilized successfully to bring individuals out of catatonia.
4. It Can Be a Feature of Autism
Catatonic features are listed as a specifier in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revised (DSM-5-TR) under the criteria for autism spectrum disorder (American Psychiatric Association, 2022).
A meta-analysis showed that catatonia may affect around 10 percent of autistic people (Vaquerizo-Serrano et al., 2022). Catatonia has some overlapping features with autism, including repeating words (echolalia) and repetitive movements.
Related: Are Empaths On The Autism Spectrum? Exploring Similarities And Uniqueness
5. It May Be More Common Than We Know
Some have estimated that catatonia may be sometimes overlooked.
Research has shown that even among psychiatrists, understanding of and ability to identify catatonia using a standardized instrument applied to video case examples was poor (Wortzel et al., 2021).
Another study of psychiatrists working in emergency settings found that care for potential patients experiencing catatonia was often of low quality and that many respondents felt comfortable with interventions that were not evidence-based (Reinfield et al., 2024).
Tragically, some mental health professionals may mistakenly regard the experience as a willful or manipulative behavior leading to inappropriate responses. Increased awareness of catatonia is desperately needed.
References:
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.)
Edinoff, A. N., Kaufman, S. E., Hollier, J. W., Virgen, C. G., Karam, C. A., Malone, G. W., & Kaye, A. D. (2021). Catatonia: clinical overview of the diagnosis, treatment, and clinical challenges. Neurology international, 13(4), 570-586.
Hirjak, D., Rogers, J. P., Wolf, R. C., Kubera, K. M., Fritze, S., Wilson, J. E., & Northoff, G. (2024). Catatonia. Nature Reviews Disease Primers, 10(1), 49.
Luccarelli, J., Smith, J. R., Kalinich, M., Amad, A., & Rogers, J. P. (2025). The Population-Based Incidence and Prevalence of Catatonia. The Journal of Neuropsychiatry and Clinical Neurosciences, appi-neuropsych.
Reinfeld, S. (2024). Evaluating catatonia care in the psychiatric emergency room: A retrospective study. Journal of Psychiatric Research, 180, 439-442.
Vaquerizo-Serrano, J., De Pablo, G. S., Singh, J., & Santosh, P. (2022). Catatonia in autism spectrum disorders: a systematic review and meta-analysis. European Psychiatry, 65(1), e4.
Wortzel, J. R., Maeng, D. D., Francis, A., & Oldham, M. A. (2021). Prevalent gaps in understanding the features of catatonia among psychiatrists, psychiatry trainees, and medical students. The Journal of Clinical Psychiatry, 82(5), 36084.
Wu, H., Wu, C., Zhou, Y., Huang, S., & Zhu, S. (2023). Catatonia in adult anti-NMDAR encephalitis: an observational cohort study. BMC psychiatry, 23(1), 94.
Written By Jennifer Gerlach LCSW
Originally Appeared On Psychology Today
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