Evolutionary Psychiatry

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  • Created by: katetr
  • Created on: 20-10-16 22:38

Core Symptoms

  • Stupor - Semi-coma (not responding to environment)
  • Immobility - Don't move
  • Mutism - Don't speak

There's also more complex and active symptoms:

  • Charactically imotivated 
  • Feel pointless and purposeless
  • Can get a frenzy of hyperactivity/hostility, stereotypical patterns, movement and mannerisms
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Causes

Doesn't happen on it's own, caused by:

  • Schizophrenia
  • Mania and melancholic depression (including psychotic depression)
  • Side effects of drugs such as anti-psychotics (Chlorpromazine) and more rarely SSRI anti-depressants (Prozac, Fluoxetine)
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Link between catatonia and anxiety

  • Detailed studies of people with catatonia have shown extreme anxiety
  • Catatonia was once thought to be a type of schizophrenia, now it's known to be part of sevral psychosis - in a milder form, catatonia is found in about 10% of new acute psychiatric admissions
  • Main treatment of catatonia is anti-anxiety drugs - BZ's in high doses (Lorazepam) usually cures about 2/3rds of catatonia cases
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Tonic immobility

  • Triggered by prolonged stillness/unresponsivness in the face of extreme threat
  • Exacerbated in animals by retraint, entrapment, inversion (upside down)
  • Has the same core features as catatonia - waxy flexibility, muscle rigidity etc.
  • Can result in death
  • Can last minutes to hours
  • Catatonia in humans may last days to years to a whole lifetime and may result in death (Malignant Catatonia)
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Causal factors of catatonia

  • It's a response to a threat - in humans the threat comes from within (within the brain) e.g. psychotic illness and drugs
  • When there's a source of danger, the threat can't be localized or pinpointed therefor you can't escape fromt he threat and it makes you feel trapped and cornered
  • T.I. comes from a present threat but with catatonia there's no present threat, it's from a potential threat
  • Feeling of dread (fear of the future)
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Why should they cause death?

  • There are no obvious causes of death on a post-morterm
  • They look like they are scared to death
  • In normal catatonia and T.I. there is a high activity of the SNS
  • For example malignant catatonia/neuroleptic malignant syndromes can be caused by anti-psychotics or SSRI's - in this situation you hyperventilate, racing heart, high blood preassure, muscle rigidity and high temperature
  • Parasympathetic nervous system takes over - uses acetylochline as a transmitter and the vagal nerve is hyperstimulated (this may stop the heart which causes death and it isn't visible)
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Conclusions

  • Catatnoia is a relic of T.I. 
  • They share many features
  • T.I features are innapropriately triggered by inner threats of psychosis and drugs
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