The psychological and subjective experience of catatonia

Abstract Background Catatonia is a severe psychomotor disorder that presents as abnormality of movement which may also be excessive or severely slowed. It often inhibits communication when protracted or severe. In this study we investigated the emotive and cognitive experience of patients with catatonia during a prevalence study in an acute mental health unit from August 2020 to September 2021. Methods Ethical approval was received from the Nelson Mandela University Human Research Committee and convenience sampling was undertaken to recruit participants, four to eight weeks after discharge, following admission for a catatonic episode. Participants were requested to describe their thoughts, feelings and behaviours during the catatonic episode, in their own words. Results Forty-four (18.3%) of 241 participants had catatonia. Thirty (68.2%) of the 44 participants with catatonia provided data on their experience during the catatonic episode. The dominant themes of thoughts, feelings, and behaviors centered around yearning for or missing loved ones, heightened fear, intense anxiety, negative affect, aggression, obedience and withdrawal. Conclusions These findings indicate that catatonia mirrors the fight, flight, freeze and fawn reaction induced by extreme fear, anxiety or distress. Suggested psychological interventions include supportive, behavioural and cognitive behavioural strategies. Trial registration: Not applicable