Physically immobile - the patient cannot speak or move. They may stare and hold their body in a fixed position. They appear to be unaware of their surroundings (catatonic stupor).
Waxy flexibility - this is part of physical immobility. If the patient’s arm, for example, is moved by someone else into a certain position, it remains in that position for possibly hours.
Excessive mobility - the patient moves excitedly with what appears to have no specific or useful purpose. This may include pacing around energetically, walking in circles, making loud and unusual utterances.
Uncooperative - the patient may resist any attempt to move them. They may say absolutely nothing (not speak) and not respond to instructions.
Strange movements - the patient’s posture may be unusual or inappropriate. There may be bizarre mannerisms and grimacing.
Unusual behavior - the patient may repeat words, follow a ritual/routine with obsession. He/she may be obsessed with lining things up in a specific way.
Echolalia (mimicking utterances) and/or Echopraxia (mimicking movements) - the patient may repeat something someone else has just said. There may be repetition of a movement or gesture made by another person.
Apart from the above, which are examples of catatonic schizophrenia symptoms, the patients may also have the following signs and symptoms of schizophrenia:
Delusions - The patient has false beliefs of persecution, guilt of grandeur. He/she may feel things are being controlled from outside. It is not uncommon for people with schizophrenia to describe plots against them. They may think they have extraordinary powers and gifts. Some patients with schizophrenia may hide in order to protect themselves from an imagined persecution.
Hallucinations - hearing voices is much more common than seeing, feeling, tasting, or smelling things which are not there, but seem very real to the patient.
Thought disorder - the person may jump from one subject to another for no logical reason. The speaker may be hard to follow. The patient’s speech might be muddled and incoherent. In some cases the patient may believe that somebody is messing with his/her mind.
Lack of motivation (avolition) - the patient loses his/her drive. Everyday automatic actions, such as washing and cooking are abandoned. It is important that those close to the patient understand that this loss of drive is due to the illness, and has nothing to do with slothfulness.
Poor expression of emotions - responses to happy or sad occasions may be lacking, or inappropriate.
Social withdrawal - when a patient with schizophrenia withdraws socially it is often because he/she believes somebody is going to harm them. Other reasons could be a fear of interacting with other humans because of poor social skills.
Unaware of illness - as the hallucinations and delusions seem so real for the patients, many of them may not believe they are ill. They may refuse to take medications which could help them enormously for fear of side-effects, for example.
Cognitive difficulties - the patient’s ability to concentrate, remember things, plan ahead, and to organize himself/herself are affected. Communication becomes more difficult.
There may also be incoherent speech, poor personal hygiene, angry outburst, and uncoordinated movements (clumsiness).
Without proper treatment a catatonic episode can persist for days and even weeks.
Patients with catatonic schizophrenia symptoms are not usually able to get medical help on their own. When their symptoms appear to have subsided, it is common for them to believe they are fine and do not need treatment. Seeking medical help is frequently initiated by a family member or good friend.