Malignant Catatonia Triggered by Acute Psychological Traumatic Experience in a Patient with Schizophrenia: A Case Report

Abstract

Malignant catatonia is defined as catatonia accompanied by hyperthermia and/or autonomic instability. Catatonia can develop in association with psychiatric disorders such as schizophrenia, bipolar disorder, and major depressive disorder, as well as various medical and neurological conditions. However, our knowledge regarding the role of acute traumatic experiences in the development of catatonia remains limited. This case report discusses a presentation of malignant catatonia triggered by an acute psychological trauma in a patient with schizophrenia in remission. A 41-year-old male patient has been followed with a diagnosis of schizophrenia since 2003. Following an acute psychological traumatic event, the patient developed withdrawal, reduced speech, refusal to eat and drink, and generalized rigidity. Upon examination, the patient exhibited catatonic stupor, rigidity, mutism, negativism, and vital signs indicating hyperthermia and hypertension. Based on these findings, a diagnosis of malignant catatonia was considered. The patient was administered electroconvulsive therapy. After eight sessions of electroconvulsive therapy, a significant improvement in the patient's clinical symptoms was observed. Traumatic experiences may contribute to the development of malignant catatonia through mechanisms such as acute threat perception, inflammatory responses, autonomic instability, and dysregulated dopaminergic signaling