Non catatonic mutism in schizophrenia- a case report and discussion

ABSTRACT

Background: Mutism is a common accompaniment of catatonic schizophrenia. It responds to treatment with benzodiazepines and electro convulsive therapy. However mutism can also occur in non catatonic schizophrenia. There are very few reports of the same in literature and most show resistance to conventional treatment. The present case report deals with one such case and the challenges it poses. Case description A young Asian man, with a diagnosis of paranoid schizophrenia presented with long standing mutism in the absence of any other catatonic features. A trial of various antipsychotics and also electroconvulsive therapy failed to show any improvement in mutism. He ultimately responded to amisulpride 800 mg/day. Discussion: Mutism though is most widely reported in catatonic schizophrenia, can also be seen in non catatonic schizophrenia. It shows poor response to conventional treatment. Conclusion: Mutism is a challenging symptom which may persist after the resolution of other psychotic symptoms and continue to hinder the patient’s social, occupational and personal life.