Mutism in non-catatonic schizophrenia: Psychotic symptom and adaptive behavioral strategy
Mutism in adults has a wide differential, and can be difficult to evaluate. Defined as an absence or reduction of speech, either voluntary or avolitional, mutism is typically associated with catatonia, usually in schizophrenia, but also depression, bipolar disorder, intoxication, and neurological conditions. Mutism in non-catatonic schizophrenia was common before anti-psychotic use, correlating with untreated illness. Case reports continue to appear in developing nations, but accounts of mutism in patients with advanced treatment are scarce. Here we present an unusual case of mutism in non-catatonic schizophrenia, in which it appears as both psychotic symptom and adaptive behavioral strategy.