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Psychopharmacology Bulletin › All Volumes & Issues › VOL 56 No. 2 › Non-Catatonic Mutism as...
COMPLICATED CASE HISTORY

Non-Catatonic Mutism as a Presentation of Psychosis: A Case Study

Mridul Sarangal, Michael P Greenage
Psychopharmacology Bulletin 56(2): 203-205, 2026/03/11; https://doi.org/10.64719/pb.16623

Abstract

Objective

To describe a rare case of non-catatonic mutism as the primary presentation of psychosis in a patient with complex comorbidities, highlighting diagnostic differentiation and antipsychotic response.

Methods

Case report of a 47-year-old female with bipolar II disorder, post-traumatic stress disorder, polysubstance use, and homelessness presenting with intermittent mutism. Diagnostic evaluation included clinical history, Bush-Francis Catatonia Rating Scale (BFCRS), and exclusion of alternative etiologies. Treatment involved antipsychotics with legal authorization.

Results

BFCRS score of 3 ruled out catatonia. Mutism resolved with haloperidol 4 mg daily after initial olanzapine failure, with no overt psychotic symptoms. Integrated care addressed social determinants.

Conclusions

Non-catatonic mutism may represent isolated psychosis, responsive to antipsychotics. Systematic evaluation is crucial in atypical presentations with psychosocial complexity.

Keywords

antipsychotics, bipolar disorder, catatonia, dopamine dysregulation, homelessness, mutism, psychosis, substance use disorder

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How to Cite

Mridul Sarangal, Michael P Greenage. Non-Catatonic Mutism as a Presentation of Psychosis: A Case Study. Psychopharmacology Bulletin. 2026/03/11; 56(2):203-205. https://doi.org/10.64719/pb.16623