Сatatonia in Autism Spectrum Disorders: Diagnosis, Therapy and Clinical Science 608
PhD, Professor of Psychiatry, Department of Psychiatry at the University of Mississippi, USA
Catatonia has been increasingly recognized as a comorbid syndrome of autism at a rate of 12—17% in adolescents and young adults with autism spectrum disorders. Symptoms that should alert the clinician for catatonia are markedly increased psychomotor slowness which may alternate with excessive motor activity, apparently purposeless, and not influenced by external stimuli, extreme negativism or muteness, stereotypy, peculiarities of voluntary movement, increased stereotypies with or without self-injury, echolalia, or echopraxia. Upsetting life events, the loss of routine and structure, experiences of loss, conflicts with parents, caregivers, or peers, and discrepancies between the ability in the patient and parental expectations-especially, in higher functioning autistic youth, are known to precipitate catatonia as well as medical and neurological illnesses. Lacking controlled trials, successful use of benzodiazepines, sometimes at high dosages, and electroconvulsive therapy for catatonia in autism is supported by case-reports and case-series. Electroconvulsive therapy is indicated for the treatment of catatonia when lorazepam does not bring about rapid relief. Maintenance electroconvulsive therapy is important for sustained symptom remission in some cases. There is an urgent need for prospective studies of catatonia in autism spectrum disorders and for controlled treatment trials.
Ali A., Taj A., Uz-Zehra M.
Lupus catatonia in a young girl who
presented with fever and altered sensorium. Pakistan
Journal of Medical Sciences, 2014, no. 30 (2), pp. 446—448.
American Psychiatric Association. Diagnostic
and Statistical Manual of Mental Disorders, (5th Edition)
(DSM-5). Washington, DC: American Psychiatric Association;
Billstedt E., Gilberg C., Gilberg C.
Autism after adolescence:
population-based 13- to 22-year follow-up study of 120 individuals with autism
diagnosed in childhood. Journal of
Autism and Developmental Disorders. 2005, vol. 35, issue 3, pp.
Breen J., Hare D.J. The nature and prevalence of catatonic
symptoms in young people with autism. Journal of
Intellectual Disability Research, 2017, vol. 61, issue 6, pp.
Bush G., Fink M., Petrides G., Dowling F., Francis
A. Catatonia. II. Treatment with lorazepam and electroconvulsive
Psychiatrica Scandinavica, 1996, vol. 93, pp. 137—143.
Bush G., Fink M., Petrides G., Dowling F., Francis
A. Catatonia: I: Rating scale and standardized
Psychiatrica Scandinavica, 1996, vol. 93, pp. 129—136.
Carroll B., Kirkhart R., Ahuja N. et
al. Katatonia: a new conceptual understanding of catatonia and anew
rating scale. Psychiatry, 2008, vol. 5, pp.
Consoli A., Raffin M., Laurent C. et
and developmental risk factors of catatonia in children and adolescents: a
prospective case-control study. Schizophrenia Research,
2012, vol. 137, issue 1—3, pp.
DeJong H., Bunton P., Hare D.J.
A Systematic Review of Interventions
Used to Treat Catatonic Symptoms in People with Autistic Spectrum
Disorders. Journal of
Autism and Developmental Disorders, 2014, vol. 44, issue 9, pp.
Dhossche D., Bouman N.
Catatonia in an adolescent with
Prader-Willi Syndrome. Annals of
Clinical Psychiatry, 1997, vol. 4, pp. 247—253.
Dhossche D., Reti I., Wachtel L.
Catatonia and Autism: A historical
review, with implications for Electroconvulsive Therapy.
Journal of Electroconvulsive Therapy,
2009, vol. 25, pp.
Dhossche D., Wilson C., Wachtel L.
Catatonia in childhood and
adolescence: implications for the DSM-5. Primary
vol. 17, pp. 35—39.
Dhossche D. Catatonia: the ultimate yet treatable motor
reaction to fear in autism. Autism —
Open Access. 2011,
vol. 1. doi:
Dhossche D., Fink M., Shorter E., Wachtel
L.E. Anti-NMDA receptor encephalitis versus pediatric
catatonia. The American
Journal of Psychiatry, 2011, vol. 168, issue 7, pp. 749—750;
Dhossche D. Autonomic dysfunction in catatonia in autism:
implications of a vagal theory. Autism —
Open Access, 2012,
vol. 2, issue 4:
Dhossche D.M., Wachtel L.E.
Catatonia is hidden in plain sight
among different pediatric disorders: a review article.
2010, vol. 43, issue 5, pp.
Dhossche D.M., Ross C.A., Stoppelbein
role of deprivation, abuse, and trauma in pediatric catatonia without a clear
medical cause. Acta
Psychiatrica Scandinavica, 2012, vol. 125, issue 1, pp.
Fink M. Rediscovering catatonia: the biography of a treatable
Psychiatrica Scandinavica Supplement, 2013, issue 441, pp.
Ghaziuddin N., Dhossche D., Marcotte K.
Retrospective chart review of
catatonia in child and adolescent psychiatric patients.
Acta Psychiatrica Scandinavica,
2012, vol. 125, issue 1, pp.
Jap S.N., Ghaziuddin N.
Catatonia Among Adolescents With Down
Syndrome: A Review and 2 Case Reports. Journal of
Electroconvulsive Therapy, 2011, vol. 27, issue 4, pp.
Kakooza-Mwesige A., Wachtel L., Dhossche
D. Catatonia in autism: implications across the life
span. European Child & Adolescent
vol. 17, pp. 327—335.
Kanbayashi T., Tsutsui K., Tanaka K. et
al. [Anti-NMDA encephalitis in psychiatry; malignant catatonia,
atypical psychosis and ECT]. Rinsho
2014, vol. 54, issue 12, pp.
Kanner L. Autistic disturbances of affective contact.
Nervous Child, 1943, vol. 2, pp.
Kellner C., Knapp R., Petrides G. et
al. Continuation electroconvulsive therapy vs pharmacotherapy for
relapse prevention in major depression: a multisite study from the Consortium
for Research in Electroconvulsive Therapy (CORE).
Archives of General Psychiatry,
2006, vol. 63, pp.
Leon T., Aguirre A., Pesce C., Sanhueza P., Toro
P. Electroconvulsive therapy for catatonia in juvenile
neuropsychiatric lupus. Lupus, 2014, vol. 23, issue 10, pp.
Matson J.L., Lovullo S.V.
A review of behavioral treatments for
self-injurious behaviors of persons with autism spectrum
vol. 32, issue 1, pp. 61—76.
Mon T., L’Ecuyer S., Farber N.B. et al.
The use of electroconvulsive therapy
in a patient with juvenile systemic lupus erythematosus and
catatonia. Lupus, 2012, vol. 21, issue 14, pp.
Moskowitz A.K. “Scared stiff”: catatonia as an
evolutionary-based fear response. Psychological Review,
2004, vol. 111, issue 4, pp.
Oliver C., Licence L., Richards C.
Self-injurious behaviour in people
with intellectual disability and autism spectrum disorder.
Current Opinion in Psychiatry.
2017, vol. 30, issue 2, pp.
Petrides G., Dhossche D., Fink M., Francis
A. Continuation ECT: relapse prevention in affective
vol. 10, pp. 189—94.
Porges S.W. Social engagement and attachment: a
phylogenetic perspective. Annals of
the New York Academy of Sciences, 2003, vol. 1008, pp.
Shah A., Wing L. Psychological approaches to chronic
catatonia-like deterioration in autism spectrum disorders.
International Review of Neurobiology,
2006, vol. 72, pp.
Sienaert P., Rooseleer J., De Fruyt J.
Measuring catatonia: a systematic
review of rating scales. Journal of
Affective Disorders, 2011, vol. 135, issue 1-3, pp.
Verhoeven W., Tuinier S.
Prader-Willi syndrome: atypical
psychoses and motor dysfunctions. International Review of Neurobiology,
2006, vol. 72, pp.
Wachtel L., Dhossche D.
ECT for self-injuriuos behavior.
In: Ghaziuddin M., Walter
eds. Electroconvulsive Therapy in Children and
York City: Oxord University Press, 2013. Pp.
Wachtel L.E., Dhossche D.M.
Self-injury in autism as an alternate
sign of catatonia: implications for electroconvulsive therapy.
Medical Hypotheses, 2010, vol. 75, issue 1, pp.
Wachtel L.E., Hermida A., Dhossche D.M.
Maintenance electroconvulsive therapy
in autistic catatonia: a case series review. Progress in
Neuro-psychopharmacology & Biological Psychiatry,
2010, vol. 34, issue 4, pp.
Wilson J.E., Shuster J., Fuchs C.
Anti-NMDA receptor encephalitis in a
14-year-old female presenting as malignant catatonia: medical and psychiatric
approach to treatment. Psychosomatics, 2013, vol. 54, issue 6, pp.
Wing L., Shah A. Catatonia in autistic spectrum
Journal of Psychiatry. 2000;176:357-362.
Wing L., Shah A. A systematic examination of catatonic-like
clinical pictures in autism spectrum disorders. International Review of Neurobiology.