Autistic catatonia

Autistic catatonia or catatonic breakdown is a type of disorder that affects roughly 10 percent of all adults with autism spectrum disorder and intellectual disabilities. Most are not severely affected but a few exhibit stupor and severe excitement, which is the most extreme form of the disorder. Full expression of excitement could be a sign of comorbid bipolar disorder but more research is needed.[1]

More than 40 symptoms have been identified to be a result of the disorder, but some of the symptoms overlap with those of autism spectrum disorder, making diagnosing difficult even for a seasoned professional. In a few cases stupor and hyperactivity can continue for weeks or even months. During the excitement phase individuals show combativeness and can have delusions and hallucinations and can also pose a danger to themselves or others and can make marked destruction of property. In the later stages of medium and even more in the severe (and, if left untreated, lethal) state they will also experience autonomic instability.[2]

Childhood schizophrenia increases the risk for autistic catatonia later in life dramatically. There seems to be a common font of brain pathology for psychosis, catatonia and autism.[3][4]

Symptoms

List of symptoms that has been observed in those with autistic catatonia:[5]

Treatment

Treatment consists of high-dose lorazepam or in some cases ECT. The response to the treatment is usually good, especially if detected early.

History

In the 19th century the psychiatrist Karl Ludwig Kahlbaum observed several symptoms of the disorder. Among them were stupor, mutism, excitement, hyperactivity, posing, negativism, rigidity, waxy flexibility and automatic obedience, stereotypies, tics, grimacing, echo-phenomenon, and self-harming.

Also marbling of the skin, profuse sweating, deviation of the pupils and odd reaction to light were considered catatonic phenomenons.[6]

During most of the 20th century catatonia was regarded as schizophrenic in its nature, but towards the end of the century it was more commonly observed in those with bipolar disorder and other mood disorders. Now only 15 percent of those with catatonia are considered to have schizophrenia.

See also

References
  1. Wing, Lorna (1998). "The History of Asperger Syndrome". In Schopler, Eric; Mesibov, Gary B.; Kunce, Linda J. (eds.). Asperger Syndrome or High-Functioning Autism?. Springer. pp. 11–28. ISBN 978-0-306-45746-3.
  2. Wilcox, James Allen; Reid Duffy, Pam (2015-12-09). "The Syndrome of Catatonia". Behavioral Sciences. 5 (4): 576–588. doi:10.3390/bs5040576. PMC 4695780. PMID 26690229.
  3. Shorter, E.; Wachtel, L. E. (2013). "Childhood catatonia, autism and psychosis past and present: is there an 'iron triangle'?". Acta Psychiatrica Scandinavica. 128 (1): 21–33. doi:10.1111/acps.12082. PMC 3714300. PMID 23350770.
  4. Dhossche, Dirk Marcel; Carroll, Brendan T.; Carroll, Tressa D. (2006). "Is There a Common Neuronal Basis for Autism and Catatonia?". In Dhossche, Dirk Marcel; Wing, Lorna; Ohta, Masataka; et al. (eds.). Catatonia in Autism Spectrum Disorders. International Review of Neurobiology. Vol. 72. pp. 151–64. doi:10.1016/S0074-7742(05)72009-2. ISBN 978-0-12-366873-8. PMID 16697296.
  5. Wing, Lorna; Shah, Amitta (2000). "Catatonia in autistic spectrum disorders". The British Journal of Psychiatry. 176 (4): 357–62. doi:10.1192/bjp.176.4.357. PMID 10827884.
  6. Brake, Jonathan A.; Abidi, Sabina (2010). "A Case of Adolescent Catatonia". Journal of the Canadian Academy of Child and Adolescent Psychiatry. 19 (2): 138–40. PMC 2868561. PMID 20467550.

Further reading
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