Autistic catatonia
Autistic catatonia is a rare type of disorder[1] that affects roughly 10 percent of all adults with autism spectrum disorder. Most of them 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.[2]
More than 40 symptoms has 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.[citation needed] 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.[citation needed] In the later stages of medium and even more in the severe (and, if left untreatead, lethal) state they will also experience autonomic instability.[3]
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.[4]
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.[citation needed]
Also marbling of the skin, profuse sweating, deviation of the pupils and odd reaction to light were considered catatonic phenomenons.[5]
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 autism spectrum disorder. Now only 15 percent of those with catatonia are considered to have schizophrenia.[medical citation needed]
Treatment
Treatment consists of high-dose lorazepam or in some cases ECT. The response to the treatment is usually good, especially if detected early.[6]
Symptoms
List of symptoms that has been observed in those with autistic catatonia:[7][failed verification]
- Stupor
- Mutism
- Hyperactivity
- Agitation
- Excitement
- Posing
- Negativism
- Rigidity
- Waxy flexibility, mitmachen, mitgehen – tendency to remain in immobile posture, inability to resist external pressure on posture
- Automatic obedience
- Combativeness (during excitement)
- Aggressivity
- Stereotypies
- Tics
- Grimacing
- Echolalia
- Echopraxia
- Perseveration
- Verbigeration
- Staring, gaze fixation
- Withdrawal
- Immobility
- Challenging behaviour
- Tremor
- Slowness
- Amotivation
- Grasp reflex
- Mannerism[clarification needed]
- Choreoathetoid movements of the trunk and extremities
- Autonomic instability (during excitement)
- Inability to start or stop actions (if during excitement episodes needs acute psychiatric care)
- Freezing[clarification needed]
- Impulsivity
- Psychotic
- Sleep problems, reversal of day and night
- Urinary or fecal incontinence
- Odd gait[clarification needed]
- Passivity
- Eyerolling
- Stiff muscles
- Catalepsy
- Physiological pillow[clarification needed]
- Difficulty crossing lines[clarification needed]
- Gegenhalten
- Ambitendency – contradictory behavior
- Rituals – repetitive behaviors
See also
References
- ^ "Autism/AS and Catatonia". www.aspie-editorial.com. 2009-05-02. Retrieved 2015-10-10.[self-published source?]
- ^ 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.
{{cite book}}: External link in|chapterurl=|chapterurl=ignored (|chapter-url=suggested) (help) - ^ Wilcox, James Allen; Reid Duffy, Pam (2015-12-09). "The Syndrome of Catatonia". Behavioral Sciences. 5 (4): 576–588. doi:10.3390/bs5040576.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ 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.
- ^ 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.
- ^ "Catatonia: Once Diagnosed, What is the Best Treatment Approach? « Primary Psychiatry". Primarypsychiatry.com. 2013-05-21. Retrieved 2015-10-10.[self-published source?]
- ^ 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.
Additional sources
 | This article includes a list of general references, but it lacks sufficient corresponding inline citations. (October 2015) |
- Med.umich.edu
- Myaspergerschild.com
- Catatonia~clinical at eMedicine
- 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. pp. 151–64. doi:10.1016/S0074-7742(05)72009-2. ISBN 978-0-12-366873-8. PMID 16697296.
{{cite book}}: External link in|chapterurl=|chapterurl=ignored (|chapter-url=suggested) (help) - Dhossche, Dirk M. (2014). "Decalogue of Catatonia in Autism Spectrum Disorders". Frontiers in Psychiatry. 5: 157. doi:10.3389/fpsyt.2014.00157. PMC 4222130. PMID 25414675.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - Ghaziuddin, M.; Quinlan, P.; Ghaziuddin, N. (2005). "Catatonia in autism: a distinct subtype?". Journal of Intellectual Disability Research. 49 (1): 102–5. doi:10.1111/j.1365-2788.2005.00666.x. PMID 15634317.