Catatonia in Autism or the Elephant in the Room

Dirk Dhossche, MD, PhD
Professor of Psychiatry
University of Mississippi Medical Center
2500 North State Street, Jackson, Mississippi 39216
USA
dr6340451@pol.net

Catatonia has been increasingly recognized in adolescents and young adults with autism, over the last 15 years. A case vignette of an adolescent with Asperger Disorder and catatonia is described. Recommendations are made for the assessment and treatment of catatonia in autism spectrum disorders. A case vignette of lorazepam treatment for catatonia in autism, and a case vignette of electroconvulsive therapy for catatonia in a child that also met the criteria for childhood disintegrative disorder, or late-onset autism, are presented. It is recommended that catatonia should be considered in any autistic patient, of any age, when there is an obvious and marked deterioration in movement, pattern of activities, self-care, and practical skills, and that autism should be considered as the underlying condition in patients presenting with catatonia, especially in those with histories of developmental problems. The need for systematic studies in this novel area is emphasised.