Autistic catatonia or catatonic breakdown is a type of disorder that affects roughly 10 percent of all adults with
autism spectrum disorder
The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental disorder, neurodevelopmental condition (or conditions) ...
and
intellectual disabilities
Intellectual disability (ID), also known as general learning disability in the United Kingdom and formerly mental retardation,Rosa's Law, Pub. L. 111-256124 Stat. 2643(2010). is a generalized neurodevelopmental disorder characterized by signific ...
. 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
Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...
but
more research is needed.
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
Dysautonomia or autonomic dysfunction is a condition in which the autonomic nervous system (ANS) does not work properly. This may affect the functioning of the heart, bladder, intestines, sweat glands, pupils, and blood vessels. Dysautonomia has ...
.
Childhood schizophrenia
Childhood schizophrenia (also known as childhood-onset schizophrenia, and very early-onset schizophrenia) is similar in characteristics of schizophrenia that develops at a later age, but has an onset before the age of 13 years, and is more diffic ...
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.
Symptoms
List of symptoms that has been observed in those with autistic catatonia:
Treatment
Treatment consists of high-dose
lorazepam
Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication. It is used to treat anxiety disorders, trouble sleeping, severe agitation, active seizures including status epilepticus, alcohol withdrawal, and c ...
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
Karl Ludwig Kahlbaum (28 December 1828 – 15 April 1899) was a German psychiatrist.
Life and career
In 1855 he received his medical doctorate at Berlin, and subsequently worked as a physician at the mental asylum in Wehlau. For a period he wa ...
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.
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
Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...
and other mood disorders. Now only 15 percent of those with catatonia are considered to have
schizophrenia
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
.
See also
*
Catatonia
Catatonia is a complex neuropsychiatric behavioral syndrome that is characterized by abnormal movements, immobility, abnormal behaviors, and withdrawal. The onset of catatonia can be acute or subtle and symptoms can wax, wane, or change during ...
References
Further reading
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External links
*{{EMedicine, article, 1154851, Catatonia, clinical
Autism