[Catatonia in autism spectrum disorders: review and case-report]. / Katatonie bij autismespectrumstoornis; overzicht en gevalsbeschrijving.

BACKGROUND: Catatonia develops in children, adolescents, and adults with autism spectrum disorders. AIM: To review catatonia in autism spectrum disorders. METHOD: A case-report is presented and discussed. RESULTS: Catatonia is a comorbid syndrome occurring in 12-17% of selected groups of adolescents and young adults with autism spectrum disorders who have been referred for specialised care or admitted to hospital. Clinical experience and case-reports indicate that benzodiazepines and electroconvulsive therapy can be used safely and effectively in both the treatment in acute cases and maintenance treatments for catatonia patients with autism spectrum disorders. CONCLUSION: Catatonia is a recognisable and treatable syndrome in children and adolescents with autism spectrum disorders.

[Mechanisms of catatonia]. / Mechanismen van katatonie.

BACKGROUND: Catatonia is being increasingly viewed as a unique syndrome consisting of specific motor signs that respond characteristically and uniformly to benzodiazepines and electroconvulsive therapy. This interpretation is also reflected in changes in the classification of catatonia in DSM-5. An all-embracing pathogenesis of catatonia remains elusive. AIM: To review the mechanisms of catatonia. METHOD: We reviewed the literature. RESULTS: Certain aspects of catatonia can be explained by a number of different mechanisms. We present a new, more comprehensive model involving the vagal nerve. CONCLUSION: Further research into the underlying mechanisms of catatonia is needed in order to to find new therapies.

[Anti-NMDA-receptor encephalitis: a new axis-III disorder in the differential diagnosis of childhood disintegrative disorder, early onset schizophrenia and late onset autism]. / Anti-NMDA-receptorencefalitis: een nieuwe as III-stoornis in de differentiaaldiagnose van desintegratiestoornis van de kinderleeftijd, vroeg optredende schizofrenie en laat optredend autisme.

Childhood disintegrative disorder (CDD), early onset schizophrenia (EOS), and late onset autism (LOA) often follow a similar course: initially, development is normal, then there is a sudden neuropsychiatric deterioration of social interaction and communication skills, which is combined with a decline in intelligence and reduction in daily activities. A 9-year-old boy was admitted to the paediatric ward with acute onset of secondary epileptic seizures. It was not long until the boy's symptoms resembled that of patients with cdd, eos and loa. Intensive tests led to the diagnosis of anti-NMDA-receptor encephalitis. Anti-NMDA-receptor encephalitis should be regarded as a possible organic cause underlying the syndromal presentation of CDD, EOS and LOA.

The role of deprivation, abuse, and trauma in pediatric catatonia without a clear medical cause.

OBJECTIVE: Catatonia is considered a unique syndrome of motor signs, at times life-threatening when aggravated by autonomic dysfunction and fever, but eminently treatable with specific medical treatments, if recognized early. Catatonia commonly occurs in children and adolescents with a wide range of associated disorders. The role of deprivation, abuse, or trauma in the development of pediatric catatonia is examined. METHOD: Reports considering deprivation, abuse, or trauma as precipitants of catatonia in pediatric cases are culled from the classic writings on catatonia and from a selective review of modern contributions. RESULTS: Kahlbaum gave trauma a central role in catatonia in many young adult cases. Kanner described children with psychogenic catalepsy. Anaclitic depression, a condition found by Spitz in deprived institutionalized children, strongly resembles stuporous catatonia. Leonhard considered lack of communication with the mother or substitute mother as an important risk factor for childhood catatonia. Children including those with autism who experience emotional and physical trauma sometimes develop catatonia. The clinical descriptions of children with classic catatonic syndromes and those of contemporary refugee children with a syndrome labeled Pervasive Refusal Syndrome are similar. CONCLUSION: The literature supports the view that deprivation, abuse, and trauma can precipitate catatonia in children and adolescents.

[Autism and catatonia: successful treatment using lorazepam. A case study]. / Autisme en katatonie. Een succesvolle behandeling met lorazepam.

A 24-year-old man who was mentally retarded and had an autistic disorder, developed mutism and motor symptoms. He was diagnosed with catatonia and was treated successfully with lorazepam. Additionally, we review the literature about the diagnosis and treatment of catatonia in patients with autism; in such cases accurate diagnosis is vital but is complicated by overlapping symptoms.

A retrospective study of general hospital patients who commit suicide shortly after being discharged from the hospital.

OBJECTIVE: To assess the scope of diagnostic screening for suicide prevention in general hospital patients. METHODS: Retrospective medical record review of general hospital patients who committed suicide and matched-control subjects who did not commit suicide shortly after being discharged from the hospital. RESULTS: The suicide rate was 32 per 100 000 patient-years. Eight (73%) of 11 patients who committed suicide were diagnosed with depression, substance use disorder, or both at their last hospital admission compared with 11 (33%) of the controls (P<.05). Only 1 of 44 patients (both cases and controls) was referred for psychiatric consultation. CONCLUSIONS: The suicide rate in general hospital patients was almost 3-fold higher than in the general population. Depression and/or substance use disorders were risk factors for suicide. Screening for those disorders may be beneficial for suicide prevention in the general hospital population, but will likely benefit more patients who will not commit suicide.

Catatonia in an adolescent with Prader-Willi Syndrome.

Catatonia in children and adolescents has received little research attention. Treatment and course of catatonia in an adolescent patient with Prader-Willi Syndrome are presented. Clinical features of a small series of published case reports of catatonia in children and adolescents are reported. The association between catatonia, Prader-Willi Syndrome, and other neurodevelopmental disorders is discussed.