Catatonia in childhood and adolescence

Abstract

Child and adolescent catatonia has been poorly investigated. A literature review was undertaken to clarify phenomenology, diagnosis, etiology, and treatment as well as ethical problems of catatonia in childhood and adolescence. Although there are no accepted standardized criteria for catatonia in childhood and adolescence, catatonic features described by child psychiatrists are similar to Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria for catatonia. With respect to etiology, the motor and behavioral symptoms that are part of catatonia bear some similarities with those seen in autism. Several case reports suggest an association between catatonia and general medical conditions. Certain drugs abused by youngsters as well as prescribed medicine can induce catatonia. Regarding catatonic cases originally diagnosed as schizophrenia, it is unclear whether all of these cases should be identified as schizophrenia or whether some of them are pervasive developmental disorders that develop psychic features in adolescence. Environmental changes preceding the onset of catatonia in patients with mood disorder play a possibly important role. Examples that suggest stress-induced catatonia, although rare, also exist. A few patients exhibit features of malignant catatonia, some without taking neuroleptics and others having taken them. Benzodiazepines and electroconvulsive therapy are considered to be effective treatments for catatonic youngsters.

Catatonia in an Adolescent with Asperger's Disorder

“…Catatonia was first defined and described by Karl Kahlbaum in the late 1800s (Takaoka, 2003). Catatonia may be associated with psychiatric, metabolic, and neurologic disorders but is most often associated with mood disorders.…”

Catatonia in DSM-5

“…Presence of catatonia in other psychiatric conditions and undiagnosed general medical conditions. There have been several hundred reports of catatonia in a range of other psychiatric conditions such as autism and other disorders in the pediatric setting (Wing and Shah, 2000;Takaoka and Takata, 2003;Hare and Malone, 2004;Cornic et al, 2007;Dhossche and Wachtel, 2010). Additionally, the link between catatonia and a causal general medical condition may not be clear in the initial stages of clinical assessment/treatment and/or the general medical condition putatively causing catatonia may not be initially evident.…”

Clinical & Diagnostic Issues in Catatonia

“…Nowadays, there is growing evidence reinforcing the view that catatonia is a common syndrome in adolescents with a nonpsychotic disorder such as autism and other neurodevelopmental disorders is close 20% using a relatively stringent criterion [51,52]. Therefore, a new specifier was included for catatonia associated with autism spectrum and other neurodevelopmental disorders to indicate the presence of comorbid catatonia.…”