Detailed contribution information
| Contribution title | 3689 - Thinking about catatonia when adolescence comes for Autism Spectrum Disorders: Findings on characterisation and treatment from a systematic review |
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| Contribution code | PS02-15 (P) |
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| Form of presentation | Poster |
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| Abstract |
Introduction: Catatonia is a neuropsychiatric, life-threatening1 syndrome of psychomotor deregulation. Considered now non-syndrome specific2,3,4, it’s been reported to occur in up to 17% of adolescents with Autism Spectrum Disorders (ASD)5. With theoretically shared biological findings (chromosome 15q, GABA dysfunction), both can overlap2, with exacerbations in adolescence and transition to early adulthood5. Challenges in their confluence extend from a proper identification and characterisation in a still neurodeveloping population, to safe, effective and evidence backed treatment. Objectives: To systematically analyse literature on Catatonia in young people with ASD. To characterise catatonia in ASD. To evaluate clinical evidence of treatments used. Methods: A systematic search of scientific databases was carried out for the available literature (Limited in types of publications) from the last 20 years (01/1996-12/2016) for publications on Catatonia in ASD in human subjects with <18y. A qualitative and quantitative review has been completed following PRISMA guidelines. Results: Of 89 identified publications, 30 went through a full article assessment after exclusion of non-compliant publications, discarding a further 6 records. A total of 24 articles were qualitatively analysed and 18 quantitatively. A total of 57 cases are published. In general cohorts, onset often reported since adolescence5. Sudden behavioural changes, regression, psychosis and intensification of obsessive symptoms were most reported as possible predecessors. Onset is characterised by a progression of symptoms like posturing, freezing, catalepsy, need for prompt, or the rapid alternation between intense agitation/aggression and slowness/stupor. Comorbidity often accompany (mainly psychotic and affective acute states). Accounts of neurological and general medical conditions are scarce. Case report evidence supports Benzodiazepines (BZD) and ECT in acute and maintenance treatment2,6. Most ECT treatments coincided with BZD, main effective adjunctive treatment. Effective antipsychotics (AP) were in acute psychosis, with the highest number of adverse events followed by antiepileptics. Lithium is suggested useful. Conclusions: Considerable prevalence and morbidity of Catatonia in ASD. Catatonia should be ruled out as a cause of regression in autism2. Effective, safe, treatments are used in ASD with catatonia, with clinical evidence that supports the use of BZD and ECT. References: 1. Ghaziuddin, N., Gih, D., Barbosa, V., Maixner, D., & Ghaziuddin, M. (2010). Onset of Catatonia at Puberty. The Journal Of ECT, 26(4), 274-277. 2. Haq, A. & Ghaziuddin, N. (2014). Maintenance Electroconvulsive Therapy for Aggression and Self-Injurious Behavior in Two Adolescents With Autism and Catatonia. The Journal Of Neuropsychiatry And Clinical Neurosciences, 26(1), 64-72 3. Mazzone, L., Postorino, V., Valeri, G., & Vicari, S. (2014). Catatonia in Patients with Autism: Prevalence and Management. CNS Drugs, 28(3), 205-215. 4. Zaw, F. (2006). ECT and The Youth: Catatonia in Context. International Review Of Neurobiology, 207-231 5. Wing, L. (2000). Catatonia in autistic spectrum disorders. The British Journal Of Psychiatry, 176(4), 357-362. 6. Wachtel, L., Hermida, A., & Dhossche, D. (2010). Maintenance electroconvulsive therapy in autistic catatonia: A case series review. Progress In Neuro-Psychopharmacology And Biological Psychiatry, 34(4), 581-587. |