Английская Википедия:Autistic catatonia
Шаблон:More medical citations needed Шаблон:Outdated
Autistic catatonia is a term used to describe the occurrence of catatonia in autistic people.[1] Catatonia occurs in roughly 10 percent of people diagnosed with an autism spectrum disorder.[2] In addition to the common sign of catatonia (posturing, negativism, mutism, and stupor), autistic people with catatonia are more likely to stim and self-harm.[3]Шаблон:Rp
The DSM-5 lists "with catatonia" as one of the possible specifiers for an autism spectrum disorder diagnosis.[3]Шаблон:Rp
Pathology
There exists debate over the biological origins of autistic catatonia. Some studies have suggested that dysfunction of GABA and its receptors are primary causes for autistic catatonia.[2] Also, neuroimaging studies have indicated that autistic catatonic patients have abnormally small cerebellar structures.[2] Furthermore, genetic studies have implied that alterations on chromosome 15 may underpin the disease.[2]
Alternatively, catatonia has been frequently observed in patients with severe anxiety.[2] Because autism can cause individuals to be susceptible to anxiety, the prevalence of catatonia in autism may be attributable to anxiety.[2]
Symptoms
Autistic catatonia is associated with more than 40 symptoms, many in common with autism.Шаблон:Citation needed
The most severe cases display stupor, hyperactivity, or severe excitement, which can sometimes continue for weeks or even months.[4] During excitement, individuals show combativeness, can have delusions and hallucinations, and can also pose a danger to themselves and others.Шаблон:Citation needed In the medium, severe, and lethal states, they will also experience autonomic instability.[5]
Symptoms overlap with autism spectrum disorder. Thus, diagnosis of catatonic breakdown can be difficult.[5] Childhood schizophrenia increases the risk for autistic catatonia later in life dramatically. Also, it seems that the processes that give rise to psychosis, catatonia, and autism are similar.[6][7]
Treatment
There exists great diversity in treatments for autistic catatonia. The psycho-ecological approach considers the individual's profile of autism, identifies the underlying causes behind their catatonia, and formulates support strategies. These strategies vary depending on the individual and their difficulties.[8]
It has also been shown that benzodiazapines are effective for some patients.[9] More recently, electroconvulsive therapy (ECT) has been trialed, with mixed effect.[9] Several patients have responded well to intensive, multi-month ECT regimens after other treatments failed.[9] Furthermore, ECT was successfully used to treat symptoms in patients prone to self-injury and compulsive behavior.[9] However, it seems that ECT must be continued for long periods of time to prevent re-onset of autistic catatonic symptoms.[9] Furthermore, there is popular resistance to the idea of inducing seizures as treatment - which ECT relies on - especially in pediatric patients.[9]
History
Karl Ludwig Kahlbaum was among the first to systematically describe catatonia, which in 1874 he documented as a separate brain disorder.[9] The phenomenon was later described by Emil Kraepelin as a precursor disease that led to dementia.[9] It was not until the 1970s that catatonia was recognized as a feature of other affective psychiatric disorders in adults, especially manias.[9]
References
Further reading
Шаблон:Pervasive developmental disorders
- ↑ Шаблон:Cite journal
- ↑ 2,0 2,1 2,2 2,3 2,4 2,5 Шаблон:Cite journal
- ↑ 3,0 3,1 Шаблон:Cite book
- ↑ Шаблон:Cite journal
- ↑ 5,0 5,1 Шаблон:Cite journal
- ↑ Шаблон:Cite journal
- ↑ Шаблон:Cite book
- ↑ Shah, Amitta Catatonia, Shutdown and Breakdown in Autism: A Psycho-Ecological Approach. Jessica Kingsley Publishers, 2019, p. 97.
- ↑ 9,0 9,1 9,2 9,3 9,4 9,5 9,6 9,7 9,8 Шаблон:Cite journal
