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Legrand A, Moyal M, Deschamps C, Louveau C, Iftimovici A, Krebs MO, Héron B, Keren B, Afenjar A, Chaumette B. Catatonia and genetic variant in GABA receptor: A case report involving GABRB2. Schizophr Res 2024; 263:191-193. [PMID: 37517920 DOI: 10.1016/j.schres.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/02/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Affiliation(s)
- Adrien Legrand
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014 Paris, France
| | - Mylène Moyal
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014 Paris, France
| | - Claire Deschamps
- Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Cécile Louveau
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014 Paris, France
| | - Anton Iftimovici
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014 Paris, France; Université Paris Cité, Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U1266, Paris, France
| | - Marie-Odile Krebs
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014 Paris, France; Université Paris Cité, Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U1266, Paris, France
| | - Benedicte Héron
- Department of Pediatric Neurology, Armand Trousseau Hospital, AP-HP.Sorbonne University, Paris, France
| | - Boris Keren
- Department of medical genetics, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne University, Paris, France
| | - Alexandra Afenjar
- APHP Sorbonne University, Reference Center for Intellectual Disabilities From Rare Causes, Department of Genetics and Medical Embryology, Armand Trousseau Hospital, F-75012 Paris, France
| | - Boris Chaumette
- GHU PARIS Psychiatrie & Neurosciences, Sainte-Anne Hospital, F-75014 Paris, France; Université Paris Cité, Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U1266, Paris, France; Department of Psychiatry, McGill University, Montreal, Canada.
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Karl S, Sartorius A, Aksay SS. Catatonia and ECT across the lifespan. Schizophr Res 2024; 263:246-251. [PMID: 37087393 DOI: 10.1016/j.schres.2023.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 03/10/2023] [Accepted: 04/12/2023] [Indexed: 04/24/2023]
Abstract
Electroconvulsive therapy (ECT) is a safe and effective treatment for catatonia with high response rates. Although empirical data suggest that tolerability and efficacy are at least as good as in adults, ECT treatment of children, adolescents, and geriatric patients seems to pose a specific challenge for many practitioners. This article intends to explore and discuss reasons hindering the use of ECT in these patient groups, give an overview on the use of ECT to treat catatonia and provide practical advice on ECT in children, adolescents, and geriatric patients for the treatment of catatonia. Classification of catatonia as a subform of schizophrenia and a diagnostic overlap with other common conditions in children, adolescents, and geriatric patients might lead to underdiagnosis of catatonia. Concerns about the mechanism of action and about a lack of controlled studies as well as general concerns about the use of ECT in children and adolescents might lead to underutilization of ECT. However, studies of ECT to treat catatonia in children, adolescents, and geriatric patients consistently show its safety and effectiveness. Administration of ECT needs to consider some specific characteristics of children, adolescents, and geriatric patients. In conclusion, ECT is a safe and highly effective treatment for catatonia across the lifespan. Existing evidence does not warrant restrictions of its use in certain age groups.
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Affiliation(s)
- Sebastian Karl
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany.
| | - Alexander Sartorius
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Suna Su Aksay
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
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Bird F, Shah R, Williams S, Shlesinger A, Luiselli JK, Wachtel LE. Multiyear Evaluation of Maintenance Electroconvulsive Therapy in an Adult With Autism Spectrum Disorder, Catatonia, and Challenging Behavior. J ECT 2023; 39:53-55. [PMID: 35462379 DOI: 10.1097/yct.0000000000000856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We report the case of a 30-year-old man diagnosed with autism spectrum disorder who received electroconvulsive therapy (ECT) over a 4-year period to treat catatonia associated with life-threatening self-injury, aggression, major depression, and associated self-care, daily living, and communication skills deficits. A systematic schedule of maintenance ECT (m-ECT) was associated with elimination of challenging behavior, catatonic and depressive symptom remission, removal of protective equipment, and reduced dosages of psychotropic medications.
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Affiliation(s)
- Frank Bird
- From the Melmark New England, Andover, MA
| | - Ruchi Shah
- From the Melmark New England, Andover, MA
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Moore S, Amatya DN, Chu MM, Besterman AD. Catatonia in autism and other neurodevelopmental disabilities: a state-of-the-art review. NPJ MENTAL HEALTH RESEARCH 2022; 1:12. [PMID: 38609506 PMCID: PMC10955936 DOI: 10.1038/s44184-022-00012-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/26/2022] [Indexed: 04/14/2024]
Abstract
Individuals with neurodevelopmental disabilities (NDDs) may be at increased risk for catatonia, which can be an especially challenging condition to diagnose and treat. There may be symptom overlap between catatonia and NDD-associated behaviors, such as stereotypies. The diagnosis of catatonia should perhaps be adjusted to address symptom overlap and to include extreme behaviors observed in patients with NDDs, such as severe self-injury. Risk factors for catatonia in individuals with NDDs may include trauma and certain genetic variants, such as those that disrupt SHANK3. Common etiologic features between neurodevelopmental disabilities and catatonia, such as excitatory/inhibitory imbalance and neuroimmune dysfunction, may partially account for comorbidity. New approaches leveraging genetic testing and neuroimmunologic evaluation may allow for more precise diagnoses and effective treatments.
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Affiliation(s)
- Shavon Moore
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
- Rady Children's Hospital San Diego, Division of Behavioral Health Services, San Diego, CA, USA
| | - Debha N Amatya
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
- UCLA Semel Institute of Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Michael M Chu
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
- Rady Children's Hospital San Diego, Division of Behavioral Health Services, San Diego, CA, USA
- Children's Hospital of Orange County, Division of Child and Adolescent Psychiatry, Orange, CA, USA
- University of California Irvine, Department of Psychiatry, Irvine, CA, USA
| | - Aaron D Besterman
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA.
- Rady Children's Hospital San Diego, Division of Behavioral Health Services, San Diego, CA, USA.
- Rady Children's Institute for Genomic Medicine, San Diego, CA, USA.
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Vaquerizo-Serrano J, Salazar De Pablo G, Singh J, Santosh P. Catatonia in autism spectrum disorders: A systematic review and meta-analysis. Eur Psychiatry 2021; 65:e4. [PMID: 34906264 PMCID: PMC8792870 DOI: 10.1192/j.eurpsy.2021.2259] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Catatonic features can appear in autism spectrum disorders (ASDs). There can be overlap in symptoms across catatonia and ASD. The overall aim of this review is to provide evidence for the presence of catatonic features in subjects with ASD. METHODS A systematic literature search using the Web of Science database from inception to July 10, 2021 was conducted following PRISMA, MOOSE guidelines and the PROSPERO protocol. (CRD42021248615). Twelve studies with information about catatonia and ASD were reviewed. Data from a subset was used to conduct meta-analyses of the presence of catatonia in ASD. RESULTS The systematic review included 12 studies, seven of which were used for the meta-analysis, comprising 969 individuals. The mean age was 21.25 (7.5) years. Two studies (16.6%) included only children and adolescents. A total of 70-100% were males. Our meta-analysis showed that 10.4% (5.8-18.0 95%CI) of individuals with ASD have catatonia. Motor disturbances were common in ASD subjects with catatonia. No differences were found in comorbidity. Several treatments have been used in ASD with catatonic features, including benzodiazepines, antipsychotics, and electroconvulsive therapy (ECT). The findings of the systematic review showed that ECT might help manage catatonic symptoms. CONCLUSIONS Different features of catatonia can exist in individuals with ASD and core symptoms of catatonia are reported in ASD. Longitudinal and longer-term studies are required to understand the relationship between catatonia and ASD, and the response of catatonic symptoms to treatment.
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Affiliation(s)
- J. Vaquerizo-Serrano
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases
(CIPPRD), National and Specialist Child and Adolescent Mental Health Services, Maudsley
Hospital, LondonSE5 8AB, United Kingdom
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of
Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, LondonSE5 8AF, United Kingdom
- Institute of Psychiatry and Mental Health, Department of Psychiatry, Hospital
General Universitario Gregorio Marañón Instituto de Investigación Sanitaria Gregorio
Maranón, Universidad Complutense, Centro de Investigación Biomédica en Red Salud Mental
(CIBERSAM), 28009Madrid, Spain
| | - G. Salazar De Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of
Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, LondonSE5 8AF, United Kingdom
- Institute of Psychiatry and Mental Health, Department of Psychiatry, Hospital
General Universitario Gregorio Marañón Instituto de Investigación Sanitaria Gregorio
Maranón, Universidad Complutense, Centro de Investigación Biomédica en Red Salud Mental
(CIBERSAM), 28009Madrid, Spain
| | - J. Singh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases
(CIPPRD), National and Specialist Child and Adolescent Mental Health Services, Maudsley
Hospital, LondonSE5 8AB, United Kingdom
| | - P. Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases
(CIPPRD), National and Specialist Child and Adolescent Mental Health Services, Maudsley
Hospital, LondonSE5 8AB, United Kingdom
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Vieira TLPR, Schlittler LXC, Vieira LC, Celeri EHRV, Banzato CEM. Effective Electroconvulsive Therapy for Catatonia in a Patient With Pitt-Hopkins Syndrome and Autism Spectrum Disorder. J ECT 2021; 37:e33-e34. [PMID: 34145172 DOI: 10.1097/yct.0000000000000778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Døssing E, Pagsberg AK. Electroconvulsive Therapy in Children and Adolescents: A Systematic Review of Current Literature and Guidelines. J ECT 2021; 37:158-170. [PMID: 34424874 DOI: 10.1097/yct.0000000000000761] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
ABSTRACT There is a lack of studies regarding the efficacy of electroconvulsive therapy (ECT) in children and adolescents. In this study, we aimed to assess benefits and harms of ECT in children and adolescents with major psychiatric diseases. We conducted a systematic search in PubMed, EMBASE, and PsycINFO for peer-reviewed articles written in English regarding the use of ECT as treatment for major psychiatric diseases in children and adolescents. This study consists of 192 articles, mostly case studies (n = 50), reviews and overview articles (n = 52), and retrospective studies (n = 30). We present an overview of evidence for ECT in children and adolescents with mood disorders, catatonia, schizophrenia, intellectual disability, self-injurious behavior, and other indications. This article is also a summary of international guidelines regarding the use of ECT in children and adolescents. We evaluated the overall quality of evidence by using Grading of Recommendations, Assessment, Development and Evaluations and found the overall level of evidence to be of low quality. There are no absolute contra indications for ECT in children and adolescents. Fears regarding cognitive dysfunction have not been reproduced in studies. Electroconvulsive therapy should be considered in severe, treatment-resistant mood disorders, catatonia, and schizophrenia, especially in older adolescents. High-quality studies are warranted to assess the efficacy of ECT, especially in these potentially life-threatening diseases.
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Affiliation(s)
- Erik Døssing
- From the Child and Adolescent Mental Health Centre, Mental Health Services, Zealand Region, Roskilde
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8
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Treatment of Catatonic Symptoms in a Patient With Autism Spectrum Disorder and Addison Disease: A Case Report. J ECT 2020; 36:e10-e12. [PMID: 32108665 DOI: 10.1097/yct.0000000000000670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE To review the treatment courses of 22 autistic patients diagnosed with catatonia over a 12-year period, including treatment with benzodiazepines and electroconvulsive therapy. METHOD Retrospective review of inpatient and outpatient records of 22 autistic youth presenting to a neurobehavioral service who were treated for catatonia. RESULTS Six girls and 16 boys ranging from ages 8 to 26 years old presenting for neurobehavioral assessment were found to meet criteria for catatonia according to the DSM5 and were treated for such. All but one patient was initially unsuccessfully treated with benzodiazepines in dosages ranging from 1 to 27 mg daily, and all patients underwent electroconvulsive therapy. Mean age of ECT start was 15.6 years old, and the total number of ECT received ranged from 16 to 688, with 13 patients still receiving maintenance ECT at the end of the study period. ECT conferred prominent patient benefit in terms of catatonic symptom reduction, including alleviation of incapacitating, treatment-resistant self-injury. CONCLUSION Myriad symptoms of catatonia were seen in this sample of 22 autistic youth. Implementation of anti-catatonic paradigms, particularly electroconvulsive therapy, conferred vast patient benefit.
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Affiliation(s)
- L E Wachtel
- Kennedy Krieger Institute, Baltimore, MD, USA
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Breen J, Hare DJ. The nature and prevalence of catatonic symptoms in young people with autism. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:580-593. [PMID: 28150394 DOI: 10.1111/jir.12362] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 11/30/2016] [Accepted: 12/21/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND A proportion of young people with autism are reported to show catatonic-like symptoms in adolescence. The aetiology and prevalence of such presentations is unknown but include a set of behaviours that can best be described as attenuated. METHOD The current study empirically investigated the presence and nature of such attenuated behaviours in children and adolescents with autism using a newly developed 34-item third party report measure, the Attenuated Behaviour Questionnaire. Caregivers or parents of young people with autism reported on the presentation of symptoms via the online completion of the Attenuated Behaviour Questionnaire and two established clinical measures of repetitive behaviour and depression. RESULTS Initial results indicate that the Attenuated Behaviour Questionnaire is a workable clinical measure in this population with a degree of discriminant validity with regard to catatonia. Attenuated behaviour indicative of catatonia was relatively common in young people with autism with up to 20.2% having an existing diagnosis of catatonia and evidence of a relationship between attenuated behaviours and measures of depression and repetitive and restricted behaviours. CONCLUSION Catatonic symptoms are more prevalent in young people with autism than previously thought, and the Attenuated Behaviour Questionnaire has potential as a clinical and research tool.
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Affiliation(s)
- J Breen
- Department of Psychology, Royal Holloway University of London, Egham, Surrey, UK
| | - D J Hare
- School of Psychology, Cardiff University, Cardiff, UK
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11
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Response to Electroconvulsive Therapy in Patients With Autism Spectrum Disorder and Intractable Challenging Behaviors Associated With Symptoms of Catatonia. J ECT 2017; 33:63-67. [PMID: 27428481 DOI: 10.1097/yct.0000000000000338] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND There are several reports of electroconvulsive therapy (ECT) used in autism spectrum disorder (ASD) in the context of catatonic symptoms. We describe response to ECT in two adults with ASD and intellectual disability with intractable aggression and self-injurious behaviors associated with catatonic symptoms who had not responded to standard interventions. METHOD Unilateral ECT at a frequency of 3 times a week was given followed by weekly maintenance ECT. RESULTS Patients' catatonic symptoms included episodes of agitation and echophenomena. Electroconvulsive therapy resulted in significant improvement in their behavior problems but 1 patient relapsed when the ECT was discontinued or frequency of treatment reduced. The second patient required 2 courses of ECT before improvement which was maintained on weekly ECT. CONCLUSIONS Electroconvulsive therapy could be a potentially beneficial intervention in patients with ASD and severe challenging behaviors associated with catatonic symptoms including agitated or excited forms of catatonia.
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Abstract
An increasing number of case reports and series document the safe and effective use of electroconvulsive therapy (ECT) in children, adolescents, and young adults with autism spectrum disorder who engage in severe, intractable, repetitive self-injurious behavior (SIB) without environmental or operant function. Although the treatment is very effective for such patients, they typically remain highly dependent on frequent maintenance ECT (M-ECT) to maintain suppression of the SIB achieved during the acute course. Some patients receive M-ECT as frequently as once every 5 days. Such a regimen is quite burdensome for the patient and the patient's family, and the long-term effects of such regimens, starting as early as childhood, are unknown. In this review, we explore the expanding literature supporting the use of ECT for suppressing severe SIB associated with autism spectrum disorder. We also focus on the possible development of alternate nonconvulsive focal forms of brain stimulation, which might replace frequent M-ECT or reduce how frequently a patient needs to receive it. Although there are scarce clinical data currently available supporting these latter treatments, future studies are clearly indicated.
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Advances in the Application of Electroconvulsive Therapy. Curr Behav Neurosci Rep 2016. [DOI: 10.1007/s40473-016-0074-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wijemanne S, Jankovic J. Movement disorders in catatonia. J Neurol Neurosurg Psychiatry 2015; 86:825-32. [PMID: 25411548 DOI: 10.1136/jnnp-2014-309098] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 10/28/2014] [Indexed: 12/13/2022]
Abstract
Catatonia is a complex neuropsychiatric syndrome characterised by a broad range of motor, speech and behavioural abnormalities. 'Waxy flexibility', 'posturing' and 'catalepsy' are among the well-recognised motor abnormalities seen in catatonia. However, there are many other motor abnormalities associated with catatonia. Recognition of the full spectrum of the phenomenology is critical for an accurate diagnosis. Although controlled trials are lacking benzodiazepines are considered first-line therapy and N-Methyl-d-aspartate receptor antagonists also appears to be effective. Electroconvulsive therapy is used in those patients who are resistant to medical therapy. An underlying cause of the catatonia should be identified and treated to ensure early and complete resolution of symptoms.
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Affiliation(s)
- Subhashie Wijemanne
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
| | - Joseph Jankovic
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
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Abstract
Electroconvulsive therapy (ECT) is infrequently considered an "emergency" medical procedure; however, there are certain conditions in which there is considerable urgency to initiate ECT. For example, prompt administration of ECT to treat neuroleptic malignant syndrome and malignant catatonia is necessary to improve a patient's overall prognosis and potentially save the patient's life. In this case, a 57-year-old woman with Huntington's disease was admitted to our medical intensive care unit for failure to thrive due to severe psychotic symptoms. Prior to her admission, the patient had become increasingly psychotic and agitated, resulting in her refusal and/or inability to eat. Efforts to treat her severe psychiatric and behavioral symptoms with various psychopharmacological strategies were largely unsuccessful. As the patient's physical health continued to decline, with loss of approximately 35 pounds over 2 months, her family began making arrangements to transfer her to a hospice facility. The day before she was to be transferred, the psychiatry consultation-liaison service recommended ECT. Unfortunately, this recommendation was complicated because the patient was unable to provide consent. This case report describes the legal and administrative process used to ethically and legally administer ECT without consent from the patient or a court-appointed guardian in order to treat a life-threatening condition. To the best of our knowledge, this report documents the first time ECT has been granted "medical emergency" status in Texas.
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Shoirah H, Hamoda HM. Electroconvulsive therapy in children and adolescents. Expert Rev Neurother 2014; 11:127-37. [DOI: 10.1586/ern.10.178] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Dhossche DM. Decalogue of catatonia in autism spectrum disorders. Front Psychiatry 2014; 5:157. [PMID: 25414675 PMCID: PMC4222130 DOI: 10.3389/fpsyt.2014.00157] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 10/23/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Dirk M Dhossche
- University of Mississippi Medical Center , Jackson, MS , USA
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Dhossche DM, Goetz M, Gazdag G, Sienaert P. New DSM-5 category ‘unspecified catatonia’ is a boost for pediatric catatonia: review and case reports. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/npy.13.42] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Abstract
OBJECTIVE Catatonia, a disorder of movement and mood, was described and named in 1874. Other observers quickly made the same recognition. By the turn of the century, however, catatonia was incorporated as a type within a conjured syndrome of schizophrenia. There, catatonia has lain in the psychiatric classification for more than a century. METHOD We review the history of catatonia and its present status. In the 1970s, the tie was questioned when catatonia was recognized among those with mood disorders. The recognition of catatonia within the neuroleptic malignant syndrome offered effective treatments of high doses of benzodiazepines and electroconvulsive therapy (ECT), again questioning the tie. A verifying test for catatonia (the lorazepam sedation test) was developed. Soon the syndromes of delirious mania, toxic serotonin syndrome, and the repetitive behaviors in adolescents with autism were recognized as treatable variations of catatonia. RESULTS Ongoing studies now recognize catatonia among patients labeled as suffering from the Gilles de la Tourette's syndrome, anti-NMDAR encephalitis, obsessive-compulsive disease, and various mutisms. CONCLUSION Applying the treatments for catatonia to patients with these syndromes offers opportunities for clinical relief. Catatonia is a recognizable and effectively treatable neuropsychiatric syndrome. It has many faces. It warrants recognition outside schizophrenia in the psychiatric disease classification.
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Affiliation(s)
- Max Fink
- Department of Psychiatry and Neurology Emeritus, Stony Brook University, Long Island, NY, USA.
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Consoli A, Cohen J, Bodeau N, Guinchat V, Wachtel L, Cohen D. Electroconvulsive therapy in adolescents with intellectual disability and severe self-injurious behavior and aggression: a retrospective study. Eur Child Adolesc Psychiatry 2013; 22:55-62. [PMID: 22923049 DOI: 10.1007/s00787-012-0320-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 08/06/2012] [Indexed: 12/01/2022]
Abstract
Efficacious intervention for severe, treatment-refractory self-injurious behavior and aggression (SIB/AGG) in children and adolescents with intellectual disability and concomitant psychiatric disorders remains a complex and urgent issue. The aim of this study is to assess the efficacy of electroconvulsive therapy (ECT) on severe and treatment-resistant SIB/AGG in young people with intellectual disability and current psychiatric disorder. We reviewed the charts of all patients (N = 4) who received ECT in the context of SIB/AGG with resistance to behavioral interventions, milieu therapy and pharmacotherapy from 2007 to 2011. We scored the daily rate of SIB/AGG per patient for each hospital day. Inter rater reliability was good (intraclass correlations = 0.91). We used a mixed generalized linear model to assess whether the following explanatory variables (time, ECT) influenced the course of SIB/AGG over time, the dependant variable. The sample included two girls and two boys. The mean age at admission was 13.8 years old [range 12-14]. The patients had on average 19 ECT sessions [range 16-26] and one patient received maintenance ECT. There was no effect of time before and after ECT start. ECT was associated with a significant decrease in SIB/AGG scores (p < 0.001): mean aggression score post-ECT was half the pre-ECT value. ECT appears beneficial in severe, treatment-resistant SHBA in adolescents with intellectual disability.
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Affiliation(s)
- Angele Consoli
- Department of Child and Adolescent Psychiatry, GH Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l'Hôpital, 75013, Paris, France.
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Wachtel LE, Dhossche DM, Kellner CH. When is electroconvulsive therapy appropriate for children and adolescents? Med Hypotheses 2011; 76:395-9. [DOI: 10.1016/j.mehy.2010.11.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 11/04/2010] [Indexed: 11/29/2022]
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Wachtel LE, Reti IM, Dhossche DM, Slomine BS, Sanz J. Stability of neuropsychological testing during two years of maintenance electroconvulsive therapy in an autistic man. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:301-2. [PMID: 21111019 DOI: 10.1016/j.pnpbp.2010.11.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 11/09/2010] [Accepted: 11/10/2010] [Indexed: 10/18/2022]
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Sienaert P. What we have learned about electroconvulsive therapy and its relevance for the practising psychiatrist. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:5-12. [PMID: 21324237 DOI: 10.1177/070674371105600103] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In this narrative review, the current knowledge base on the efficacy and the practice of electroconvulsive therapy (ECT) is reviewed, and its relevance for the practising psychiatrist is appreciated. In the past decade, several large-scale studies have confirmed the significant superiority of ECT in the treatment of severe and refractory psychiatric conditions, such as major depressive disorder and bipolar disorder. However, the efficacy of ECT is not reflected in current treatment algorithms, where ECT is often reserved as a last resort. However, clinical characteristics, such as the presence of psychotic symptoms, suicidality, or catatonic signs, should prompt the clinician to consider ECT earlier in the treatment course. ECT is a safe procedure, without absolute contraindications for its use. Nevertheless, patients' fears and complaints should be acknowledged, and patients should be adequately informed about expected benefits and possible risks, such as memory problems, that are generally transient. Research focusing on further minimizing memory problems, while maintaining a superior efficacy, is ongoing. Adequate continuation treatment, either pharmacotherapy or continuation ECT, after a successful ECT course is of vital importance to maintain the benefits achieved and should be the focus of future research.
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Affiliation(s)
- Pascal Sienaert
- ECT Department, University Psychiatric Center-Catholic University Leuven, campus Kortenberg, Leuvensesteenweg 517, Kortenberg, Belgium.
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Abstract
OBJECTIVES In child and adolescent psychiatry, catatonia is infrequent, but it is one of the most severe syndromes, characterized by the coexistence of psychic and motor symptoms. In this report, we explore the therapeutic experience with electroconvulsive therapy (ECT) in adolescents with catatonia. METHODS We review the literature (1985-2009) to clarify issues related to the use of ECT in child and adolescent patients with catatonia. RESULTS Electroconvulsive therapy is used as second-line management after high-dose benzodiazepine trials. Electroconvulsive therapy is an effective, safe, and useful procedure in the treatment of catatonic youngsters as reported in 59 patients. Ethical issues regarding the use of ECT are analyzed and their implications briefly discussed in the light of general medical ethics. CONCLUSIONS Electroconvulsive therapy is a safe and effective treatment for catatonia in children and adolescents.
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Dhossche D, Cohen D, Ghaziuddin N, Wilson C, Wachtel LE. The study of pediatric catatonia supports a home of its own for catatonia in DSM-5. Med Hypotheses 2010; 75:558-60. [DOI: 10.1016/j.mehy.2010.07.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Accepted: 07/17/2010] [Indexed: 11/30/2022]
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Catatonia is hidden in plain sight among different pediatric disorders: a review article. Pediatr Neurol 2010; 43:307-15. [PMID: 20933172 DOI: 10.1016/j.pediatrneurol.2010.07.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 05/07/2010] [Accepted: 07/13/2010] [Indexed: 11/20/2022]
Abstract
Over the past two decades, catatonia has been better demarcated in adult psychiatry as a unique syndrome that consists of specific motor signs with a characteristic response to benzodiazepines and electroconvulsive therapy. Pediatric catatonia is considered rare, but may be underdiagnosed, and hence undertreated. Discussed here are the current diagnostic criteria of catatonia in individual cases of children and adolescents diagnosed with childhood disintegrative disorder, Kleine-Levin syndrome, Prader-Willi syndrome, tic disorder, and autoimmune encephalitis, and the effects of benzodiazepines and electroconvulsive therapy. In these cases, catatonia resolved safely once it was recognized and treated properly. Children and adolescents presenting with these disorders should be systematically assessed for catatonia; when the presence of catatonia is confirmed, the use of benzodiazepines and electroconvulsive therapy should be considered. The occurrence of catatonia in such a wide range of child and adolescent disorders supports the view that pediatric catatonia is not so rare, that there are shared elements in the etiology, psychopathology, and pathophysiology of these disorders, and that catatonia is best classified as a unique neurobiologic syndrome.
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Wachtel LE, Griffin MM, Dhossche DM, Reti IM. Brief report: Electroconvulsive therapy for malignant catatonia in an autistic adolescent. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2010; 14:349-58. [PMID: 20591959 DOI: 10.1177/1362361309350135] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 14-year-old male with autism and mild mental retardation developed malignant catatonia characterized by classic symptoms of catatonia, bradycardia and hypothermia. Bilateral electroconvulsive therapy and lorazepam were required for resolution. The case expands the occurrence of catatonia in autism into its malignant variant.
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Current World Literature. Curr Opin Neurol 2010; 23:194-201. [DOI: 10.1097/wco.0b013e328338cade] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Serendipity and science: the double anniversary of a treatment and a journal. J ECT 2009; 25:1-2. [PMID: 19258862 DOI: 10.1097/yct.0b013e31818f5755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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