Catatonia in Autistic Adults in a Tertiary Inpatient and Outpatient Neurodevelopmental Service: A Retrospective Review.

Catatonia is a syndrome that affects movement, speech and behaviours, in varying degrees of severity. There is an increasing research interest in catatonia in autistic adults. Bulk of the studies are in children and youth, and few have reported on clinical presentation and treatment outcomes of catatonia in autistic adults. The aim of the study is to determine the prevalence, clinical characteristics and treatment outcomes for catatonia in adults with autism spectrum disorder in a tertiary neurodevelopmental service. This retrospective chart review was carried out to identify autistic adults presenting with catatonic symptoms. Wing and Shah criteria for catatonia were used for confirmation of the diagnosis. Out of 143 individuals with a confirmed diagnosis of autism spectrum disorder, sixteen (11.1%) of them were identified to have catatonic symptoms and co-occurring intellectual disability Commonly reported catatonic symptoms included difficulties in initiating actions (n = 16), posturing (n = 14), freezing (n = 6), and reduced motor movements (n = 16). Eleven (11) of them responded rapidly to lorazepam (dose range 6 mg- 24 mg). One participant received ECT with full improvement in catatonic symptoms, and two declined. The prevalence rate of catatonia (11.1%) in autistic adults in the tertiary neurodevelopmental service, a specialized setting, is similar to previous studies. Most study participants showed complete resolution of symptoms with a combination of high dosages of benzodiazepines and psychosocial interventions. Use of specific tools for diagnosis of catatonia in autism spectrum disorder, such as Wing and Shah's criteria, can help with diagnostic accuracy.