Catatonia and autism in adult psychiatric services

Catatonia is a severe, potentially life-threatening syndrome of progressing motor and behavioural symptoms. Catatonia can occur as a complication to a number of psychiatric disorders, e. g. bipolar disorder or schizophrenia. According to current knowledge, around 10% of adult psychiatric inpatients are affected by catatonia. After over 100 years of having been exclusively associated with schizophrenia, catatonia was reinstated as a diagnosis of its own with the introduction of the DSM-5 in 2013. Because of the recent re-introduction, the knowledge gaps are substantial. There are readily available and effective treatments for catatonia – but the syndrome is commonly underdiagnosed. The symptoms of catatonia are often attributed to other psychiatric disorders, that commonly co-occur with catatonia (e.g. psychosis or severe depression).

Autism is a developmental disability characterized by deficits in social reciprocity and communication, and restricted or repetitive behaviours. Autism affects between 1-1,5% of the population, and is associated with genetic as well as environmental factors. A substantial degree of co-occurring psychiatric and somatic conditions are commonly seen in children, adolescents and adults with autism. During the last 10-20 years, a number of studies have shown that autism is over-represented in adult psychiatric settings. Adults with autism, who hasn’t received a diagnosis of autism until adult age, is an increasing group in adult psychiatric settings. The knowledge gaps regarding this group is substantial, especially in terms of prognosis / longitudinal outcomes.

According to a number of studies during the last 20-30 years, individuals with autism are more susceptible than others to develop catatonia. Differentiating symptoms of autism from symptoms of catatonia is difficult – as is also the case when differentiating catatonia and scizhophrenia – because of the substantial symptomatic overlap.

The purpose of this project is to describe catatonia and its symptomatic overlap with other psychiatric disorders, e. g. schizophrenia and autism. The project aims at improving diagnostic procedures for catatonia and increase access to effective treatment for those affected. The project will also describe longitudinal outcomes in adult psychiatric patients with autism. The project will involve clinical assessments of adult psychiatric inpatients with catatonia at the hospitals in Helsingborg and Skövde. As part of the project, we will also conduct a literature review of the symptomatic overlap between catatonia, schizophrenia and autism, and conduct long-term follow-ups using charts and registers of American and Swedish patients.