ABSTRACT
Autism spectrum disorder and psychotic disorders/schizophrenia are separate disorders in the DSM-5. Due to overlapping symptoms and increased frequency in comorbidity they can be a diagnostic and therapeutic challenge in clinical practice. Relevant literature regarding the correlation between these disorders is discussed and linked to a case-report. An increased prevalence of autism/autistic traits is observed within psychotic patients and vice versa. Common symptoms and risk-factors, but also differential factors, are described. Despite of several hypotheses concerning increased frequency in comorbidity, no clear explanation was found so far. Little is known concerning treatment in case of comorbidity. In this case-report there was significant amelioration after treatment with an atypical antipsychotic. Psycho-education and attention to structuring are also important elements of the treatment plan.
Subject(s)
Autism Spectrum Disorder , Psychotic Disorders , Schizophrenia , Humans , Autism Spectrum Disorder/diagnosis , Autism Spectrum Disorder/epidemiology , Autism Spectrum Disorder/therapy , Comorbidity , Diagnosis, Differential , Psychotic Disorders/diagnosis , Schizophrenia/diagnosis , Schizophrenia/epidemiology , AdolescentABSTRACT
Catatonia is a psychomotor syndrome characterised by multiple symptoms like stereotypies - repetitive, abnormally frequent, non-goal-directed movements. A problem is the lack of unanimity regarding the number of symptoms needed for diagnosis. We describe repetitive inappropriate sexual behaviour in a patient with bipolar depression and excited catatonia with Bush-Francis Catatonia Rating Scale score of 12. Electroconvulsive therapy resulted in disappearance of catatonia and inappropriate sexual behaviour and remission of depression. A recurrent episode with similar inappropriate sexual behaviour was successfully treated with electroconvulsive therapy. We interpreted the repetitive inappropriate sexual behaviour as a catatonic stereotypy. Similar stereotypies are reported in children with autism. Tics and self-injury in patients with autism are described as a stereotypy within catatonia. The agitated depression is another possible diagnosis with the repetitive inappropriate sexual behaviour as an example of psychomotor agitation. More research is needed towards repetitive inappropriate sexual behaviour as a possible stereotypy within catatonia.
