as small as a world and as large as alone, What is autistic catatonia?

12:37pm June 30, 2014

Anonymous asked: What is autistic catatonia?

http://bjp.rcpsych.org/content/176/4/357.long

That’s the article that got me diagnosed.

Criteria for catatonia

There are no generally accepted standardised criteria for diagnosing catatonia. In this study, a diagnosis of catatonia was given when exacerbation of certain features of behaviour occurred in sufficient degree to interfere with movement and everyday functions of self-care, education, occupation and leisure. The essential features were:

increased slowness affecting movements and verbal responses;

difficulty in initiating and completing actions;

increased reliance on physical or verbal prompting by others; and

increased passivity and apparent lack of motivation.

Other abnormalities of behaviour often associated were:

e. reversal of day and night;

f. Parkinsonian features: tremor, eyerolling, dystonia, odd stiff posture, freezing in postures, etc.;

g. excitement and agitation; and

h. increase in repetitive, ritualistic behaviour.

Basically catatonic features exist in autistic people in general, most people don’t know what catatonia is, but it’s a complex condition affecting movement in complex ways, basically.

Here’s a description of catatonia compiled by Martha Leary and Anne Donnellan:

The possible connection between symptoms of movement disturbance and “mental” disorders was first discussed in 1874 by Ludwig Kahlbaum a German physician. A summary of Kahlbaum and others’ descriptions of patients can be seen in the list below. In the nineteenth century the term catatonia was used. Later, catatonia came to be defined more narrowly as a kind of schizophrenia characterized by absence of movement. Regardless of the terms used, there has been a continuing awareness of these behaviors in persons diagnosed with a variety of psychiatric and neurological disorders, including autism/mental retardation.

Characteristics of Catatonia

Simple Disorders of Movement

Repetitive movements — self stimulation, repeated actions

Abnormal facial movement — expressionless, flaccid or fixed expression, abnormal eye movements, grimaces, teeth grinding, facial tics, lip movements

Abnormal gait — too fast, slow, halting, peculiar, stiff walking

Mannerisms — posing, unusual manner of eating, tic-like movements

Blocking and freezing — lack of movement, difficulty starting movement, stopping during on-going movement, difficulty completing actions

Unusual postures — odd hand and body postures, flexion of neck, trunk or limbs

Abnormalities in muscle tone — too little or too much muscle tone, rigid, floppy

More Complex Disorders of Volition

Automatic obedience — excessive compliance, follows commands instantly

Echopraxia — forced imitation of another person

Lack of imitation — unable to imitate others

Negativism — does the opposite of what is expected or routine

Stripping

Extreme suggestibility

Difficulty initiating actions, postures, thoughts

Difficulty stopping or switching actions, postures, thoughts

Very Complex Disorders of Overall Behavior

General overactivity — continuous movement, difficulty stopping

Impulsiveness — action without consciousness of motives, easily aroused without inhibiting components

Frenzy — explosive or violent movement episodes

Destructiveness, aggression

Self mutilation

Extreme response to minor changes

Decreased activity — motionless, stays in one place for long periods, difficulty initiating

Decreased responsiveness — little or no response to others, aversion to contact with others, stupor or arrest, deepening and intensification of attention

Maintenance of postures — including thought and perceptual postures

Disorders of Speech

Vocal or verbal tics

Stereotyped verbalizations

Mutism — lack of speech or decreased use of speech

Slowness or delay in answering

Labored speech

Unusual vocal melody — lack of intonation, stereotyped intonation, monotone voice

Unusual loudness of volume — shouting, screaming, whispering

Disturbance of rhythm of speech — talks too fast, too slowly, with unusual stress patterns

Outbursts of speech

Swearing

Falsetto voice

Repeats names of places, cities, towns

Unmotivated laughter

Echolalia

Repetition of words, phrases, topics

Unintelliglble speech

(Sources include Kahlbaum (1874/1973), Bleuler (1911/1950), Abrams and Taylor (1976), Wing and Attwood (1987), Sacks (1990), Realmuto and August (1991), Lund, Mortimer, Rogers, and McKenna (1991), Johnson (1993).)

[…]

In contrast to the view that catatonia is a type of schizophrenia, the literature contains documentation of a wide range of causes of catatonia including infections (e.g., encephalitis lethargica, herpes simplex); vascular events; brain lesions; metabolic differences (e.g., porphyria, carbon monoxide poisoning); drugs (e.g., alcohol, neuroleptics, lithium); and epilepsy (i.e., non-convulsive epileptic status).

In Characteristics of Catatonia, above, we list some of the symptoms that have been associated with catatonia. Our interest is in understanding the symptoms, rather than the label, syndrome, or diagnostic category. Many of these symptoms have also been identified as problematic for people with labels of autism/mental retardation.

Most autistic people have some catatonic traits. But some autistic people develop more of them in adolescence, and that’s what the first article deals with. It can be slowly progressive, it can happen really fast, or it can be an intermittent thing. For me it was like a slow back and forth with things getting more and more difficult over time, but at any given time things could be fluctuating a lot. Like a wavy line going downwards overall but wavy over the shorter distances. I started showing signs when I was about 12 (and had some traits before that), but was not diagnosed until I was 20, which is when the above article came out and was brought to the attention of a psychiatrist who had known me for 6 years at that point.

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