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- Title
Neurodevelopmental Disorders, Schizophrenia Spectrum Disorders and Catatonia: The "Iron Triangle" Rediscovered in a Case Report.
- Authors
Fantozzi, Pamela; Del Grande, Claudia; Berloffa, Stefano; Tolomei, Greta; Salluce, Carmen; Narzisi, Antonio; Salarpi, Gianluca; Capovani, Barbara; Masi, Gabriele
- Abstract
Catatonia is a complex neuropsychiatric syndrome, occurring in the context of different psychiatric and neurodevelopmental disorders, in neurological and medical disorders, and after substance abuse or withdrawal. The relationship between Autism Spectrum Disorder (ASD), Schizophrenia Spectrum Disorders (SSDs) and catatonia has been previously discussed, with the three disorders interpreted as different manifestations of the same underlying brain disorder (the "Iron Triangle"). We discuss in this paper the diagnostic, clinical and therapeutic implications of this complex relationship in an adolescent with ASD, who presented an acute psychotic onset with catatonia, associated with mixed mood symptoms. Second-generation antipsychotics were used to manage psychotic, behavioral and affective symptoms, with worsening of the catatonic symptoms. In this clinical condition, antipsychotics may be useful at the lowest dosages, with increases only in the acute phases, especially when benzodiazepines are ineffective. Mood stabilizers with higher GABAergic effects (such as Valproate and Gabapentin) and Lithium salts may be more useful and well tolerated, given the frequent association of depressive and manic symptoms with mixed features.
- Subjects
THERAPEUTIC use of lithium; DIAGNOSIS of schizophrenia; DIAGNOSIS of autism; SUBSTANCE abuse; ELECTROCONVULSIVE therapy; CATATONIA; CHILD psychopathology; MENTAL depression; CLASSIFICATION of mental disorders; EMOTION regulation; ANTIPSYCHOTIC agents; VALPROIC acid; GABAPENTIN; TRANQUILIZING drugs; SYMPTOMS; ADOLESCENCE
- Publication
Children, 2023, Vol 10, Issue 1, p77
- ISSN
2227-9067
- Publication type
Article
- DOI
10.3390/children10010077