Catatonia and Autoimmune Conditions in Children and Adolescents: Should We Consider a Therapeutic Challenge?

J Child Adolesc Psychopharmacol. 2017 Mar;27(2):167-176. doi: 10.1089/cap.2015.0086. Epub 2016 Apr 19.

Abstract

Objective: Catatonia as a result of autoimmune conditions offers new therapeutic opportunities for patients that child and adolescent psychiatrists should consider. However, the diagnosis is sometimes challenging when an autoimmune signature is not identified.

Methods: In this study, we aim to summarize seven cases from a 20-year series of 84 youths with catatonia, including three cases that represented a diagnostic challenge because of the absence of positive autoimmune testing.

Results: Immunosuppressive/modulatory treatment improved catatonic and psychotic features in all cases.

Conclusion: To facilitate treatment decision-making, we propose a causality assessment score and a treatment algorithm, which may help clinicians consider whether an autoimmune condition is associated with catatonia.

Keywords: acute psychotic episode; autoimmune condition; catatonia; immunosuppressive treatment; treatment algorithm.

MeSH terms

  • Adolescent
  • Algorithms
  • Autoimmune Diseases / diagnosis*
  • Autoimmune Diseases / drug therapy
  • Catatonia / diagnosis*
  • Catatonia / drug therapy
  • Catatonia / immunology
  • Child
  • Clinical Decision-Making
  • Female
  • Humans
  • Immunologic Factors / therapeutic use*
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Prospective Studies

Substances

  • Immunologic Factors
  • Immunosuppressive Agents