Longitudinal Symptom Burden and Pharmacologic Management of Catatonia in Autism With Intellectual Disability: An Observational Study / Joshua Ryan SMITH ; Seri LIM ; Snehal BINDRA ; Sarah MARLER ; Bavani RAJAH ; Zachary J. WILLIAMS ; Isaac BALDWIN ; Nausheen HOSSAIN ; Jo Ellen WILSON ; D. Catherine FUCHS ; James LUCCARELLI in Autism Research, 18-2 (February 2025)  

Public ISBD [article]  inAutism Research > 18-2 (February 2025) . - p.449-462 Titre : Longitudinal Symptom Burden and Pharmacologic Management of Catatonia in Autism With Intellectual Disability: An Observational Study : Autism Research Type de document : texte imprimé Auteurs : Joshua Ryan SMITH, Auteur ; Seri LIM, Auteur ; Snehal BINDRA, Auteur ; Sarah MARLER, Auteur ; Bavani RAJAH, Auteur ; Zachary J. WILLIAMS, Auteur ; Isaac BALDWIN, Auteur ; Nausheen HOSSAIN, Auteur ; Jo Ellen WILSON, Auteur ; D. Catherine FUCHS, Auteur ; James LUCCARELLI, Auteur Article en page(s) : p.449-462 Langues : Anglais (eng) Mots-clés : aggression autism catatonia electroconvulsive therapy psychopharmacology self-injurious behavior Index. décimale : PER Périodiques Résumé : ABSTRACT Catatonia is a highly morbid psychomotor and affective disorder, which can affect autistic individuals with and without intellectual disability. Catatonic symptoms are treatable with pharmacotherapy and electroconvulsive therapy, but the longitudinal effectiveness of these treatments in autistic individuals has not been described. We conducted a prospective observational cohort study of patients with autism and co-morbid catatonia who received outpatient care in a specialized outpatient clinic from July 1, 2021 to May 31, 2024. Data investigating pharmacologic interventions, and clinical measures including the Bush Francis Catatonia Rating Scale (BFCRS), Kanner Catatonia Severity Scale (KCS), Kanner Catatonia Examination (KCE), and Clinical Global Impression Improvement (CGI-I) were collected. Forty-five autistic patients with co-morbid catatonia were treated during the study period. The mean age was 15.6 (SD 7.9) years [Mdn 16.0, range 6.0 31.0]. Forty-one patients (91.1%) met criteria for autism with co-occurring intellectual disability. All patients received pharmacotherapy. Forty-four (97.8%) were treated with benzodiazepines with a mean maximal daily dose of 17.4 mg (SD 15.8) lorazepam equivalents. Thirty-five patients (77.8%) required more than one medication class for treatment. Sixteen (35.6%) patients received electroconvulsive therapy. Fourteen patients (31.1%) attempted to taper off benzodiazepines after achieving clinical improvement during the study period; of these, 5 patients (11.1%) were successfully tapered off, and the remaining 9 (17.8%) discontinued the taper due to a return of catatonic symptoms. Statistically significant improvement was observed across all clinical domains except the KCS. However, the majority remained at least partially symptomatic over the study period. Three patients (6.7%) died over the study period. Despite clinical improvements while receiving the gold standard for psychopharmacologic management of catatonia, chronic symptoms remained for the majority of catatonia patients over the study period, and few were able to taper and discontinue benzodiazepine treatment. Notably, the open label design of this study is a limiting factor when interpreting the results. En ligne : https://doi.org/10.1002/aur.3315 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=547 [article] Longitudinal Symptom Burden and Pharmacologic Management of Catatonia in Autism With Intellectual Disability: An Observational Study : Autism Research [texte imprimé] / Joshua Ryan SMITH, Auteur ; Seri LIM, Auteur ; Snehal BINDRA, Auteur ; Sarah MARLER, Auteur ; Bavani RAJAH, Auteur ; Zachary J. WILLIAMS, Auteur ; Isaac BALDWIN, Auteur ; Nausheen HOSSAIN, Auteur ; Jo Ellen WILSON, Auteur ; D. Catherine FUCHS, Auteur ; James LUCCARELLI, Auteur . - p.449-462. Langues : Anglais (eng) in Autism Research > 18-2 (February 2025) . - p.449-462 Mots-clés : aggression autism catatonia electroconvulsive therapy psychopharmacology self-injurious behavior Index. décimale : PER Périodiques Résumé : ABSTRACT Catatonia is a highly morbid psychomotor and affective disorder, which can affect autistic individuals with and without intellectual disability. Catatonic symptoms are treatable with pharmacotherapy and electroconvulsive therapy, but the longitudinal effectiveness of these treatments in autistic individuals has not been described. We conducted a prospective observational cohort study of patients with autism and co-morbid catatonia who received outpatient care in a specialized outpatient clinic from July 1, 2021 to May 31, 2024. Data investigating pharmacologic interventions, and clinical measures including the Bush Francis Catatonia Rating Scale (BFCRS), Kanner Catatonia Severity Scale (KCS), Kanner Catatonia Examination (KCE), and Clinical Global Impression Improvement (CGI-I) were collected. Forty-five autistic patients with co-morbid catatonia were treated during the study period. The mean age was 15.6 (SD 7.9) years [Mdn 16.0, range 6.0 31.0]. Forty-one patients (91.1%) met criteria for autism with co-occurring intellectual disability. All patients received pharmacotherapy. Forty-four (97.8%) were treated with benzodiazepines with a mean maximal daily dose of 17.4 mg (SD 15.8) lorazepam equivalents. Thirty-five patients (77.8%) required more than one medication class for treatment. Sixteen (35.6%) patients received electroconvulsive therapy. Fourteen patients (31.1%) attempted to taper off benzodiazepines after achieving clinical improvement during the study period; of these, 5 patients (11.1%) were successfully tapered off, and the remaining 9 (17.8%) discontinued the taper due to a return of catatonic symptoms. Statistically significant improvement was observed across all clinical domains except the KCS. However, the majority remained at least partially symptomatic over the study period. Three patients (6.7%) died over the study period. Despite clinical improvements while receiving the gold standard for psychopharmacologic management of catatonia, chronic symptoms remained for the majority of catatonia patients over the study period, and few were able to taper and discontinue benzodiazepine treatment. Notably, the open label design of this study is a limiting factor when interpreting the results. En ligne : https://doi.org/10.1002/aur.3315 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=547

Symptoms of Catatonia Observed in Down Syndrome Regressive Disorder: A Retrospective Analysis / Joshua R. SMITH in Journal of Autism and Developmental Disorders, 55-11 (November 2025)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 55-11 (November 2025) . - p.4160-4166 Titre : Symptoms of Catatonia Observed in Down Syndrome Regressive Disorder: A Retrospective Analysis Type de document : texte imprimé Auteurs : Joshua R. SMITH, Auteur ; Isaac BALDWIN, Auteur ; Seri LIM, Auteur ; James LUCCARELLI, Auteur Article en page(s) : p.4160-4166 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Down Syndrome Regressive Disorder (DSRD) is a neuropsychiatric condition associated with severe symptomology and a negative impact on quality of life. DSRD frequently presents with catatonic symptoms. However, few studies have reported the specific catatonic symptoms that occur in DSRD. En ligne : https://doi.org/10.1007/s10803-024-06249-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570 [article] Symptoms of Catatonia Observed in Down Syndrome Regressive Disorder: A Retrospective Analysis [texte imprimé] / Joshua R. SMITH, Auteur ; Isaac BALDWIN, Auteur ; Seri LIM, Auteur ; James LUCCARELLI, Auteur . - p.4160-4166. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 55-11 (November 2025) . - p.4160-4166 Index. décimale : PER Périodiques Résumé : Down Syndrome Regressive Disorder (DSRD) is a neuropsychiatric condition associated with severe symptomology and a negative impact on quality of life. DSRD frequently presents with catatonic symptoms. However, few studies have reported the specific catatonic symptoms that occur in DSRD. En ligne : https://doi.org/10.1007/s10803-024-06249-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570

Use of ECT in Autism Spectrum Disorder and/or Intellectual Disability: A Single Site Retrospective Analysis / Joshua R. SMITH in Journal of Autism and Developmental Disorders, 54-3 (March 2024)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 54-3 (March 2024) . - p.963-982 Titre : Use of ECT in Autism Spectrum Disorder and/or Intellectual Disability: A Single Site Retrospective Analysis Type de document : texte imprimé Auteurs : Joshua R. SMITH, Auteur ; Corey E. HOPKINS, Auteur ; Jiangmei XIONG, Auteur ; James LUCCARELLI, Auteur ; Elizabeth SHULTZ, Auteur ; Simon VANDEKAR, Auteur Article en page(s) : p.963-982 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Autism spectrum disorder (ASD) and intellectual disability (ID) are heterogenous and prevalent conditions which may occur in isolation or as a co-morbidity. Psychiatric co-morbidity is common with limited treatment options. Preliminary research into electroconvulsive therapy (ECT) for these conditions has been encouraging. Thus, further research in this patient population is warranted. We conducted a 10-year retrospective review of the electronic medical record and identified intellectually capable individuals with ASD (IC-ASD), and those with ASD+ID or ID who received at least three ECT treatments. 32 patients were identified of which 30 (94%) experienced positive clinical response, defined as a clinical global impression-improvement (CGI-I) score of 3 or less. The average retrospective CGI-I score across all groups was 1.97, and results of a t-test performed on CGI-I scores indicated improvement across all groups [t = ? 16.54, df = 31, p<0.001, 95% CI = (1.72, 2.22)]. No significant adverse events were identified based on clinical documentation. Our findings further support previous ECT research in this patient population. En ligne : https://doi.org/10.1007/s10803-022-05868-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=524 [article] Use of ECT in Autism Spectrum Disorder and/or Intellectual Disability: A Single Site Retrospective Analysis [texte imprimé] / Joshua R. SMITH, Auteur ; Corey E. HOPKINS, Auteur ; Jiangmei XIONG, Auteur ; James LUCCARELLI, Auteur ; Elizabeth SHULTZ, Auteur ; Simon VANDEKAR, Auteur . - p.963-982. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 54-3 (March 2024) . - p.963-982 Index. décimale : PER Périodiques Résumé : Autism spectrum disorder (ASD) and intellectual disability (ID) are heterogenous and prevalent conditions which may occur in isolation or as a co-morbidity. Psychiatric co-morbidity is common with limited treatment options. Preliminary research into electroconvulsive therapy (ECT) for these conditions has been encouraging. Thus, further research in this patient population is warranted. We conducted a 10-year retrospective review of the electronic medical record and identified intellectually capable individuals with ASD (IC-ASD), and those with ASD+ID or ID who received at least three ECT treatments. 32 patients were identified of which 30 (94%) experienced positive clinical response, defined as a clinical global impression-improvement (CGI-I) score of 3 or less. The average retrospective CGI-I score across all groups was 1.97, and results of a t-test performed on CGI-I scores indicated improvement across all groups [t = ? 16.54, df = 31, p<0.001, 95% CI = (1.72, 2.22)]. No significant adverse events were identified based on clinical documentation. Our findings further support previous ECT research in this patient population. En ligne : https://doi.org/10.1007/s10803-022-05868-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=524

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