Catatonia Associated with Late Regression in Autism

November 29, 2021

Mean Onset Age of Late Regression is 13 years

According to the American Academy of Pediatrics, approximately 25% of cases of autism are due to early regression. This phenomenon, often referred to as regressive autism, occurs when symptoms of autism materialize after a period of normal development, typically between 18-24 months of age. Most parents of children with autism are familiar with regressive autism. But many parents are unaware of another type of regression associated with ASD that can happen later. In most cases, this late regression occurs in adolescents with an established diagnosis of autism. A new brief report published in Frontiers in Psychiatry examines this heartbreaking condition. The article defines late regression as a significant decline in social, communication and other areas of functioning that occurred in a relatively well functioning adolescent with ASD. The report followed 20 individuals with ASD that developed late regression and looked at the presentation of their conditions, as well as their comorbidities and short-term outcomes. Of the 20 patients sampled (12 males, 8 females; age 13-17), the mean age of onset of late regression was 13 years old. Their presenting symptoms consisted of an increase in obsessive slowing and ritualistic behaviors, severe aggressive behavior either of a recent onset or worsening of an established behavioral pattern, intense mood symptoms, auditory or visual hallucinations, eating problems with excessive or minimal food intake, changes in speech patterns including muteness, or a combination of these behaviors. The most common comorbid condition of these patients was catatonia (85%) followed by disruptive behavior disorder (50%), mood disorder (50%), and psychotic disorder (35%). Many of the subjects (75%) had a family history of psychiatric illnesses in first-degree relatives. Seven patients had chromosomal abnormalities including two with Down syndrome. Each patient that had chromosomal abnormalities experienced catatonia. Treatment for late regression consisted of medication trials (antipsychotics and benzodiazepines), behavioral therapy and in some cases, electroconvulsive therapy (ECT). In the end, the outcome was rated “fair” for 12 patients, “poor” for six patients, and “good” in only two patients. The study’s author calls for more research on this little known condition in order to identify the etiology of this phenenomenon, assess risk and vulnerability factors, including its comorbidity with catatonia so that early diagnosis and treatment can occur. 

Original Study

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