Decalogue of Catatonia in Autism Spectrum Disorders

This article is an unabashed drumroll for increased recognition and treatment of catatonia in autism spectrum disorders (ASD). This new diagnostic and treatment paradigm has emerged during the last decade (1, 2) and is supported by changes in catatonia classification in DSM-5 (3) purporting to boost recognition of pediatric catatonia and catatonia in ASD (4). Findings are summarized, a vignette is presented, and a Decalogue (or“10 commandments”) is offered covering rules for assessment, diagnosis, treatment, and research in the field of catatonia in ASD. Unlike the biblical Decalogue handed to Moses on Mount Sinai, these rules are hardly divine, do not mark universal truths, are mainly based on clinical experience, and need to be calibrated further as knowledge increases. They do represent the best available recommendations, at least in my opinion, for future research and in order to achieve positive outcomes that are equally rewarding for the patients and their families, and for their physicians.