Case reports with a child psychiatric exploration of catatonia, autism, and delirium

This chapter starts with some remarks on the conceptual history of catatonia, which begins with Kahlbaum and continues with Kraeplin, Bleuler, and Leonhard. The Diagnostic and Statistical Manual, 4th ed., Text Revision, criteria for catatonia and the multicausal origin of the disorder are discussed. So, not only schizophrenia and mood disorders associated with catatonia, which is the primary form, are introduced but also an extensive list of somatic disorders-resulting in secondary catatonia-along with the work of Gelenberg and Wing. Next, two very difficult cases, of boys with autism, catatonia, and one of them with mental retardation as well, are presented. Major textbooks, PubMed, and Medline were used for a select literature search. The results show the main and really relevant but scarce data concerning primary and secondary catatonia. In the discussion the topics are this dearth in knowledge, the concept of catatonia and its similarities with delirium, and the relation catatonia-autism, and where to find the data. The conclusions summarize the main points and end with a gentle reminder, or is it an appeal?