Rethinking Catatonia in Neurodevelopmental Conditions: Toward a Refined Typology and Research Framework

Area of Science:

• Neuroscience
• Psychiatry
• Developmental Psychology

Background:

• Catatonia is a complex syndrome seen across various disorders.
• Current diagnostic criteria in the DSM-5-TR risk misdiagnosis in neurodevelopmental populations.
• Autism spectrum disorder and intellectual developmental disorders share symptoms with catatonia.

Purpose of the Study:

• To review current knowledge on catatonia in pediatric populations with neurodevelopmental disorders.
• To propose a refined diagnostic framework for improved specificity.
• To summarize neurobiological findings and discuss assessment tools.

Main Methods:

• Literature review of catatonia in children, adolescents, and individuals with neurodevelopmental disorders.
• Analysis of DSM-5-TR criteria and their overlap with baseline behaviors.
• Examination of existing rating scales and neurobiological evidence.

Main Results:

• Existing catatonia criteria overlap with neurodevelopmental disorders, risking false positives.
• A new framework requires at least 2 new or worsened core signs (stupor, mutism, posturing, negativism, excitement) from baseline.
• Limitations of current assessment tools (e.g., Bush-Francis Catatonia Rating Scale) in developmental contexts were identified.

Conclusions:

• Refined diagnostic criteria are crucial for accurate catatonia assessment in neurodevelopmental disorders.
• Further research should focus on validating pediatric tools, reducing items, and integrating biomarkers.
• Improved assessment will enhance clinical care and treatment prediction for affected children.