This page was translated automatically from Turkish. Read the original

Bu sayfa, 26. Dünya Psikiyatri Kongresi'nde sunulan çalışmanın yapay zekâ desteğiyle hazırlanmış Türkçe özetidir. Çalışmanın sahibi sunan yazarlardır; atıf için orijinal kaynağa başvurun.

EV0168

Early electroconvulsive therapy in life-threatening catatonia: uncovering underlying autism spectrum disorder in an adolescent

EARLY ELECTROCONVULSIVE THERAPY FOR LIFE-THREATENING CATATONIA: REVEALING UNDERLYING AUTISM SPECTRUM DISORDER IN AN ADOLESCENT

Early electroconvulsive therapy achieved complete remission in an adolescent with benzodiazepine-resistant, life-threatening catatonia and revealed an underlying diagnosis of autism spectrum disorder.

The aim is to demonstrate the critical role of early electroconvulsive therapy (ECT) in resolving life-threatening catatonia and uncovering previously undiagnosed autism spectrum disorder (ASD). The case concerns a 16-year-old male adolescent who presented with a one-month history of acute refusal to eat and drink, mutism, and severe psychomotor retardation; deterioration began following a stressor, risperidone 1 mg/day worsened the psychomotor retardation, and oral clonazepam 1 mg/day produced no response. On admission, severe negativism, posturing, waxy flexibility, and stereotypies (upward and lateral gaze, grimacing) were observed, with a Bush–Francis Catatonia Rating Scale (BFCRS) score of 21; EEG and metabolic screening were normal, and brain MRI revealed an incidental left parietal arachnoid cyst. A course of 14 bitemporal ECT sessions was promptly initiated, and oral olanzapine was titrated to 20 mg/day. Clinical milestones were as follows: oral fluid and food intake and independent toileting at the second session; resumption of spontaneous single-word verbal communication and addition of sertraline at the fourth session; short-sentence responses during interviews and addition of aripiprazole at the sixth session; a marked reduction in response latency and improvement in grimacing and stereotypies at the eighth session; and complete remission of catatonia, with a BFCRS score of 2, at the fourteenth session. For persistent negative symptoms, apathy, and affective symptoms, olanzapine was cross-tapered to aripiprazole 15 mg/day and sertraline 100 mg/day; intermittent tachycardia and mild post-ECT fever emerged as another core feature of catatonia and resolved without complications. Three weeks after discharge, ASD was confirmed by an ADOS-2 score of 14 (cutoff ≥10), and a retrospective developmental history revealed early motor and speech delays, lifelong solitary play, restricted collecting rituals, monotonous speech, and poor eye contact. At three-month follow-up, remission of catatonia remained stable and the patient had readjusted to school, while baseline deficits in social reciprocity persisted; given the high rate of benzodiazepine treatment failure in autistic catatonia, the authors recommend an early transition to ECT to halt functional decline and assessment for undiagnosed neurodevelopmental disorders in adolescents with treatment-resistant catatonia or acute catatonic deterioration.

Tüm WCP 2026 özetleri