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Propionic acidemia, an autosomal recessive disorder, is a common form of organic aciduria resulting from the deficiency of propionyl-CoA carboxylase. It is characterized by frequent and potentially lethal episodes of metabolic acidosis often accompanied by hyperammonemia. A wide range of brain abnormalities have been reported in propionic acidemia. We report recurrent visual hallucinations in 2 children with propionic acidemia. Four visual hallucination events were observed in the 2 patients. Three episodes were preceded by an intercurrent illness, and 2 were associated with mild metabolic decompensation. The 2 events in one patient were associated with a seizure disorder with abnormal electroencephalogram. Brain magnetic resonance imaging showed abnormal basal ganglia and faint temporo-occipital swelling bilaterally. This is probably the first report of visual hallucinations in propionic acidemia and should alert the treating clinicians to look for visual hallucinations in patients with organic acidurias, especially in an unusually anxious child. [ABSTRACT FROM PUBLISHER]

Relatively little has been published about the prevalence of autism in adults with psychiatric disorders. In this study, all new patients referred to an adult psychiatric outpatient clinic in Sweden between November 2019 and October 2020 (n = 562) were screened for autism spectrum disorders using the Ritvo Autism and Asperger Diagnostic Scale Screen (RAADS-14). Out of the 304 (58%) responders, 197 who scored above the cut off (14) were invited to participate in an in-depth assessment. Twenty-six of the 48 that participated in the assessment met criteria for ASD and an additional eight had subthreshold ASD symptoms. We estimated the prevalence of ASD in this population to at least 18.9%, with another 5–10% having subthreshold symptoms. [ABSTRACT FROM AUTHOR]

The aim of this preliminary study was to identify the practice patterns and potential barriers to diagnosing autism in Bosnia & Herzegovina. 126 children aged 23 to 94 months with developmental concerns referred to treatment centers participated in the study. Although parents had reported developmental problems in their children usually around the age of 17 months, it took them 812 visits to professionals (> 6 visits per child) over several months (mean 16.8, range 2–52 months) to get diagnosed with any developmental disorder. Only 8 children (6.3%) received a diagnosis of autism. However, when we re-examined 110 of the 126 children, 90 of them (71%) were identified with autism. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Eating disorders frequently accompany autism spectrum disorder (ASD). One such novel eating disorder is avoidant/restrictive food intake disorder (ARFID). This study compares the eating attitudes, quality of life, and sensory processing of typically developing children (TDC), autistic children, and autistic children with ARFID. A total of 111 children aged 4–10 with a diagnosis of ASD and ARFID (n = 37), ASD without ARFID (n = 37), and typical development (n = 37) were recruited. After an interview in which Childhood Autism Rating Scale (CARS) was administered, Child Eating Behavior Questionnaire (CEBQ), Pediatric Quality of Life Inventory (PedsQL), Social Responsiveness Scale (SRS) and Sensory Profile (SP) were completed by caregivers. Autistic children with ARFID had higher scores in CEBQ subscales relating to low appetite and lower scores on the subscales associated with weight gain. Both groups of autistic children scored lower than TDC on all PedsQL subscales and autistic children with ARFID had lower social QL scores than both groups. SRS scores were highest in autistic children with ARFID, followed by autistic and typically developing children. CARS scores were similar in both groups of autistic children, but higher than TDC. Auditory, vision, touch, multi-sensory, oral processing scores; as well as all quadrant scores, were significantly lower in autistic children with ARFID. Oral sensory processing scores were found to be the most significant predictor of ARFID comorbidity in ASD and reliably predicted ARFID in autistic children in the clinical setting. Autistic children with ARFID demonstrate differences in social functioning, sensory processing, eating attitudes, and quality of life compared to autistic and TD children. [ABSTRACT FROM AUTHOR]

Purpose: There is a dearth of information about patients with autism spectrum disorder (ASD) or intellectual disability (ID) who seek emergency psychiatric care. Given this backdrop, this retrospective study aims to explore clinical, demographic, and disposition-related information about this patient population over a 10-year period.This study includes individuals with ASD or ID (n = 1461) and had presented to a psychiatric emergency department between 2012 and 2021. Data were extracted using a structured chart review methodology, and included demographic, clinical and visit information. Bivariate and multivariate logistic regressions were estimated to explore associations between key variables and dispositions of interest.Sample was predominantly White (77.21%), adolescent (mean age ± SD = 15.5 ± 4.3) and male (72.76%). The most common reason for their presentation was aggression towards others (36.39%). 28.27% of patients were psychiatrically hospitalized but 30% of those who needed hospitalization were discharged due to lack of inpatient bed availability.This study adds to the limited literature about individuals with ASD or ID seeking emergency care. The results indicate a highly acute patient population with aggression, suicidal thoughts, and self-injurious behaviors who are frequently prescribed psychotropic medications and face barriers to accessing higher levels of care.Methods: There is a dearth of information about patients with autism spectrum disorder (ASD) or intellectual disability (ID) who seek emergency psychiatric care. Given this backdrop, this retrospective study aims to explore clinical, demographic, and disposition-related information about this patient population over a 10-year period.This study includes individuals with ASD or ID (n = 1461) and had presented to a psychiatric emergency department between 2012 and 2021. Data were extracted using a structured chart review methodology, and included demographic, clinical and visit information. Bivariate and multivariate logistic regressions were estimated to explore associations between key variables and dispositions of interest.Sample was predominantly White (77.21%), adolescent (mean age ± SD = 15.5 ± 4.3) and male (72.76%). The most common reason for their presentation was aggression towards others (36.39%). 28.27% of patients were psychiatrically hospitalized but 30% of those who needed hospitalization were discharged due to lack of inpatient bed availability.This study adds to the limited literature about individuals with ASD or ID seeking emergency care. The results indicate a highly acute patient population with aggression, suicidal thoughts, and self-injurious behaviors who are frequently prescribed psychotropic medications and face barriers to accessing higher levels of care.Results: There is a dearth of information about patients with autism spectrum disorder (ASD) or intellectual disability (ID) who seek emergency psychiatric care. Given this backdrop, this retrospective study aims to explore clinical, demographic, and disposition-related information about this patient population over a 10-year period.This study includes individuals with ASD or ID (n = 1461) and had presented to a psychiatric emergency department between 2012 and 2021. Data were extracted using a structured chart review methodology, and included demographic, clinical and visit information. Bivariate and multivariate logistic regressions were estimated to explore associations between key variables and dispositions of interest.Sample was predominantly White (77.21%), adolescent (mean age ± SD = 15.5 ± 4.3) and male (72.76%). The most common reason for their presentation was aggression towards others (36.39%). 28.27% of patients were psychiatrically hospitalized but 30% of those who needed hospitalization were discharged due to lack of inpatient bed availability.This study adds to the limited literature about individuals with ASD or ID seeking emergency care. The results indicate a highly acute patient population with aggression, suicidal thoughts, and self-injurious behaviors who are frequently prescribed psychotropic medications and face barriers to accessing higher levels of care.Conclusion: There is a dearth of information about patients with autism spectrum disorder (ASD) or intellectual disability (ID) who seek emergency psychiatric care. Given this backdrop, this retrospective study aims to explore clinical, demographic, and disposition-related information about this patient population over a 10-year period.This study includes individuals with ASD or ID (n = 1461) and had presented to a psychiatric emergency department between 2012 and 2021. Data were extracted using a structured chart review methodology, and included demographic, clinical and visit information. Bivariate and multivariate logistic regressions were estimated to explore associations between key variables and dispositions of interest.Sample was predominantly White (77.21%), adolescent (mean age ± SD = 15.5 ± 4.3) and male (72.76%). The most common reason for their presentation was aggression towards others (36.39%). 28.27% of patients were psychiatrically hospitalized but 30% of those who needed hospitalization were discharged due to lack of inpatient bed availability.This study adds to the limited literature about individuals with ASD or ID seeking emergency care. The results indicate a highly acute patient population with aggression, suicidal thoughts, and self-injurious behaviors who are frequently prescribed psychotropic medications and face barriers to accessing higher levels of care. [ABSTRACT FROM AUTHOR]

This study explored the physical and clinical phenotype of Bangladeshi children with autism spectrum disorder (ASD). A totally of 283 children who were referred for screening and administered Module 1 of the Autism Diagnostic Observation Schedule (ADOS) were included. Overall, 209 met the ADOS algorithmic cutoff for ASD. A trend for greater weight and head circumference was observed in children with ASD versus non-ASD. Head circumference was significantly (p < 0.03) larger in ASD males compared with non-ASD males. A trend was also observed for symptom severity, higher in females than males (p = 0.068), with further analyses demonstrating that social reciprocity (p < 0.014) and functional play (p < 0.03) were significantly more impaired in ASD females than males. The findings help understand sex differences in ASD. [ABSTRACT FROM AUTHOR]

Autism seldom occurs in its pure form. Often labeled as behavioral disorders or psychological reactions, comorbid psychiatric disorders are common. Bipolar disorder is one of the most common psychiatric disorders that occur in persons with autism across their life spans. It can be comorbid with and mistaken for several other conditions. Similarly, psychosis occurs in several psychiatric disorders. Schizophrenia is the prototype psychotic disorder that has a close but controversial relationship with autism. Assessment and treatment of bipolar disorder and psychosis should be based on their individual characteristics, family dynamics, and community resources., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Catatonia was first described by Karl Ludwig Kahlbaum in 1874, occurring in association with other psychiatric and medical disorders. However, in the nineteenth century the disorder was incorrectly classified as a subtype of schizophrenia. This misclassification persisted until the publication of DSM-5 in 2013 when important changes were incorporated. Although the etiology is unknown, disrupted gamma-aminobutyric acid has been proposed as the underlying pathophysiological mechanism. Key symptoms can be identified under 3 clinical domains: motor, speech, and behavioral. Benzodiazepines and electroconvulsive therapy are the only known effective treatments. Timely recognition and treatment have important outcome, and sometimes lifesaving, implications., Competing Interests: Disclosure N. Ghaziuddin: Royalties from book, Use of Electroconvulsive Therapy in Children and Adolescents. Publisher: Oxford University Press, 2013. M. Ghaziuddin and L. Andersen do not have any disclosures., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Catatonia was first described by Karl Ludwig Kahlbaum in 1874, occurring in association with other psychiatric and medical disorders. However, in the nineteenth century the disorder was incorrectly classified as a subtype of schizophrenia. This misclassification persisted until the publication of DSM-5 in 2013 when important changes were incorporated. Although the etiology is unknown, disrupted gamma-aminobutyric acid has been proposed as the underlying pathophysiological mechanism. Key symptoms can be identified under 3 clinical domains: motor, speech, and behavioral. Benzodiazepines and electroconvulsive therapy are the only known effective treatments. Timely recognition and treatment have important outcome, and sometimes lifesaving, implications., Competing Interests: Disclosure N. Ghaziuddin: Royalties from book, Use of Electroconvulsive Therapy in Children and Adolescents. Publisher: Oxford University Press, 2013. M. Ghaziuddin and L. Andersen do not have any disclosures., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The DSM IV defines Asperger syndrome (AS) as a pervasive developmental (autistic spectrum) disorder characterized by social deficits and rigid focused interests in the absence of language impairment and cognitive delay. Since its inclusion in the DSM-IV, there has been a dramatic increase in its recognition both in children and adults. However, because studies have generally failed to demonstrate a clear distinction between AS and autism, some researchers have called for its elimination from the forthcoming DSM V. This report argues for a modification of its diagnostic criteria and its continued retention in the diagnostic manual.