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Catatonia is a life-threatening disorder characterized by motor abnormalities, mutism, and disturbances of behaviour, which is increasingly being diagnosed in persons with autism. In this report, we describe the presentation and course of catatonia in an adolescent with autism who responded to electroconvulsive therapy (ECT). The illness started with depressive symptoms, but the predominant feature was one of extreme obsessive slowing and immobility. We propose that catatonia should be ruled out as a cause of regression sometimes seen in adolescents with autism, and that catatonia of autism may index a distinct subtype with a particularly poor outcome.

This study reviewed the literature on the clinical features of Asperger Syndrome, a form of autism, looking for evidence that a tendency toward violence is common in individuals with the syndrome. Although many studies were excluded on the basis of inadequate data, findings of remaining studies did not support the speculation that violence is common in Asperger Syndrome. (DB)

The report describes the successful treatment of trichotillomania (compulsive hair pulling) in a mentally retarded 11-year-old boy with autism and severe mental retardation. Administration of haloperidol resulted in complete cessation of hair pulling which reappeared when the dosage was decreased and ceased again when dosage was reestablished. (DB)

Autism is a neurodevelopmental disorder characterized by a pattern of social and communication deficits. Although it occurs in all cultures and countries, most of the published research has come from Western industrialized countries. In particular, relatively little is known about its clinical correlates and comorbidity in African and Middle Eastern countries. In this paper, we report two cases of G6PD deficiency with autism, recruited as part of a larger study on the occurrence of autism in Saudi Arabia. These findings suggest that a different set of medical conditions may be associated with autism in developing countries. [ABSTRACT FROM AUTHOR]

Asperger syndrome (AS) is a disorder of early childhood characterized by autistic social deficits, subtle communication impairment, and excessive isolated interests. There is no history of language delay or of mental retardation. Despite its increasing popularity as a distinct condition, its diagnostic validity remains uncertain. It is still unclear to what extent AS differs from autism with normal intelligence sometimes referred to as high-functioning autism (HFA). However, some reports have suggested that persons with AS possess a distinct profile on tests of intelligence characterized by a high verbal IQ and a low performance IQ, whereas in most cases with HFA, the pattern is reversed. Since few studies have directly compared AS subjects with HFA controls using unmodified diagnostic criteria and standardized measures of assessment, in this report we compared 22 AS subjects with 12 HFA controls, matched on age, sex and level of intelligence. As a group, subjects with AS showed a higher verbal IQ and higher scores on information and vocabulary subtests than those with HFA. However, scores of several AS and HFA subjects showed a mixed pattern. Implications of these findings are discussed in the context of the validity of Asperger Syndrome. [ABSTRACT FROM AUTHOR]

Several studies have suggested a positive association between anxiety symptoms and suicidality in adults. However, relatively little is known about this topic in adolescents. To investigate this issue, we examined a group of adolescents admitted to our psychiatric inpatient unit. Fifty-six adolescents (mean age = 14.8 +/- 1.4; females = 34, males = 22; race = 95% Caucasians) participated in the study. Diagnoses were made using the DSM-III-R criteria and a diagnostic interview. Anxiety was found to significantly correlate with depression (r = .60; P = < .05) and suicidality (r = .72; P < .05). A multiple regression analysis revealed that anxiety and depression together accounted for more than half (55%) of the variance in suicidal ideation [F(2,46) = 28.4; P < .0001]. In addition, anxiety had an independent ability to predict suicidality (t = 5.01; P < .0001). Self-rated but not clinician-rated suicidality was positively correlated with both anxiety and depression. Clinical and research implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Several reports have described the occurrence of chromosome abnormalities in autism, a neuro-developmental disorder characterized by social deficits, communication impairment, and a restricted range of interests. These include the fragile X abnormality and 15q duplications. In this report, we describe two cases of chromosome 2q37 and review the literature on this topic. We propose that deletion of the distal portion of the long arm of chromosome 2 (2q37) may be associated with some cases of autism and with a distinct phenotype. Increased awareness of the dysmorphic features associated with 2q37 deletions may aid in the molecular genetic analysis of this chromosome anomaly and clarify its relationship with autism. [ABSTRACT FROM AUTHOR]

Limited information is available about the occurrence of depression in children with autism and other pervasive developmental disorders (PDD). Although depression has been described in autistic children, questions about its validity have often been raised. One approach to address this issue is to investigate family histories of those autistic children diagnosed with clinical depression. Based on data available in nonautistic children, autistic children with depression would be expected to show an increased family history of depression. Since studies of this nature have not been attempted in autistic children, we compared the family history of 13 autistic/PDD children with depression (11 male; 2 female; M full-scale IQ 86.2, SD 24.2; M age 10.4 years, SD 2.2) with 10 autistic/PDD children without a history of current or previous depression (9 male; 1 female; M full-scale IQ 67, SD 12.9; M age 10.5 years, SD 1.6). Diagnosis of depression was based on the DSM-III-R criteria and confirmed independently by two psychiatrists. Ten (77%) of the depressed children had a positive family history of depression compared to 3 (30%) of the nondepressed group, t(21)=-2.4; p=.02. These findings lend support to the validity of depression as a distinct condition in some children with autism/PDD and suggest that, as in the normal population, autistic children who suffer from depression are more likely to have a family history of depression. [ABSTRACT FROM AUTHOR]

Asperger syndrome (AS) is a pervasive developmental disorder recently introduced as a new diagnostic category in the ICD-10 and the DSM-IV. Along with motor clumsiness, pedantic speech has been proposed as a clinical feature of AS. However, few attempts have been made to define and measure this symptom. We studied 17 patients with AS (ICD-10; 14 male, 3 female; mean age 16.4 years, mean full-scale IQ 97) and compared them with a control group of 13 patients with normal-intelligence autism or high-functioning autism (HFA) (ICD-10/DSM-III-R; 12 male, 1 female; mean age 15.5 years, mean full-scale IQ 81.2). An operational definition of pedantic speech was formulated and a rating scale devised. 13 (76%) of the AS patients were rated as pedantic compared to 4 (31%) of the HFA group (chi 2 = 6.3; p = .01). Results suggest that pedantic speech is common in AS and may help differentiate AS from high-functioning autism. [ABSTRACT FROM AUTHOR]

Asperger syndrome (AS) is a pervasive developmental disorder generally regarded as a variant of autism. While it has been included in the ICD-10 and DSM-IV as a distinct diagnostic entity, it is still unclear to what extent it differs from high-functioning autism (HFA). Persons with HFA have been reported to show a variety of deficits of thought processes. Abnormalities such as poor reality testing, perceptual distortions, and areas of cognitive slippage have been described using the Rorschach inkblot test (Dykens, Volkmar, & Glick, 1991). Since AS has been conceptualized as a mild variant of autism, we hypothesized that persons with AS will have fewer abnormalities on the Rorschach test compared to persons with HFA. To test this hypothesis, we compared 12 subjects with AS (ICD-10, 10 male, mean age = 12.2 +/- 3.3 years, mean full-scale IQ = 99.6) with 8 subjects with HFA (ICD-10/DSM-III-R, 7 male, mean age = 12.2 +/- 3.8 years, mean full-scale IQ = 83.4) on the Rorschach test. AS subjects demonstrated a trend towards greater levels of disorganized thinking than the HFA group. They were also more likely to be classified as 'Introversive' suggesting that AS subjects may have more complex inner lives involving elaborate fantasies, Also, AS subjects tended to be more focused on their internal experiences. However, overall, the Rorschach test was not found to differentiate the two diagnostic groups on the majority of structural variables. Implications of these findings are discussed with regard to the diagnostic validity of Asperger syndrome. [ABSTRACT FROM AUTHOR]

The article describes the case of a mentally retarded 34-year-old woman suffering from polycystic ovary disease (POD), who later developed features of manic-depressive illness. At the age of 20, she developed obesity and hirsuitism. In view of the fact that she also suffered from scanty and irregular menstrual periods, she was fully investigated and was found to have elevated levels of luteinizing hormone, ACTH and increased androgen production rates. The association of POD, manic-depressive illness and mental retardation raises the question of how these three conditions might interrelate pathophysiologically.

The article focuses on a study which discusses the pattern of psychiatric referrals of mentally handicapped patients living in the community and investigates the role of factors modifying the referral-pattern. Ninety-eight consecutive referrals made to the Consultant Psychiatrist were studied retrospectively. The sample consisted of 66 males and 32 females. The majority of the referrals came from social workers, followed by the general practitioners, other psychiatrists, community nurses, adult training centres, school medical officers, hostels and psychologists. Five of the seven patients who had a recorded diagnosis of epilepsy presented with behaviour disturbance.