Browsing by Author "Dhossche, Dirk M."

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Catatonia in Autism: Implications Across the Life Span
    (European child & adolescent psychiatry, 2008) Mwesige, Angelina Kakooza; Wachtel, Lee E.; Dhossche, Dirk M.
    There is increasing evidence that catatonia is an important source of impairment in adolescents and adults with autism.Review of the evaluation, diagnosis, differential diagnosis, and treatment of catatonia in autism.Presentation and discussion of a case-vignette spanning early childhood to adulthood.Autistic and catatonic symptoms overlap, yet catatonia is diagnosable in about one of seven adolescents and young adults with autism. Case-reports suggest that benzodiazepines and electroconvulsive therapy are effective treatments in the acute and maintenance phase for people with autism who develop catatonia.Catatonia should be assessed in people with autism when there is an obvious and marked deterioration in movement, vocalizations, pattern of activities, self-care, and practical skills. Benzodiazepines and electroconvulsive therapy are favored options for acute and maintenance treatment in these cases. Further studies on the possible biological-genetic overlap between autism and catatonia would be helpful.
  • Thumbnail Image
    Item
    Catatonia in Ugandan Children with NoddingSyndrome andEffects of Treatment with Lorazepam: a pilot study
    (BMC research notes, 2015) Kakooza‑Mwesige, Angelina; Dhossche, Dirk M.; Idro, Richard; Akena, Dickens; Nalugya, Joyce; Opar, Benard T.
    Nodding syndrome (NS) is a severe neuropsychiatric syndrome of an unknown etiology affecting children and adolescents mostly in Eastern Africa. Symptoms of NS and catatonia seem to overlap. We investigated the presence and types of catatonic symptoms in NS and their response to one or two doses of lorazepam, the first-line treatment for catatonia.A cross-sectional descriptive study with systematic assessment of catatonia in 33 patients with NS using a modified version of the Bush Francis Catatonia Rating Scale. Sixteen patients met criteria for catatonia and were observed in an open and uncontrolled study to examine the effects of one or two doses of lorazepam in them.Sixteen of 33 patients with NS had an average of 5 catatonia symptoms and met criteria for catatonia. The highest scores were found for mutism, staring, poor eating/drinking, stupor, and grimacing. Excitement, rigidity, negativism and impulsivity had lower scores. None of the children had echolalia or echopraxia. In 6 children, there was a reduction of more than 50 % in catatonia ratings, representing a positive response to lorazepam. Three out of six children whose catatonia ratings did not change after the first dose, responded after administration of a second double dose. There were no unusual or critical side-effects. About half of a selected sample of children with NS met criteria for catatonia. Catatonia scores decreased in most patients after one or two doses of lorazepam. Larger, longer, and controlled studies are warranted to assess the prevalence of catatonia in NS and to assess the use of lorazepam in NS through its effects on catatonia.
  • Thumbnail Image
    Item
    Psychosis in Autism
    (The Spectrum of Psychotic Disorders, 2006) Mwesige, Angelina Kakooza; Stoppelbein, Laura; Dhossche, Dirk M.
    Psychosis has carried different meanings since its introduction more than 150 years ago (Beer, 1996). Others have described the social and intellectual contexts that have shaped the concept of psychosis at different times and places (Berrios,1987; Beer, 1995). Modern classification systems incorporate psychosis in various disorders as a serious disturbance in ‘‘reality testing’’ expressed as hallucinations, delusions, thought disturbance, disorganized behavior, or catatonia. Recent advances in neuroscience hold the promise of elucidating the brain mechanisms of psychosis and finding improved antipsychotic treatments. Fujii & Ahmed (2004) have recently proposed conceptualizing psychosis as a neurobiological syndrome with its own pathophysiology and treatment algorithm regardless of etiological factors and underlying diagnoses.