Early-onset mania presenting as catatonia in childhood: A case report

We describe a case of a teenage boy with the initial presentation of severe catatonia at age 8, which led to the subsequent diagnosis of autism spectrum disorder on background of mild to moderate intellectual disability and strong family history for severe mental illness. The evolution of his symptoms over the next few years included a relapsing pattern of catatonia, the development of psychotic symptoms and then a sustained manic episode. The aetiology of catatonia in young people is discussed, including the risks of diagnostic overshadowing in the context of neurodevelopmental disorders. Finally, treatments including benzodiazepines and ECT are discussed in relation to this dramatic and potentially life-threatening syndrome.